The influence of the female reproductive tract and sperm features on the design of microfluidic sperm-sorting devices.

Although medical advancements have successfully helped a lot of couples with their infertility by assisted reproductive technologies (ART), sperm selection, a crucial stage in ART, has remained challenging. Therefore, we aimed to investigate novel sperm separation methods, specifically microfluidic systems, as they do sperm selection based on sperm and/or the female reproductive tract (FRT) features without inflicting any damage to the selected sperm during the process. In this review, after an exhaustive studying of FRT features, which can implement by microfluidics devices, the focus was centered on sperm selection and investigation devices. During this study, we tried not to only point to the deficiencies of these systems, but to put forth suggestions for their improvement as well.

Long-term male fertility after treatment with radioactive iodine for differentiated thyroid carcinoma.

CONTEXT: Whilst radioactive iodine (RAI) is often administered in the treatment for differentiated thyroid carcinoma (DTC), long-term data on male fertility after RAI are scarce. OBJECTIVE: To evaluate long-term male fertility after RAI for DTC, and to compare semen quality before and after RAI. DESIGN, SETTING, AND PATIENTS: Multicenter study including males with DTC ≥2 years after their final RAI treatment with a cumulative activity of ≥3.7 GBq. MAIN OUTCOME MEASURE(S): Semen analysis, hormonal evaluation, and a fertility-focused questionnaire. Cut-off scores for 'low semen quality' were based on reference values of the general population as defined by the World Health Organization (WHO). RESULTS: Fifty-one participants had a median age of 40.5 (interquartile range (IQR): 34.0-49.6) years upon evaluation and a median follow-up of 5.8 (IQR: 3.0-9.5) years after their last RAI administration. The median cumulative administered activity of RAI was 7.4 (range: 3.7-23.3) GBq. The proportion of males with a low semen volume, concentration, progressive motility, or total motile sperm count did not differ from the 10th percentile cut-off of a general population (P = 0.500, P = 0.131, P = 0.094, and P = 0.500, respectively). Cryopreserved semen was used by 1 participant of the 20 who had preserved semen. CONCLUSIONS: Participants had a normal long-term semen quality. The proportion of participants with low semen quality parameters scoring below the 10th percentile did not differ from the general population. Cryopreservation of semen of males with DTC is not crucial for conceiving a child after RAI administration but may be considered in individual cases.

Introduction: Male fertility testing: the past, present, and future.

Semen analysis remains the initial laboratory evaluation for infertile men. The limitations of the standard semen analysis along with past attempts to improve the analysis of sperm are reviewed. Advances in genetic testing will lead to fewer diagnoses of idiopathic male infertility, and improvements in picking the best sperm offer hope of improved assisted reproduction outcomes. The development of simplified testing has opened up the availability of tests performed in settings without advanced laboratory facilities as well as by patients in their own homes.

Original investigations into the clearance of spermatozoa after vasectomy.

"The urologist and patient, with the cooperation of the laboratory performing the sperm counts, can determine within a few days after operation that aspermia has been produced and that the procedure has been successful." -Freund M, Davis JE. Disappearance rate of spermatozoa from the ejaculate following vasectomy. Fertil Steril 1969;20:163-70.

'One of the good guys': sperm donor masculinity and the falling Danish sperm count discourse.

Sperm banks in Denmark produce and export donor semen worldwide. The role of the sperm bank is to provide high-quality, safe semen from desirable donors. However, over the last 20 years, global sperm counts are reported to be falling. Along with these discourses comes the implication that poor fertility is a personal failing, which implies a conflation of 'fertility' with 'potency'. This paper draws on qualitative research with Danish sperm donors to explore how donors construct their identities as donors and as the producers of 'good sperm'. Accounts of the drive to produce the best sperm possible and the resultant confidence boost are bound up in ideas about masculine potency and potential and bodily performance and set against a backdrop of a moral panic surrounding the apparently declining Danish sperm count.

Declining Sperm Counts or Rather Not? A Mini Review.

