Epididymal specific, selenium-independent GPX5 protects cells from oxidative stress-induced lipid peroxidation and DNA mutation.

STUDY QUESTION: Can selenium (Se) independent, epididymal-specific glutathione peroxidase 5 (GPX5) protect CHO-K1 cells from oxidative damage and, more specifically, from lipid peroxidation and DNA mutation? SUMMARY ANSWER: CHO-K1 cells expressing GPX5 have increased resistance to oxidative challenge and, more specifically, decreased levels of lipid peroxidation and decreased levels of the downstream DNA lesion 8-oxo-7,8-dihydroguanine (8-oxodG) compared with control cells. WHAT IS KNOWN ALREADY: GPX5 associates with sperm during transit of the epididymis, and has been postulated to protect sperm from peroxide-mediated attack. However, its function as an active glutathione peroxidase has been questioned due to substitution of the classical selenocysteine residue at its active site. Indirect evidence for a functional role for GPX5 has been provided by in vivo studies, in particular from the GPX5 knockout mouse whereby offspring sired by GPX5(-/-) males have a higher rate of spontaneous abortion and developmental defects, attributed to increased oxidative injury (8-oxodG) to sperm DNA, but only when the GPX5(-/-) males are over 1 year of age. Interestingly, we have previously shown severely reduced levels of GPX5 in humans. STUDY DESIGN, SIZE, DURATION: To look more directly at its role in protection against oxidative damage, we have used an in vitro system, generating a CHO-K1 mammalian cell line expressing recombinant rat GPX5. PARTICIPANTS/MATERIALS, SETTING, METHODS: We have used the recombinant CHO-K1 cells to determine whether GPX5 is able to protect these cells from an administered oxidative challenge, using a range of approaches. We compared the viability of GPX5-expressing cells with control cells by both MTT and trypan blue exclusion assays. We next investigated whether GPX5 protects the cells specifically from lipid peroxidation, by using the fluorescent reporter molecule C11-BODIPY(581/591), and thus from downstream DNA mutation, by comparing levels of the DNA lesion 8-oxodG. We also investigated whether GPX5 can be transferred to rat sperm via epididymosomes. MAIN RESULTS AND THE ROLE OF CHANCE: GPX5-expressing CHO-K1 cells had increased viability compared with control cells following oxidative challenge (P < 0.005). We also found that GPX5-expressing CHO-K1 cells had significantly lower levels of C11-BODIPY(581/591) oxidation, and hence lipid peroxidation, compared with control cells. Levels of 8-oxodG DNA damage were also markedly lower in the nuclei of GPX5-expressing cells than in control cells. Finally, we showed that GPX5 can be transferred to rat sperm via epididymosomes. LIMITATIONS, REASONS FOR CAUTION: GPX5 is not active in glutathione peroxidase assays using H2O2 as the substrate. However, the related non-mammalian Se-independent GPXs show preference for electron donors other than glutathione, with a number utilizing thioredoxin as a reducing equivalent. Hence, the in vitro activity of GPX5 needs to be assessed using a range of alternative substrates and electron donors. GPX5 is secreted by the epididymis and associates with the sperm plasma membrane. We showed that this transfer can occur via epididymosomes; however, the mechanism for transfer and the identity of a potential binding partner in the sperm membrane needs to be determined. Finally, our study utilized an in vitro system that needs to be translated to human sperm. WIDER IMPLICATIONS OF THE FINDINGS: Our study supports an important role for GPX5 as an antioxidant, possibly acting as a phospholipid hydroperoxidase and participating in the maintenance of cell and DNA integrity.

Comments on the release of the 5th edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen.

