Abnormal Human Sperm Parameters Contribute to Sperm DNA Fragmentation in Men with Varicocele

PURPOSE: This study was performed to evaluate and compare threshold sperm parameters and sperm DNA fragmentation index (DFI), and further analyzed whether sperm DFI could be predicted from sperm parameters in men with varicocele. MATERIALS AND METHODS: A total of 157 semen samples underwent both semen analysis and sperm DNA fragmentation (SDF) testing in men with varicocele. Sperm parameters were assessed using the World Health Organization guidelines. SDF testing was performed using the Halosperm kit. Sperm parameters and sperm DFI results were compared. RESULTS: The overall sperm parameter results and sperm DFI showed normal values; however, the morphology value was at the lower limit of normal. High sperm DFI was associated with significantly lower motility and viability (p < 0.001, respectively). Sperm motility and morphology were significantly higher in the higher sperm count group compared to the lower sperm count group (p < 0.05), while sperm DFI was higher in the lower sperm count group (p < 0.05). Sperm count and viability and sperm DFI were significantly associated with the quality of sperm motility (p < 0.001). Sperm motility and sperm DFI were significantly different (p < 0.001) between normal and abnormal sperm viability groups. Between normal and abnormal sperm morphology groups, sperm count, motility, and sperm DFI showed significant differences (p < 0.001). CONCLUSIONS: In this study, a correlation between SDF and sperm parameters was confirmed in men with varicocele. SDF may be contributing factors to sperm motility, viability, and morphology. Abnormal sperm count, motility, and viability showed high sperm DFI. Therefore, lower sperm parameters were indicative of increasing SDF in men with varicocele.

Comparison of clinical outcomes between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in IVF-ICSI split insemination cycles / 대한생식의학회지

OBJECTIVE: This study aimed to compare the clinical outcomes between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in sibling oocytes. Additionally, we evaluated whether the implementation of split insemination contributed to an increase in the number of ICSI procedures. METHODS: A total of 571 cycles in 555 couples undergoing split insemination cycles were included in this study. Among them, 512 cycles (89.7%) were a couple's first IVF cycle. The patients were under 40 years of age and at least 10 oocytes were retrieved in all cycles. Sibling oocytes were randomly allocated to IVF or ICSI. RESULTS: Total fertilization failure was significantly more common in IVF cycles than in ICSI cycles (4.0% vs. 1.4%, p<0.05), but the low fertilization rate among retrieved oocytes (as defined by fertilization rates greater than 0% but <30%) was significantly higher in ICSI cycles than in IVF cycles (17.2% vs. 11.4%, p<0.05). The fertilization rate of ICSI among injected oocytes was significantly higher than for IVF (72.3%±24.3% vs. 59.2%±25.9%, p<0.001), but the fertilization rate among retrieved oocytes was significantly higher in IVF than in ICSI (59.2%±25.9% vs. 52.1%±22.5%, p<0.001). Embryo quality before embryo transfer was not different between IVF and ICSI. Although the sperm parameters were not different between the first cycle and the second cycle, split insemination or ICSI was performed in 18 of the 95 cycles in which a second IVF cycle was performed. CONCLUSION: The clinical outcomes did not differ between IVF and ICSI in split insemination cycles. Split insemination can decrease the risk of total fertilization failure. However, unnecessary ICSI is carried out in most split insemination cycles and the use of split insemination might make ICSI more common.

Effects of maternal age on embryo quality and pregnancy outcomes using testicular sperm with intracytoplasmic sperm injection / 대한생식의학회지

OBJECTIVE: The aim of this study was to evaluate the influence of maternal age on fertilization, embryo quality, and clinical pregnancy in patients undergoing intracytoplasmic sperm injection (ICSI) using testicular sperm from partners with azoospermia. METHODS: A total of 416 ICSI cycles using testicular spermatozoa from partners with obstructive azoospermia (OA, n=301) and non-obstructive azoospermia (NOA, n=115) were analyzed. Female patients were divided into the following age groups: 27 to 31 years, 32 to 36 years, and 37 to 41 years. The rates of fertilization, high-quality embryos, clinical pregnancy, and delivery were compared across maternal age groups between the OA and NOA groups. RESULTS: The rates of fertilization and high-quality embryos were not significantly different among the maternal age groups. Similarly, the clinical pregnancy and delivery rates were not significantly different. The fertilization rate was significantly higher in the OA group than in the NOA group (p<0.05). Age-group analysis revealed that the fertilization and high-quality embryo rates were significantly different between the OA and NOA groups in patients aged 27 to 31 years old, but not for the other age groups. Although the clinical pregnancy and delivery rates differed between the OA and NOA groups across all age groups, significant differences were not observed. CONCLUSION: In couples using testicular sperm from male partners with azoospermia, pregnancy and delivery outcomes were not affected by maternal age. However, women older than 37 years using testicular sperm from partners with azoospermia should be advised of the increased incidence of pregnancy failure.