IMPORTANCE: Temporal global trends of sperm quality remain a matter of debate. OBJECTIVE: The aim of this study was to present a comprehensive review of studies reporting on sperm quality counts, summarize the main end points, and assess the main reasons for potential discrepancies. EVIDENCE ACQUISITION: An evidence-based review of PubMed and Scopus databases was performed regarding studies reporting on modification of sperm quality counts, independently of study character, study language, or date. RESULTS: Since the meta-analysis of Carlsen et al in 1992 (Br Med J 1992;305:609-613) that suggested an annual decline in sperm count of 1%, several reports confirmed the decline in sperm quality, whereas others disproved them, suggesting a slight increase or absence of change in sperm count. Such controversies may be attributed to geographical and time-related variability in sperm values and also to several confounding factors that influence the semen parameters. Intrinsic weaknesses of the studies include heterogeneity of subjects recruited, lack of adjustment for confounding factors, and samples that do not always represent the general population. CONCLUSIONS: No consensus exists on whether sperm counts actually decrease because studies' results are often controversial or inconclusive with methodological deficiencies. More prospective, large-scale, population based studies are needed in order to provide sound evidence of possible global trends in sperm count.

Dietary patterns are positively associated with semen quality.

OBJECTIVE: To study association of semen quality with a priori whole dietary pattern indexes, which reflect real-world dietary practices and the numerous combinations by which foods are consumed: Healthy Eating Index (HEI), Dietary Approaches to Stop Hypertension (DASH), alternate Mediterranean Diet score (aMED), and Alternative Healthy Eating Index (AHEI). DESIGN: A cross-sectional single-center study. SETTING: Hospital fertility center and university. PATIENT(S): A total of 280 men attending fertility center from 2012 to 2015. INTERVENTION(S): Food frequency questionnaire (FFQ) and semen and sperm analysis. MAIN OUTCOME MEASURE(S): Food consumption with the use of FFQ and HEI, AHEI, aMED, DASH nutritional individual scoring indexes. Semen parameters, including semen volume, sperm concentration, motility, total count, and morphology. RESULT(S): Comparing the highest and lowest quartiles of the nutritional indexes, men in the highest quartiles of HEI, AHEI, aMed, and DASH indexes had significantly higher adjusted means of sperm concentration (by 10%, 45%, and 24% for HEI, AHEI, and DASH, respectively), normal sperm morphology (by 21% and 8% for AHEI and DASH, respectively), total sperm count (by 29% for AHEI), and sperm motility (by 6% and 11% for aMed and HEI, respectively). CONCLUSION(S): Adherence to any of the four dietary indexes is associated with better overall sperm quality, with AHEI best associated. Following our novel findings, we recommend using AHEI as a clinical and practical tool for public whole nutritional recommendation for semen quality.

Decline in sperm count in European men during the past 50 years.

PURPOSE: To investigate whether the sperm concentration of European men is deteriorating over the past 50 years of time. MATERIALS AND METHODS: We analysed the data published in English language articles in the past 50 years in altering sperm concentration in European men. RESULTS: A time-dependent decline of sperm concentration ( r = -0.307, p = 0.02) in the last 50 years and an overall 32.5% decrease in mean sperm concentration was noted. CONCLUSION: This comprehensive, evidence-based meta-analysis concisely presents the evidence of decreased sperm concentration in European male over the past 50 years to serve the scientific research zone related to male reproductive health.

Interactive effects of ethanol on ulcerative colitis and its associated testicular dysfunction in pubertal BALB/c mice.