The authors of the World Health Organization Semen Analysis Manual are to be congratulated on producing a new edition; it is an essential tool to disseminate good practice in andrology. However, the tests described have poor prognostic power to predict a man's fertility and show little about the underlying causes of sub-fertility. This commentary urges a revival of research into the diagnosis of male fertility. It suggests that fertility should be regarded as a continuum and that the artificial binary division between fertile and infertile should be abandoned. Models to predict a sub-fertile couple's chance of conception in a year should be developed on the basis of prospective data. These models would allow for sophisticated decision making about management. The future lies in the identification of tests to detect underlying pathologies open to specific treatment. Leads such as oxidative stress, defects in the intracellular regulation and the developing field of proteomics should be explored.

Effects of assisted hatching method and age on implantation rates of IVF and ICSI.

The objective of this study was to investigate whether a change in assisted hatching (AH) technique from total to partial penetration of the zona pellucida improved the outcome of IVF and intracytoplasmic sperm injection cycles where AH was indicated. This was an observational study conducted from the beginning of January 2000 to the end of April 2005. Total AH was performed in 312 cycles, while partial AH was performed in 592 cycles. In women of all ages, implantation, clinical pregnancy and live birth rates were higher in the partial AH group than in the total AH group (12.6 versus 7.2%, P = 0.0001; 22.3 versus 15.7%, P = 0.02; 18.2 versus 12.5%, P = 0.03 respectively). The benefit of partial AH was most marked in women under 38 years old (i.e. the recurrent implantation failure group). The authors conclude that partial AH is associated with higher implantation and pregnancy rates than total AH, especially in women under 38 years old who suffer from recurrent implantation failure.

Glycolysis and sperm motility: does a spoonful of sugar help the flagellum go round?

It is doubtful that diffusion can deliver sufficient ATP from the mitochondria to sustain activity at the distal end of the sperm flagellum. Glycolytic enzymes bound to the fibrous sheath could provide energy along the flagellum at the point it is required. An obligatory role for glycolysis is supported by the lack of progressive motility in sperm from mice where the gene for sperm-specific glyceraldehyde-3-phosphate dehydrogenase (GAPDHs) had been 'knocked out'. Here, I review some evidence against this idea. First, pure diffusion from the mitochondrion is likely to be adequate in species with smaller sperm, and it is possible that rapid ATP delivery required in larger sperm could be achieved by an adenylate kinase shuttle. Second, experience with alpha-chlorohydrin demonstrates that sperm can remain motile with normal ATP concentrations despite inhibition of GAPDHs; adverse effects only occur if glucose is added and high levels of glycolytic intermediates accumulate. These observations undermine the GAPDHs knockout mouse as evidence for an essential role of local glycolysis. Third, sperm from many species can remain motile for long periods in sugar-free media and excepting dog sperm, evidence that gluconeogenesis is a possible explanation, is weak. In most species, it is unlikely that local glycolysis is the only way that ATP can be supplied to the distal flagellum.

Regulation of sperm function by reactive oxygen species.

Sperm capacitation can be increased by the addition of reactive oxygen species (ROS) and decreased by antioxidants. Broadly consistent results have been achieved with a wide variety of methods and across different species. Exposure to ROS increases protein tyrosine phosphorylation consequent on an increase in cAMP and activation of tyrosine kinase and inhibition of tyrosine phosphatase. The measurement of ROS production by sperm is complicated by contamination of suspensions by leukocytes, laying many studies open to doubt. In human sperm the observation that extracellular NADPH could support superoxide production detected with the chemiluminescent probe lucigenin and had physiological effects similar to hydrogen peroxide led to the suggestion that they contained NADPH oxidase activity to generate ROS to support capacitation. However, the realization that lucigenin can signal superoxide artefactually, combined with failure to detect superoxide production using spin trapping techniques or to detect NADPH oxidase components in mature sperm, and confirmation of old reports that NADPH solution contains substantial amounts of hydrogen peroxide due to autoxidation, have undermined this hypothesis. Although the presence of significant NADPH oxidase activity in mature human sperm now seems less likely, other observations continue to suggest that they can make ROS in some way. There is stronger evidence that animal sperm can make ROS although these may be mainly of mitochondrial origin.