Serum and seminal plasma insulin-like growth factor-1 in male infertility / 대한생식의학회지

OBJECTIVE: Growth hormone and its mediator, insulin-like growth factor-1 (IGF-1), have been suggested to exert gonadotropic actions in both humans and animals. The present study was conducted to assess the relationship between serum IGF-1 concentration, seminal plasma concentration, and sperm parameter abnormalities. METHODS: A total of 79 men were enrolled in this study from December 2011 to July 2012 and were prospectively analyzed. Patient parameters analyzed included age, body mass index, smoking status, urological history, and fertility history. Patients were divided into four groups based on their semen parameters: normal (A, n=31), abnormal sperm motility (B, n=12), abnormal sperm morphology (C, n=20), and two or more abnormal parameters (D, n=16). Patient seminal plasma and serum IGF-1 concentrations were determined. RESULTS: Patient baseline characteristics were not significantly different between any of the groups. The serum IGF-1 levels in groups B, C, and D were significantly lower than the levels in group A; however, the seminal plasma IGF-1 levels were not significantly different between any of the groups. CONCLUSION: Men with abnormal sperm parameters had significantly lower levels of serum IGF-1 compared with men with normal sperm parameters. Seminal plasma IGF-1 levels, however, did not differ significantly between the groups investigated here. Further investigations will be required to determine the exact mechanisms by which growth hormone and IGF-1 affect sperm quality.

Artificial oocyte activation in intracytoplasmic sperm injection cycles using testicular sperm in human in vitro fertilization / 대한생식의학회지

OBJECTIVE: Artificial oocyte activation (AOA) is an effective method to avoid total fertilization failure in human in vitro fertilization-embryo transfer (IVF-ET) cycles. AOA performed using a calcium ionophore can induce calcium oscillation in oocytes and initiate the fertilization process. We evaluated the usefulness of AOA with a calcium ionophore in cases of total fertilization failure in previous cycles and in cases of severe male factor infertility patients with non-motile spermatozoa after pentoxifylline (PF) treatment. METHODS: The present study describes 29 intracytoplasmic sperm injection (ICSI)-AOA cycles involving male factor infertility at Cheil General Hospital from January 2006 to June 2013. Patients were divided into two groups (control, n=480; AOA, n=29) depending on whether or not AOA using a calcium ionophore (A23187) was performed after testicular sperm extraction-ICSI (TESE-ICSI). The AOA group was further split into subgroups according to sperm motility after PF treatment: i.e., motile sperm-injected (n=12) and non-motile sperm-injected (n=17) groups (total n=29 cycles). RESULTS: The good embryo rate (52.3% vs. 66.9%), pregnancy rate (20.7% vs. 52.1%), and delivery rate (10.3% vs. 40.8%) were lower in the PF/AOA group than in the control group. When evaluating the effects of restoration of sperm motility after PF treatment on clinical outcomes there was no difference in fertilization rate (66.6% vs. 64.7% in non-motile and motile sperm, respectively), pregnancy rate (17.6% vs. 33.3%), or delivery rate (5.9% vs. 16.7%) between the two groups. CONCLUSION: We suggest that oocyte activation is a useful method to ensure fertilization in TESE-ICSI cycles regardless of restoration of sperm motility after PF treatment. AOA may be useful in selected patients who have a low fertilization rate or total fertilization failure.