Available epidemiological reports have indicated an increase in the incidence of ulcerative colitis, as well as alcohol consumption, globally. The present study investigated the possible interactive effects of ethanol consumption on ulcerative colitis and its associated testicular dysfunction using six groups of 12 pubertal mice each. Group I (Control) mice received drinking water alone. Group II mice received ethanol alone at 5 g/kg body weight. Group III mice received 2.5% dextran sulphate sodium (DSS) in drinking water followed by normal drinking water. Groups IV, V, and VI mice received DSS followed by ethanol at 1.25, 2.5, and 5 g/kg, respectively. Administration of ethanol to mice with ulcerative colitis intensified the disease-activity index with marked reduction in colon length, colon mass index, body weight gain, and organo-somatic indices of testes and epididymis when compared with the DSS-alone group. Moreover, ethanol exacerbated colitis-mediated decrease in enzymatic and non-enzymatic antioxidants but increased the oxidative stress and inflammatory biomarkers in the testes and epididymis. The diminution in luteinizing hormone, follicle stimulating hormone, and testosterone levels was intensified following administration of ethanol to mice with ulcerative colitis that were administered 5 g/kg ethanol alone. The decrease in sperm functional parameters and testicular spermatogenic indices as well as histopathological damage in colon, testes, and epididymis was aggravated following administration of ethanol to mice with ulcerative colitis. In conclusion, the exacerbating effects of ethanol on ulcerative colitis-induced testicular dysfunction are related to increased oxidative stress and inflammation in the treated mice.

Técnicas avanzadas para selección de espermatozoides / Advanced techniques for sperm selection

El tracto genital femenino ejecuta un análisis de semen particular, identificando y seleccionando el mejor espermatozoide para la fecundación. Este análisis in vivo trata de asegurar que la descendencia reciba el material genético de mejor calidad. La selección artificial de espermatozoides implica eliminar las barreras naturales con las que se encuentra el gameto masculino en su largo recorrido. Las técnicas convencionales de selección de espermatozoides que se emplean en reproducción asistida (swim-up y gradientes de densidad específicos), se fundamentan en la recuperación o selección de los espermatozoides con mejor movilidad y morfología, pero no distinguen espermatozoides funcionalmente capaces de fecundar ni genéticamente normales. El objetivo de las técnicas avanzadas es seleccionar el espermatozoide con las mejores características funcionales para ICSI o FIV y conseguir una progenie sana. La introducción de nuevas técnicas en el Laboratorio de Andrología podría suponer un salto cualitativo en los resultados en reproducción (AU)

The female genital tract performs a particular sperm analysis, identifying and selecting the best sperm for fertilization. This in vivo analysis seeks to ensure that the offspring receives the best genetic material. Through artificial sperm selection, natural barriers along the female tract are skipped. Conventional selection techniques used in assisted reproduction are based on sperm motility and morphology, not distinguishing between fecundating ability or genetic normality. The object of advanced sperm selection techniques is to retrieve the spermatozoa with better functional characteristics for intracytoplasmic sperm injection or in vitro fertilization. The introduction of these techniques in the andrology laboratory might represent a qualitative leap in assisted reproduction results (AU)

Semen quality in the 21st century.

Although semen quality is an important determinant of fertility, defining clear thresholds for normal ranges has proven difficult. According to 'time to pregnancy' studies, fecundity starts to decline when sperm concentrations fall below 30-55 × 106/ml, whereas the WHO criterion for normal values is currently 15 × 106/ml. Multiple studies over the past 15 years have reported median sperm concentrations of 41-55 × 106/ml in young men (mean age 18-21 years) from the general population, suggesting that many of them have suboptimal semen quality. Sperm numbers remain fairly constant between 19 and 29 years of age, which points to the importance of developmental effects. Discussion on whether population semen quality has declined has continued for decades, as regional differences in trends have been noted. The reasons for poor semen quality and adverse trends are not well established, but some associations suggest a causal relationship, for example, with maternal smoking during pregnancy. The role of chemical exposures leading to endocrine disruption and detrimental reproductive effects has been in the focus of research during the past 20 years. Identification of exposures that affect fertility could provide opportunities for effective prevention of reproductive health problems.

The Disappearing Sperms: Analysis of Reports Published Between 1980 and 2015.