Functional significance of the pentose phosphate pathway and glutathione reductase in the antioxidant defenses of human sperm.

Glutathione peroxidase is one of the principal antioxidant defense enzymes in human spermatozoa, but it requires oxidized glutathione to be reduced by glutathione reductase using NADPH generated in the pentose phosphate pathway. We investigated whether flux through the pentose phosphate pathway would increase in response to oxidative stress and whether glutathione reductase was required to protect sperm from oxidative damage. Isotopic measurements of the pentose phosphate pathway and glycolytic flux, thiobarbituric acid assay of malondialdehyde for lipid peroxidation, and computer-assisted sperm analysis for sperm motility were assessed in a group of normal, healthy semen donors. Applying moderate oxidative stress to human spermatozoa by adding cumene hydroperoxide, H(2)O(2), or xanthine plus xanthine oxidase or by promoting lipid peroxidation with ascorbate increased flux through the pentose phosphate pathway without changing the glycolytic rate. However, adding higher concentrations of oxidants inhibited both the pentose phosphate pathway and glycolytic flux. At concentrations of 50 microg/ml or greater, the glutathione reductase-inhibitor 1,3-bis-(2-chloroethyl) 1-nitrosourea decreased flux through the pentose phosphate pathway and blocked the response to cumene hydroperoxide. It also increased lipid peroxidation and impaired the survival of motility in sperm incubated under 95% O(2). These data show that the pentose phosphate pathway in human spermatozoa can respond dynamically to oxidative stress and that inhibiting glutathione reductase impairs the ability of sperm to resist lipid peroxidation. We conclude that the glutathione peroxidase-glutathione reductase-pentose phosphate pathway system is functional and provides an effective antioxidant defense in normal human spermatozoa.

Defining poor ovarian response during IVF cycles, in women aged <40 years, and its relationship with treatment outcome.

BACKGROUND: Poor ovarian response limits IVF success but assessing interventions is difficult because of the wide variation in definition. This study attempts to derive objective definitions of poor response. METHODS: A retrospective study of a consecutive series of 1190 patients aged <40 years undergoing their first IVF/ICSI cycle was undertaken. Factors adversely affecting implantation, including advanced female age, were excluded. Clinical outcome in cycles reaching oocyte retrieval (n = 1036) were evaluated with respect to gonadotrophin dose used and oocyte number. Cancelled cycles (n = 154) were analysed in relation to the stimulation dose at cancellation and outcome of their subsequent cycle. RESULTS: Cycle cancellation for patients on >/=300 IU FSH/day compared to those on a lower dose was associated with a significantly worse outcome in the subsequent cycle. If <3000 IU FSH/cycle were administered, clinical pregnancy rates remained favourable if <4 eggs were recovered (29 versus 33% for >/=5 eggs). By contrast, if >/=3000 IU FSH was required, the pregnancy rate was 25% if >/=5 eggs were recovered but declined to 7% if <4 were obtained. CONCLUSIONS: Definitions of poor response should include the degree of ovarian stimulation used. A low oocyte number is only detrimental if the cumulative dose is >3000 IU FSH. Cancellation at >/=300 IU FSH/day is associated with a significantly worse prognosis and could define poor response.

Effects of Ca-ATPase inhibitors on the intracellular calcium activity and motility of human spermatozoa.