Observation of sperm-head vacuoles and sperm morphology under light microscope / 대한생식의학회지

OBJECTIVE: The presence of sperm-head vacuoles has been suspected to be deleterious to the outcomes of assisted reproductive technology (ART). It is difficult to accurately distinguish morphologically abnormal sperm with vacuoles under a light microscope. This study was performed to analyze the result of the observation of sperm-head vacuoles using Papanicolaou staining under a light microscope and whether the male partner's age affects these vacuoles. METHODS: Sperm morphology with vacuoles was evaluated using Papanicolaou staining and observed under a light microscope (400x) in 980 men. The normal morphology was divided into three categories (group A, 14% of normal morphology). The criteria for the sperm-head vacuoles were those given in the World Health Organization manual. For the analysis of the age factor, the participants were divided into the following groups: 26-30 years, 31-35 years, 36-40 years, 41-45 years, and 46-50 years. RESULTS: The percentage of sperm-head vacuoles increased with normal sperm morphology (group A vs. groups B, C) (p<0.05). In the case of the age factor, a statistically significant difference was not observed across any of the age groups. CONCLUSION: A majority of the sperm-head vacuoles showed a statistically significant difference among normal morphology groups. Therefore, we should consider the probability of the percentage of sperm-head vacuoles not increasing with age but with abnormal sperm morphology. A further study is required to clarify the effect of the sperm-head vacuoles on ART outcomes.

Do Cigarette Smoking and Obesity Affect Semen Abnormality in Idiopathic Infertile Males?

PURPOSE: This study was conducted to find the relative risk of semen abnormality with respect to smoking history and obesity. MATERIALS AND METHODS: Subfertile or infertile men were enrolled in this study from July 2010 to June 2011. All participants provided their cigarette use information, self-reported weight, height, semen analysis, physical examination, and sexually transmitted disease status. None of the enrolled patients had any specific pathological reason for infertility. Semen abnormality was defined as a condition in which one or more parameters did not satisfy the World Health Organization's criteria. RESULTS: A total of 1,073 male patients were considered for this study. After the application of the inclusion criteria, 193 patients were finally analyzed. These patients were divided into two groups according to semen abnormality: the normal semen group (n=72) and the abnormal semen group (n=121). Baseline characteristics, except age and smoking history, were not significantly different between the two groups. Smoking history and age were risk factors for the semen abnormality of idiopathic infertile male patients. CONCLUSIONS: Smoking and old age were risk factors for semen abnormality. However, obesity did not affect the semen abnormality. Smoking affected semen quality and is therefore expected to play a negative role in conception.

Do Cigarette Smoking and Obesity Affect Semen Abnormality in Idiopathic Infertile Males?

PURPOSE: This study was conducted to find the relative risk of semen abnormality with respect to smoking history and obesity. MATERIALS AND METHODS: Subfertile or infertile men were enrolled in this study from July 2010 to June 2011. All participants provided their cigarette use information, self-reported weight, height, semen analysis, physical examination, and sexually transmitted disease status. None of the enrolled patients had any specific pathological reason for infertility. Semen abnormality was defined as a condition in which one or more parameters did not satisfy the World Health Organization's criteria. RESULTS: A total of 1,073 male patients were considered for this study. After the application of the inclusion criteria, 193 patients were finally analyzed. These patients were divided into two groups according to semen abnormality: the normal semen group (n=72) and the abnormal semen group (n=121). Baseline characteristics, except age and smoking history, were not significantly different between the two groups. Smoking history and age were risk factors for the semen abnormality of idiopathic infertile male patients. CONCLUSIONS: Smoking and old age were risk factors for semen abnormality. However, obesity did not affect the semen abnormality. Smoking affected semen quality and is therefore expected to play a negative role in conception.

Comparison of the clinical outcomes of day 4 and 5 embryo transfer cycles / 대한생식의학회지

OBJECTIVE: The majority of embryo transfers (ETs) to date have been performed on day 3 to reduce the potential risk of developmental arrest of in vitro cultured embryos before ET. Development of sequential media has significantly improved culture conditions and allowed blastocyst transfer on day 5. While day 5 ET provides higher clinical pregnancy outcomes with reduced risks of multiple pregnancies, it still has potential risks of developmental arrest of IVF embryos. The aim of this study was to evaluate the clinical outcomes of day 4 ETs and compare the efficacy of day 4 ET with day 5 ET. METHODS: From 2006 to 2009, a total of 747 fresh IVF-ET cycles were retrospectively analyzed (day 4, n=440 or and day 5, n=307). The cycles with any genetic factors were excluded. The rates of matured oocytes, fertilization, good embryos, and clinical pregnancy of the two groups were compared. The chi-square test and t-test were used for statistical analysis. RESULTS: There were no significant differences between the two groups with respect to the mean age of the females and rates of matured oocytes. The pregnancy outcomes of day 4 ET (40.7%) were similar to those of day 5 ET (44.6%). The implantation rate of day 5 ET (24.2%) was significantly higher than that of day 4 ET (18.4%) (p=0.003). CONCLUSION: Day 4 ET can be chosen to avoid ET cancellation in day 5 ET resulting from suboptimal circumstances in the IVF laboratory, but the decremented quality of embryos for transfer and the decreased pregnancy rate must be taken into consideration.