Reports regarding the changes in sperm concentration in different counties of the world are inconsistent. Furthermore, the reports that sprung up from specific epidemiological and experimental examinations did not include data of prior studies or geographical variations. The current study, following a previous report of massive fall in semen volume over the past 33 years, attempts to delineate the trend of altering sperm concentrations and factors responsible for this by reviewing article published from 1980 to July 2015 with geographic differences. The current study identified an overall 57% diminution in mean sperm concentration over the past 35 years ( r = -.313, p = .0002), which, when analyzed for each geographical region, identified a significant decline in North America, Europe, Asia, and Africa. An increasing trend of sperm concentration was identified only in Australia. The association of male age with such a trend ( R2 = .979) is reported. The authors also correlated male fertility with sperm concentration. Thus, this comprehensive, evidence-based literature review aims to concisely and systematically present the available data on sperm concentration from 1980 to 2015, as well as to statistically analyze the same and correlate male health with the declining pattern of sperm count in a single scientific review to serve the scientific research zone related to reproductive health. It points to the threat of male infertility in times ahead.

Sperm quality in New Zealand: Is the downward trend continuing?

AIM: To investigate whether the decline in sperm concentration in New Zealand sperm donors observed from 1987 to 2007 continued in the period 2008-2014. METHOD: A retrospective study from 2008 to 2014. The first semen sample of 285 men presenting as sperm donors in Auckland and Wellington was analysed for sperm concentration, seminal fluid volume and the percentage of motile sperm. These results were compared to results from 1987 to 2007 from the same clinics. RESULTS: The decline in semen volume and sperm concentration observed between 1987 and 2007 did not continue in 2008-2014. Sperm concentration decreased from 1987 until some time between 1997 and 2001, and has remained stable at an average of 62x106/ml between 2001 and 2014. Sperm motility declined significantly (8%) in the period 2008-2014, but there was no significant change over the total period studied, between 1987 and 2014. CONCLUSION: After a decline between 1987 and sometime during 1997-2001, the sperm concentration in men presenting as donors remained unchanged between 2002 and 2014, suggesting semen quality has not changed in New Zealand men over the last decade.

Infertility as a proxy of general male health: results of a cross-sectional survey.

OBJECTIVE: To evaluate the prevalence, and clinical and seminal impact of comorbidities in white European men presenting for couple infertility. DESIGN: Cross-sectional study. SETTING: Academic reproductive medicine outpatient clinic. PATIENT(S): Cohort of 2,100 consecutive infertile men (noninterracial infertile couples). INTERVENTION(S): Obtaining complete demographic, clinical, and laboratory data from 2,100 consecutive infertile men with health-significant comorbidities scored via the Charlson comorbidity index (CCI; categorized 0 vs. 1 vs. ≥2) and semen analysis values assessed based on 2010 World Health Organization reference criteria. MAIN OUTCOME MEASURE(S): Assessment of the rate of comorbidities by means of CCI scores and possible associations between CCI, semen and hormonal parameters. RESULT(S): Descriptive statistics and regression models tested the associations among semen parameters, clinical characteristics, and CCI. When assessing general comorbidity prevalence, CCI 0, CCI 1, and CCI ≥2 was found in 1,921 (91.5%), 102 (4.9%), and 77 (3.6%) patients, respectively. Patient age and follicle-stimulating hormone levels increased as the general health status decreased. Conversely, the total testosterone levels and sperm concentration decreased as CCI scores increased. A higher rate of oligozoospermia and nonobstructive azoospermia was observed in patients with CCI ≥1. No differences were observed among the considered comorbidity groups in terms of testicular volume or further hormonal or seminal parameters. Both continuously coded and categorized sperm concentrations were independent predictors of CCI ≥1. Patients with sperm concentration <45.6 million/mL (most informative cutoff value) had a 2.74-fold increased risk of having a CCI ≥1. CONCLUSION(S): Decreased general health status appears to be associated with impaired male reproductive health, including lower sperm concentration, lower total testosterone levels, and higher follicle-stimulating hormone values.

Intestinal Ischaemia-Reperfusion Injury and Semen Characteristics in West African Dwarf Bucks.