Although evidence suggests that high intracellular calcium activity ([Ca2+]i) inhibits sperm motility, data concerning [Ca2+]i within, or slightly above, the physiological range are sparse, particularly in mammalian sperm. We investigated inhibitors of the sarcoplasmic/endoplasmic reticulum Ca-ATPase (SERCA) and the plasma membrane Ca-ATPase with the objective of increasing the intracellular calcium ion activity in human spermatozoa to study its effect on motility and other functions. Thapsigargin (20 micromol/L) increased [Ca2+]i from 140 +/- 7 nmol/L over an approximately 2-min period to reach a plateau of 530 +/- 84 nmol/L (mean +/- SEM, n = 3, p < 0.05). In sperm suspended in calcium-free medium thapsigargin increased [Ca2+]i from 13 +/- 3.3 to 35 +/- 7.5 nmol/L (p < 0.01), consistent with the release of calcium from intracellular stores. Cyclopiazonic acid (60 micromol/L) caused a transient decrease in [Ca2+]i. Quercetin, (200 micromol/L) caused a rapid increase in [Ca2+]i to 1280 +/- 90 nmol/L, after which [Ca2+]i fell quickly at first but then more slowly. Thapsigargin (20 micromol/L) caused approximately 70% of sperm to acrosome react in < or = 5 min, but once acrosome reacted, many sperm died over the next 30 min. Lower concentrations of thapsigargin caused fewer acrosome reactions but were less toxic. Both thapsigargin and quercetin caused rapid dose-dependent decreases in sperm motility. The results are consistent with high [Ca2+]i in the range observed in caput epididymal or cryopreserved spermatozoa inhibiting motility, but might be confounded by other events following the acrosome reaction.

Prolonged use of oral contraception before a planned pregnancy is associated with a decreased risk of delayed conception.

BACKGROUND: The aim of this study was to investigate the association of total duration of oral contraceptive usage with time to conception. METHODS: This was a prospective study of 8497 planned pregnancies drawn from a population that recruited 85% of eligible couples in South-West England who were expecting a baby in a 21 month period. Self-completion questionnaires were administered at 18 weeks gestation to ascertain parity, paternity, co-habitation, use of the contraceptive pill, smoking and alcohol status, educational achievement, height, weight and time taken to conceive. Logistic regression was used to identify factors independently related to conception in < or =12 months. RESULTS: Of the participants, 74% conceived in < or =6 months, 14% in 6-12 months and 12% after 1 year. Previous prolonged oral contraceptive usage was statistically significantly associated with a decreased risk of delayed conception. Prolonged use of oral contraception was also associated with improved fecundity independent of other factors. Selection bias due to particularly fertile women using oral contraceptives is unlikely because similar odds ratios were calculated for nulligravid women. CONCLUSIONS: Women who have prolonged use of oral contraceptives might be reassured that they will not be disadvantaged in terms of time taken to achieve conception.

Male employment in some printing trades is associated with prolonged time to conception.

We investigated whether male employment in defined occupational groups was associated with decreased fecundity as revealed by prolonged time to conception. The analysis was carried out on data from questionnaires completed over a period of 21 months by 4808 couples with a planned pregnancy and collected as part of the Avon Longitudinal Study of Pregnancy and Childhood. Previously logistic regression had identified nine non-occupational factors associated with taking >6 or >12 months to conceive and this model was used to analyse the association of the fathers ever having worked in defined occupational groups with delayed conception. If the man had worked in 'Printing and related trades' (OPCS code 56), couples had a statistically significantly increased odds ratio (OR) of taking >6 [1.86 (1.21, 2.94)] or >12 months [1.96 (1.13, 3.39)] to conceive [OR (95% confidence intervals)] after adjustment for non-occupational factors. The association with time to conception was stronger in the subgroup 'Other printing related trades' (OPCS code 569) but no statistically significant associations after adjustment for other factors were found for other printing jobs.

The motility of demembranated human spermatozoa is inhibited by free calcium ion activities of 500 nmol/L or more.