Efficacy of testicular sperm chromatin condensation assay using aniline blue-eosin staining in the IVF-ET cycle / 대한생식의학회지

OBJECTIVE: This study was performed to evaluate testicular sperm chromatin condensation using aniline blue-eosin (AB-E) staining and its effects on IVF-ET. METHODS: Chromatin condensation was analyzed using AB-E staining in 27 cases of testicular sperm extraction. There were 19 cases of obstructive azoospermia (OA) and 8 cases of non-obstructive azoospermia (NOA) in IVF-ET. Mature sperm heads were stained red-pink whereas immature sperm heads were stained dark blue. The percentage of sperm chromatin condensation was calculated from the ratio of the number of red-pink sperm to the total number of sperm analyzed. RESULTS: The overall percentages of chromatin condensation in OA and NOA were 31.1+/-11.2% and 26.3+/-14.4%, respectively. The fertilization rate was significant higher in OA than NOA (p<0.05); however, the rates of good embryos and clinical pregnancy did not show statistical differences. In OA and NOA, statistical differences were not observed in the rate of chromatin condensation, fertilization, good embryos, and clinical pregnancy between the pregnant group and non-pregnant group. CONCLUSION: Chromatin condensation is less stable than OA and showed a low fertilization rate in NOA. While there were no significant differences in chromatin condensation results between NOA and OA, we propose that a pattern of decreased chromatin condensation in NOA is one of the factors of low fertilization results requiring further study.

Efficacy of the Aniline Blue-eosin Staining Method for Testicular Sperm Chromatin Condensation Assay in Azoospermia / 대한남성과학회지

PURPOSE: This study was performed to evaluate chromatin condensation of morphologically mature sperm using a modified aniline blue-eosin (AB-E) staining method in azoospermia. MATERIALS AND METHODS: Chromatin condensation was analyzed using an AB-E staining method in 61 cases (50 patients) of TESE or testicular biopsy with the patient's own sperm. Obstructive azoospermia (OA) was present in 48 cases in 39 patients and non-obstructive azoospermia (NOA) was present in 13 cases in 11 patients, respectively. Immature sperm heads were stained dark blue, whereas mature sperm were stained red-pink by the eosin. The percentage of sperm chromatin condensation was calculated from the ratio of the number of red-pink sperm to the total number of sperm analyzed. RESULTS: The percentage of chromatin maturity was 37.7% vs. 30.3% in OA and NOA, respectively, of the total sperm cell count. The maturity of fresh testicular sperm was 38.3% and 36.3% in OA and NOA, respectively. Also, the maturity of thawed testicular sperm was 34.5% and 10.3% (p<0.05) in OA and NOA, respectively. The maturity of fresh and thawed testicular sperm was 36.3% and 10.3% (p<0.05), respectively, in NOA. These results suggest that chromatin condensation is less stable in sperm of NOA and freezing and thawing procedures may impair sperm chromatin condensation. CONCLUSIONS: In our results, the aniline blue-eosin staining method improved the visualization of excessive histones in sperm and the diagnosis of sperm immaturity in morphologically normal testicular sperm. We found that AB-E staining method can be an effective method for analyzing testicular sperm chromatin condensation in azoospermia.

Fertilization, Embryonic Development, and Pregnancy Rate using Fresh and Frozen Testicular Sperm in Hypospermatogenesis / 대한남성과학회지

