Safety evaluation of single-sperm cryopreservation technique applied in intracytoplasmic sperm injection.

Intracytoplasmic sperm injection (ICSI) is a technique that directly injects a single sperm into the cytoplasm of mature oocytes. Here, we explored the safety of single-sperm cryopreservation applied in ICSI. This retrospective study enrolled 186 couples undergoing ICSI-assisted pregnancy. Subjects were allocated to the fresh sperm (group A)/single-sperm cryopreservation (group B) groups based on sperm type, with their clinical baseline/pathological data documented. We used ICSI-compliant sperm for subsequent in vitro fertilization and followed up on all subjects. The recovery rate/cryosurvival rate/sperm motility of both groups, the pregnancy/outcome of women receiving embryo transfer, and the delivery mode/neonatal-related information of women with successful deliveries were recorded. The clinical pregnancy rate, cumulative clinical pregnancy rate, abortion rate, ectopic pregnancy rate, premature delivery rate, live birth delivery rate, neonatal birth defect rate, and average birth weight were analyzed. The two groups showed no significant differences in age, body mass index, ovulation induction regimen, sex hormone [anti-Müllerian hormone (AMH)/follicle-stimulating hormone (FSH)/luteinizing hormone (LH)] levels, or oocyte retrieval cycles. The sperm recovery rate (51.72%-100.00%) and resuscitation rate (62.09% ± 16.67%) in group B were higher; the sperm motility in the two groups demonstrated no significant difference and met the ICSI requirements. Group B exhibited an increased fertilization rate, decreased abortion rate, and increased safety versus group A. Compared with fresh sperm, the application of single-sperm cryopreservation in ICSI sensibly improved the fertilization rate and reduced the abortion rate, showing higher safety.

A Case Study Based on the Effect of Phytoestrogen on an Oligozoospermic Patient.

We presented a 30-year-old man suffering from severe oligozoospermia caused by substantial sperm maturation arrest around the spermatid stage. Additionally, he was suffering from a varicocele. For three years, the couple had been trying to conceive. The clinical and endocrinological evaluation of the woman revealed that she was medically fit to undergo pregnancy. We performed laparoscopic ligation of the spermatic vein to treat the varicocele. Semen analysis was conducted at the beginning of the clinical pregnancy journey and after three and six months of treatment, which included 80 mg/day of phytoestrogens for six months. Six months following the end of the therapy, a second semen analysis was carried out. The inherent characteristics of the semen substantially improved in the third month, facilitating the implementation of the reproductive method referred to as intrauterine insemination. Following this treatment, the patient delivered a healthy baby weighing 3300 g. Sperm parameters improved substantially after three months of therapy; however, they reverted to baseline values during the wash-out period. These promising findings strongly suggest that phytoestrogens could be utilized for therapeutic purposes in the management of oligozoospermia. To further demonstrate the potential impact of phytoestrogens on male infertility, it is imperative to conduct a validation phase and randomized controlled trials.

M1AP interacts with the mammalian ZZS complex and promotes male meiotic recombination.

Following meiotic recombination, each pair of homologous chromosomes acquires at least one crossover, which ensures accurate chromosome segregation and allows reciprocal exchange of genetic information. Recombination failure often leads to meiotic arrest, impairing fertility, but the molecular basis of recombination remains elusive. Here, we report a homozygous M1AP splicing mutation (c.1074 + 2T > C) in patients with severe oligozoospermia owing to meiotic metaphase I arrest. The mutation abolishes M1AP foci on the chromosome axes, resulting in decreased recombination intermediates and crossovers in male mouse models. M1AP interacts with the mammalian ZZS (an acronym for yeast proteins Zip2-Zip4-Spo16) complex components, SHOC1, TEX11, and SPO16. M1AP localizes to chromosomal axes in a SPO16-dependent manner and colocalizes with TEX11. Ablation of M1AP does not alter SHOC1 localization but reduces the recruitment of TEX11 to recombination intermediates. M1AP shows cytoplasmic localization in fetal oocytes and is dispensable for fertility and crossover formation in female mice. Our study provides the first evidence that M1AP acts as a copartner of the ZZS complex to promote crossover formation and meiotic progression in males.