A number of studies have demonstrated that high calcium ion activities inhibit sperm motility, but little is known about the effect of different calcium activities close to the physiological range. Therefore, we investigated whether raising calcium activities within the submicromolar range would inhibit the motility of demembranated human spermatozoa. Spermatozoa were demembranated with Triton X-100 and motility was measured objectively by computer assisted semen analysis. Motility, reactivated by 1 mol adenosine 5'-triphosphate (AlphaTauP)/L, was short lived, with maximum activity only sustained for about 1 min. Reactivated motility was not affected by 50 micromol cAMP/L. The amplitude of lateral head displacement was significantly greater at room temperature than at 37 degrees C, but there were no significant differences between the percentage of sperm motile or their velocity at the two temperatures. The calcium buffer 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid (BAPTA) at 1 mmol/L was included in the demembranation-reactivation medium, and free calcium ion activities were calibrated using the fluorescent calcium probe Fura-2. Calcium ion activities of > or =500 nmol/L significantly inhibited the percentage of demembranated-reactivated spermatozoa that were motile, and the velocity and lateral head displacement of these cells. The range of intracellular calcium activities in spermatozoa from 24 cryopreserved ejaculates was 110-534 nmol/L; roughly twice the value in fresh spermatozoa. Therefore, calcium ion activities in the range observed in cryopreserved spermatozoa can inhibit the activity of demembranated human spermatozoa.

The role of glucose in supporting motility and capacitation in human spermatozoa.

Glucose has been reported to be beneficial to human sperm for optimal capacitation and fertilization, although it is unclear whether glucose is required for providing extra metabolic energy through glycolysis, or for generating some other metabolic product. In this study, the effects of sugars on human sperm capacitation, motility, and energy production were investigated. The glucose concentration that supported the greatest number of acrosome reactions was 5.56 mmol L(-1). Compared with incubations with no added sugar, this concentration of glucose, fructose, mannose, or galactose appeared to slightly increase the number of acrosome reactions occurring after 18 hours of capacitation, or following induction by 2 micromol A23187 + 3.6 mmol pentoxifylline L 1, but only glucose had a statistically significant effect. Glucose supported increased penetration of zona-free hamster oocytes, but its advantage was not statistically significant. The addition of 5.56 mmol glucose or fructose L(-1) to sugar-free medium immediately increased the adenosine triphosphate (ATP) concentration and motility of sperm. These parameters were then stable for 3 hours, but declined markedly after 18 hours. In the absence of a glycolysable sugar, motility began to decline in the first hour and only 2% or 3% of sperm remained motile after 18 hours. Glucose or fructose was required to support hyperactivated motility. 2-Deoxyglucose was detrimental to the ATP concentration and motility of sperm, and supported fewer spontaneous or progesterone-stimulated acrosome reactions than were observed in the absence of a sugar. We conclude that glycolytic ATP production is required for vigorous motility and hyperactivation in human sperm. Other products of glucose metabolism are not essential to support capacitation, but they may have a small, enhancing effect.

Value of the hamster oocyte test and computerised measurements of sperm motility in predicting if four or more viable embryos will be obtained in an IVF cycle.

The experimental group consisted of men from 81 couples waiting for in vitro fertilization (IVF), about half of whom had sperm dysfunction defined by a negative post-coital test. A diagnostic semen sample was subjected to a hamster oocyte penetration test (HOPT) after stimulation of the acrosome reaction with A23187 +/- pentoxifylline and to computerized sperm motility measurements (CASA) as well as conventional semen analysis according to the WHO protocol. Logistic regression was used to identify parameters that predicted the probability of achieving four or more viable embryos at IVF among the 65 couples from whom four or more oocytes were collected. The number of oocytes available and whether the woman had previously been pregnant (ever pregnant) were important factors but once these had been taken into account a number of sperm parameters had additional predictive power. The most useful of these were the percentage sperm static (CASA) or the percent sperm progressively motile (conventional semen analysis) in the Percoll preparation. A model incorporating the number of oocytes collected, ever pregnant and percentage sperm static achieved 85% correct prediction of outcome in the experimental dataset but only 62% correct prediction in an independent set of 280 IVF cycles. The percentage of hamster oocytes penetrated was a significant predictor but had no advantage over simple motility measurements. The results illustrate the difficulty of basing a prognosis for achieving satisfactory fertilization in IVF on the properties of spermatozoa.

A critical investigation of NADPH oxidase activity in human spermatozoa.