PURPOSE: This study was performed to assess the fertilization, embryonic development and pregnancy rate using fresh and frozen-thawed testicular sperm from hypospermatogenic patients. MATERIALS AND METHODS: A total of 84 cycles of ICSI were performed with fresh or frozen-thawed testicular sperm frm hypospermatogenesis patients. Of these, 55 cycles(65.5%) were performed with fresh sperm, and 29 cycles(34.5%) were performed with frozen-thawed sperm. Testicular tissue was frozen with the programmed cell freezer(Cryomagic I, Miraebiotech, Seoul, Korea). Fertilization was checked 18-20 hrs after ICSI. Embryo grade was assessed based on the day 2 and day 3 embryo morphology. Embryo grade was scored five groups, and good embryos were classified as grade I to grade II. RESULTS: The total percentage of fertilized embryos was 62.4%, the development of good embryos was 58.8%(290/493), and pregnancy rate was 39.2%(29/74). For fresh sperm, the percentage of fertilized embryos was 65.7%, the percentage of good embryos was 57.6%(204/354) and the pregnancy rate was 34.8%(16/46). For thawed sperm, the percentage of fertilized embryos was 54.4%, the percentage of good embryos was 61.9%(86/139), and pregnancy rate was 46.4%(13/28). Thawed sperm showed a higher percentage of good embryos and higher pregnancy rate than fresh sperm. CONCLUSIONS: In this study we obtained acceptable rates of fertilization and good embryos after ICSI with testicular sperm from hypospermatogenesis patients. Frozen sperm showed higher rates of good embryos and pregnancy than fresh sperm. Therefore both fresh and frozen testicular sperm are effective in ICSI for embryonic development and pregnancy in patients with hypospermatogenesis.

Fertilization, Embryonic Development, and Pregnancy Rate using Fresh and Frozen Testicular Sperm in Hypospermatogenesis / 대한남성과학회지

PURPOSE: This study was performed to assess the fertilization, embryonic development and pregnancy rate using fresh and frozen-thawed testicular sperm from hypospermatogenic patients. MATERIALS AND METHODS: A total of 84 cycles of ICSI were performed with fresh or frozen-thawed testicular sperm frm hypospermatogenesis patients. Of these, 55 cycles(65.5%) were performed with fresh sperm, and 29 cycles(34.5%) were performed with frozen-thawed sperm. Testicular tissue was frozen with the programmed cell freezer(Cryomagic I, Miraebiotech, Seoul, Korea). Fertilization was checked 18-20 hrs after ICSI. Embryo grade was assessed based on the day 2 and day 3 embryo morphology. Embryo grade was scored five groups, and good embryos were classified as grade I to grade II. RESULTS: The total percentage of fertilized embryos was 62.4%, the development of good embryos was 58.8%(290/493), and pregnancy rate was 39.2%(29/74). For fresh sperm, the percentage of fertilized embryos was 65.7%, the percentage of good embryos was 57.6%(204/354) and the pregnancy rate was 34.8%(16/46). For thawed sperm, the percentage of fertilized embryos was 54.4%, the percentage of good embryos was 61.9%(86/139), and pregnancy rate was 46.4%(13/28). Thawed sperm showed a higher percentage of good embryos and higher pregnancy rate than fresh sperm. CONCLUSIONS: In this study we obtained acceptable rates of fertilization and good embryos after ICSI with testicular sperm from hypospermatogenesis patients. Frozen sperm showed higher rates of good embryos and pregnancy than fresh sperm. Therefore both fresh and frozen testicular sperm are effective in ICSI for embryonic development and pregnancy in patients with hypospermatogenesis.

Differential Expressions of Apoptosis Regulators and Protein Profiling by SELDI-TOF Mass Spectrometry in Human Testis with Obstructive and Non-obstructive Azoospermia / 대한불임학회지

No abstract available.

Screening of the Single Nucleotide Polymorphisms in the Protamine 1 and 2 Genes of Korean Infertile Men / 대한불임학회지

OBJECTIVE: Although several genetic factors have been associated with defects in human spermatogenesis, the unambiguous causative genes have not been elucidated. The male infertility by haploinsufficiency of PRM1 or PRM2 has been reported in mouse model. The aim of this study was to identify the single nucleotide polymorphisms (SNPs) of PRM1 and PRM2, related to the genotype of Korean infertile men. METHODS: Genomic DNAs were extracted from peripheral bloods of infertile men with oligozoospermia or azoospermia, and analyzed using polymerase chain reaction (PCR) and direct sequencing. We carried out the direct sequencing analysis of amplified fragments in PRM1 (557 nucleotides from -42 to 515) and PRM2 (599 nucleotides from 49 to 648) genes, respectively. RESULTS: Three SNPs of coding region in the PRM1 gene was found in the analysis of 130 infertile men. However, the SNPs at a133g (aa 96.9%, ag 3.1% and gg 0.0%), c160a (cc 99.2%, ca 0.8% and aa 0.0%) and c321a (cc 56.9%, ca 35.4% and aa 7.7%) coded the same amino acids, in terms of silence phenotypes. On the other hand, as results of the PRM2 gene sequencing in 164 infertile men, only two SNPs, g398c (gg 62.2%, gc 31.1% and ga 6.7%) and a473c (aa 63.4%, ac 29.9% and cc 6.7%), were identified in the intron of the PRM2 gene. CONCLUSIONS: There was no mutation and significant SNPs on PRM1 and PRM2 gene in Korean infertile men. These results suggest that the PRM1 and PRM2 genes are highly conserved and essential for normal fertility of men.