Increasing production of goats takes their reproductive potential and fertility, into consideration. Gastrointestinal obstructive lesions can set up an intestinal ischaemia-reperfusion. Testicular torsion is an established cause of testicular damage and infertility and is a form of ischaemia-reperfusion injury. This study investigates the effect of intestinal ischaemia-reperfusion (IIR) injury on semen characteristics in WAD bucks. Six healthy adult male WAD goats were divided into two groups of three, a control and IIR group, one hour ischaemia and two hours of reperfusion were achieved in the intestinal ischaemia-reperfusion (IIR) group after all goats underwent a laparotomy. Semen collection was done using the electro-ejaculator method pre-operatively and weekly for four weeks post-operatively. The semen concentration, percentage of normal sperm cells, abnormal sperm cells and percentage abnormality were evaluated. In control animals, there was an increase in semen concentration postoperatively followed by a decrease whereas in IIR animals, a decrease was observed postoperatively till the 4th week. Total normal sperm cells decreased postoperatively and then increased to preoperative levels whereas a decrease was seen in IIR animals till the 3rd postoperative week. Abnormalities in sperm cells, normal head without tail, normal tail without head, bent mid-piece, curved mid-piece and rudimentary tail were all increased by the 4th week in IIR group though the total number of abnormal cells was observed to have decreased. The main effect of intestinal ischaemic-reperfusion injury on the semen characteristics of WAD goats is an increase in abnormalities with an adequate quantity of semen. Many of the abnormalities involved midpiece and tail abnormalities which are very vital to propulsion and may cause an inability of the sperm cells to fertilize. This hitherto silent phenomenon in farm animals may be the reason for iatrogenic causes of infertility.

Efecto de la cámara de recuento utilizada sobre los parámetros espermáticos, analizados con el ISASv1® / Effect of counting chamber on seminal parameters, analyzing with the ISASv1®

Introducción: El uso de las cámaras de recuento condiciona los valores de concentración y movilidad espermática debido a su tipo de carga (capilaridad o desplazamiento de la gota) y a la altura que presenten. Recientemente, se han introducido nuevas cámaras, tanto desechables (ISAS®D4C) como reusables (Spermtrack®) con diversas alturas en cada caso. Objetivo: El objetivo del presente trabajo es validar su uso, analizando diversos parámetros espermáticos con un sistema CASA, el ISASv1®. Material y método: Se analizaron muestras de donantes voluntarios (10 para las desechables y 5 para las reusables), analizando el efecto del tipo de cámara, de la altura, del tiempo de carga y del tiempo de análisis. Resultados: Los resultados obtenidos no mostraron diferencias significativas con el tiempo de carga para las cámaras reusables ni con el tiempo de análisis en ninguna de las cámaras. Discusión: La cámara reusable de 10 μm y las desechables de 10, 16 y 20 μm no mostraron diferencias entre sí, mientras que la reusable de 20 μm presentó resultados significativamente diferentes con respecto a las demás, por lo que su uso (siguiendo la recomendación de la Organización Mundial de la Salud) debe hacerse teniendo en cuenta este hecho. Conclusión: Las nuevas cámaras ofrecen un resultado muy homogéneo, con independencia del tiempo de carga o de análisis (AU)

Introduction: The use of counting chambers conditions the sperm concentration and motility values by their type of filling (capillary or drop displacement) and chamber height. We have recently introduced new chambers, both disposable (ISAS®D4C) and reusable (Spermtrack®), with different heights in each case. Objective: This study has aimed to validate its use by analyzing different sperm parameters with a CASA system, that is, the ISASv1®. Material and method: Samples from volunteer donors (10 for the disposable and 5 for reusable), analyzing the effect of chamber type, height, filling and analysis time, were used. Results: The results obtained showed no differences within the filling time for the reusable chambers, or the analysis time in any cases. Discussion: The 10 microns reusable chamber and disposable, 10, 16 and 20 microns showed no differences between them. However, the reusable 20 microns showed significantly different results, so its use (as recommended by WHO) should be taking this into account. Conclusion: The new chambers offer very consistent results, independent of filling or time of analysis (AU)