It has been suggested that human spermatozoa contain an NADPH oxidase that could generate reactive oxygen species involved in signalling pathways to promote fertility. The proposal depends on observations that the addition of NADPH to purified human spermatozoa stimulates chemiluminescence by the superoxide (O2-) probe, lucigenin. We confirmed these observations, but demonstrated that lucigenin increases NADPH consumption by spermatozoa and stimulates artefactual O2- production via a diphenyleneiodonium (DPI) sensitive flavoprotein. In the absence of cytochrome c, DPI-inhibitable NADPH oxidation by permeabilized spermatozoa was 8 times too small to account for the rate of NADPH-stimulated cytochrome c reduction. Thus NADPH can directly reduce cytochrome c by a flavoprotein dependent mechanism making this O2- assay also unreliable in sperm suspensions. We were unable to observe O2- production by 40 x 10(6) spermatozoa/ml using electron paramagnetic resonance spectroscopy but could identify O(2)(-) generation from 2000 4beta-phorbol-12-myristate-13-actetate (PMA)-stimulated leukocytes. Using spectrophotometry, we did not detect the reduced cytochrome b(558) component of the neutrophil NADPH oxidase in human spermatozoa. No hydrogen peroxide generation was observed using a sensitive Amplex Red assay. We conclude that human spermatozoa do not possess significant NADPH oxidase activity and that the mechanism by which NADPH promotes capacitation must be re-evaluated.

Delayed conception and active and passive smoking. The Avon Longitudinal Study of Pregnancy and Childhood Study Team.

OBJECTIVE: To determine whether passive as well as active smoking by women or smoking by men is associated with delayed conception, after adjustment for confounding factors. DESIGN: Population study of couples expecting a baby. Logistic regression was performed to identify factors associated with delayed conception. SETTING: The Avon Health Authority area, United Kingdom. PATIENT(S): All couples expected to deliver between April 1991 and December 1992. INTERVENTION(S): Questionnaires administered early in pregnancy. MAIN OUTCOME MEASURE(S): Time taken to conceive, categorized as <6 months, 6-11 months, 1-3 years, and >3 years. RESULT(S): After correction for confounding factors, delayed conception was statistically significantly associated with both active smoking by the woman (odds ratio [OR] 1.23 [95% CI 0.98-1.49] for > 6 months and 1.54 [95% CI 1.19-2.01] for >12 months) and her exposure to passive smoking (OR 1.17 [95% CI 1.02-1.37] and 1.14 [95% CI 0.92-1.42]) compared with women with no exposure to tobacco smoke (referent). Heavy smoking by men was independently associated with delayed conception. In active smokers, the effect increased with the number of cigarettes. CONCLUSION(S): Smoking by men and passive and active smoking by women are associated with delayed conception.

The prognostic power of the post-coital test for natural conception depends on duration of infertility.

Controversy about the value of the post-coital test (PCT) has prompted us to re-analyse data from 207 couples, originally studied between 1982 and 1983, with at least 12 months' infertility at presentation, complete diagnostic information and exclusion of female factors, to clarify the effect of duration of infertility on the prediction of conception. In couples with less than 3 years infertility and a positive PCT, 68% conceived within 2 years compared with 17% of those with a negative result. After 3 years, corresponding rates were 14% and 11%. The relative risks of conception [95% confidence interval (CI)] calculated using the Cox's proportional hazards model were 0.23 (0.12-0.43) for a negative PCT (reference positive PCT) and 0.25 (0.13-0.51) for more than 36 months infertility (reference 12-23 months). Semen analysis had no extra predictive power given the duration of infertility and the PCT. The PCT is an effective predictor of conception where defined female causes of infertility are absent and duration of infertility is less than 3 years. Once infertility is prolonged (beyond 3 years) the conception rate is low even with a positive test because a large proportion of couples remaining childless so long have true unexplained infertility. Use of the PCT will enable clinicians to allocate scarce, expensive and invasive resources effectively.