Efficiency of Percoll Gradient, PureSperm Gradient, and Swim-up Separation Techniques in Normal Semen Samples / 대한남성과학회지

PURPOSE: The aim of this study was to compare sperm concentration, motility, viability, and morphology using Percoll gradient, PureSperm gradient, and the swim-up method in normal semen samples. MATERIALS AND METHODS: Ten normal semen samples were divided into three fractions. Motile sperm were isolated with Percoll gradient, PureSperm gradient, and swim-up method. Sperm concentration, motility, viability, and morphology were determined before and after separation. RESULTS: The sperm concentrations were not significantly different among the three METHODS: Percoll gradient(34.3+/-9.4x10(6)/ml), PureSperm gradient(37.6+/-16.6x10(6)/ml), and swim-up(27.3+/-6.4x106/ml). There was no significant difference in sperm motility among the three METHODS: Percoll gradient(93.5+/-1.6%), PureSperm gradient(92.7+/-4.4%), and swim-up(95.7+/-2.7%). When sperm motility was measured 24 hr later, the results were similar among the three METHODS: Percoll gradient(81.7+/-15.5%), PureSperm gradient(84.3+/-12.2%), and swim-up(89.4+/-5.1%). Sperm viability and morphology were slightly higher in swim-up method than the other methods, but the differences were not statistically significant. Sperm viability datas were: Percoll gradient(85.5+/-5.5%), PureSperm gradient(85.6+/-3.7%), and swim-up(88.6+/-6.6%). Morphology datas were: Percoll gradient(82.0+/-10.7%), PureSperm gradient(73.9+/-9.3%), and swim-up(83.7+/-8.5%). CONCLUSIONS: The swim-up method resulted in viability and morphology that were slightly higher than the other methods. However, all methods were useful for sperm preparation in normal semen samples.

Appropriate Testosterone-to-Estradiol Ratios for Aromatase Inhibitor Usage in Oligoasthenospermic Men / 대한남성과학회지

PURPOSE: We investigated whether oligospermic or asthenospermic men have decreased testosterone-to-estradiol (TE) ratios and whether this condition can be corrected with an oral aromatase inhibitor. We also determined the predictive value of pretreatment TE ratios for aromatase inhibitor efficacy in infertile men. MATERIALS AND METHODS: From June 2002 to December 2003, a total of 68 subfertile men with abnormal TE ratios were treated with 1 mg of anastrozole daily for 3 months. Changes in serum testosterone, serum estradiol, TE ratios, and semen parameters were evaluated 3 months after this therapy. RESULTS: Men treated with anastrozole had an increase in TE ratios (mean 0.2+/-0.7 [SE] versus 0.38+/-0.15; p<0.001). Semen analysis before and during anastrozole treatment showed an increase in sperm concentration (48.96 versus 70.42 million/mL; p<0.001) and motility (26.3 versus 33.2%; p<0.005). CONCLUSIONS: Men who are subfertile with lower TE ratios can be treated with an aromatase inhibitor with an increase in TE ratios that correlates with improved semen characteristics. We advise that an aromatase inhibitor be used in oligospermic or asthenospermic men if the TE ratio is below 0.2.

Pregnancy Outcomes after Transfer of Frozen-thawed Embryos following ICSI with Ejaculated, Fresh and Frozen-thawed Testicular Sperm / 대한산부인과학회잡지

OBJECTIVES: This study was performed to evaluate the pregnancy rate following the transfers of frozen- thawed embryos which was derived from intracytoplasmic sperm injection (ICSI) using sperm obtained by ejaculated, testicular sperm extraction (TESE), and frozen-thawed testicular sperm extraction (t-TESE). METHODS: Frozen-thawed embryos were successfully transferred to the patients in 664 cycles among 695 cycles from January 1998 to December 2002, where ICSI was done with various origins of sperm. Subjects were divided into three groups according to the origin of sperm; ejaculated sperm group as a control (n=535), TESE group (n=98) and t-TESE group (n=62). After conventional ICSI, the supernumerary PN stage or developing embryos were cryopreserved by slow freezing protocol with 1, 2-propanediol as cryoprotectant. RESULTS: The survival rate of frozen-thawed embryos was 77.7% (2515/3236) in ejaculated sperm group, 76.6% (441/576) in TESE group and 83.9% (292/348) in frozen-thawed TESE group, respectively. The difference of survival rate of between t-TESE group and other two groups was statistically significant (p<0.01). The good embryo formation rate and positive beta-hCG rate was 46.3% (1164/2515), 28.8% (148/513) in ejaculated sperm group, 49.2% (217/441), 36.6% (34/93) in TESE group and 46.2% (135/292), 34.9% (22/63) in frozen-thawed TESE group, respectively. CONCLUSION: This study demonstrates that comparable pregnancy rate and implantation rate could be achieved after the transfer of frozen-thawed embryos following ICSI using various sources of sperm. As there was no statistically significant difference in pregnacy rate between ICSI with fresh testicular sperm and with frozen-thawed testicular sperm, the sequential cryopreservation of supernumerary testicular sperm and embryos may be a useful method for increasing pregnancy outcome in infertile couples with male factor.

Comparative Analysis of Pregnancy Outcomes after In Vitro Fertilization with Intracytoplasmic Sperm Injection (IVF-ICSI) between Obstructive and Non-obstructive Azoospermia / 대한불임학회지

OBJECTIVE: To compare the pregnancy outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) between obstrucvtive and non-obstrucvtive azoospermia. METHODS: From January 1994 to December 2002, 524 patients with obstructive azoospermia (886 cycles) and 163 patients with non-obstructive azoospermia (277 cycles) were included in this study. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in obstructive azoospermia and TESE in non-obstructive azoospermia were perfomed to retrieve sperm, which was used for ICSI and then fertilized embryos were transferred. The results of ICSI-fertlization rate (FR), clinical pregnancy rate (CPR), clinical abortion rate (CAR) and delivery rate (DR)- were statistically analysed in obstructive versus non-obstructive azoospermia. RESULTS: There were no differences in the number of retrieved oocytes, injected oocytes for ICSI and oocyte maturation rate. FR was significantly higher in obstructive than non-obstructive azoospermia (71.7% vs. 61.1%, p<0.001). There was no difference in CPR per embryo transfer cycle. After pregnancy was established, however, CAR was significantly higher in non-obstructive than obstructive azoospermia (25.6% vs. 12.5%, p=0.004). DR per clinical pregnancy cycle was significantly higher in obstructive than non-obstructive azoospermia (78.0% vs. 64.4%, p=0.012). In the karyotype ananlysis of abortus, abnormal karyotypes were found in 75.0% (6/8) of obstructive and 55.6% (5/9) of non-obstructive azoospermia. CONCLUSION: Our data show significantly higher FR in obstructive than non-obstructive azoospermia. Though there was no differrence in CPR, CAR was significantly higher in non-obstructive than obstructive azoospermia. The abortion may be related to the abnormal karyotype of embryo, but further investigations are necessary to elucidate the cause of clinical abortion in azoospermia.

Comparative Analysis of Sperm Motility Using Cell Soft System-3000 and Sperm Quality Analyzer-V / 대한불임학회지

OBJECTIVE: To evaluate the results of CASA systems and to compare its results. METHODS: Fifty semen sampales were analysed. Concentration, motility and forward progression were evaluated simultaneously on the same semen samples using Cell Soft System-3000 (CS system) and Sperm Quality Analyzer-V (SQA system). RESULTS: Mean semen volume was 2.8+/-.2 ml. Mean value of sperm concentration, motility, forward progression using CS system were 83.4+/-5.7x106/ml, 52.3+/-6.4% and 48.6+/-3.4%, respectively. And mean value of sperm concentration, motility, forward progression using SQA system were 78.2+/-2.9x106/ml, 57.0+/-4.0% and 50.6+/-1.9%, respectively. There were no statistical significancy of sperm concentration, motility, forward progression between the two devices. CONCLUSION: SQA system variables well correlated with the CS system. As a screening test for semen quality, CS system and SQA system is considered as useful in the management of male infertility.