Investigation of the genetic etiology in male infertility with apparently balanced chromosomal structural rearrangements by genome sequencing.

Apparently balanced chromosomal structural rearrangements are known to cause male infertility and account for approximately 1% of azoospermia or severe oligospermia. However, the underlying mechanisms of pathogenesis and etiologies are still largely unknown. Herein, we investigated apparently balanced interchromosomal structural rearrangements in six cases with azoospermia/severe oligospermia to comprehensively identify and delineate cryptic structural rearrangements and the related copy number variants. In addition, high read-depth genome sequencing (GS) (30-fold) was performed to investigate point mutations causative of male infertility. Mate-pair GS (4-fold) revealed additional structural rearrangements and/or copy number changes in 5 of 6 cases and detected a total of 48 rearrangements. Overall, the breakpoints caused truncations of 30 RefSeq genes, five of which were associated with spermatogenesis. Furthermore, the breakpoints disrupted 43 topological-associated domains. Direct disruptions or potential dysregulations of genes, which play potential roles in male germ cell development, apoptosis, and spermatogenesis, were found in all cases (n = 6). In addition, high read-depth GS detected dual molecular findings in case MI6, involving a complex rearrangement and two point mutations in the gene DNAH1. Overall, our study provided the molecular characteristics of apparently balanced interchromosomal structural rearrangements in patients with male infertility. We demonstrated the complexity of chromosomal structural rearrangements, potential gene disruptions/dysregulation and single-gene mutations could be the contributing mechanisms underlie male infertility.

Investigation of the genetic etiology in male infertility with apparently balanced chromosomal structural rearrangements by genome sequencing / 亚洲男科学杂志(英文版)

Apparently balanced chromosomal structural rearrangements are known to cause male infertility and account for approximately 1% of azoospermia or severe oligospermia. However, the underlying mechanisms of pathogenesis and etiologies are still largely unknown. Herein, we investigated apparently balanced interchromosomal structural rearrangements in six cases with azoospermia/severe oligospermia to comprehensively identify and delineate cryptic structural rearrangements and the related copy number variants. In addition, high read-depth genome sequencing (GS) (30-fold) was performed to investigate point mutations causative of male infertility. Mate-pair GS (4-fold) revealed additional structural rearrangements and/or copy number changes in 5 of 6 cases and detected a total of 48 rearrangements. Overall, the breakpoints caused truncations of 30 RefSeq genes, five of which were associated with spermatogenesis. Furthermore, the breakpoints disrupted 43 topological-associated domains. Direct disruptions or potential dysregulations of genes, which play potential roles in male germ cell development, apoptosis, and spermatogenesis, were found in all cases (n = 6). In addition, high read-depth GS detected dual molecular findings in case MI6, involving a complex rearrangement and two point mutations in the gene DNAH1. Overall, our study provided the molecular characteristics of apparently balanced interchromosomal structural rearrangements in patients with male infertility. We demonstrated the complexity of chromosomal structural rearrangements, potential gene disruptions/dysregulation and single-gene mutations could be the contributing mechanisms underlie male infertility.

Effect and in silico characterization of genetic variants associated with severe spermatogenic disorders in a large Iberian cohort.

BACKGROUND: Severe spermatogenic failure (SpF) represents the most extreme manifestation of male infertility, as it decreases drastically the semen quality leading to either severe oligospermia (SO, <5 million spermatozoa/mL semen) or non-obstructive azoospermia (NOA, complete lack of spermatozoa in the ejaculate without obstructive causes). OBJECTIVES: The main objective of the present study is to analyze in the Iberian population the effect of 6 single-nucleotide polymorphisms (SNPs) previously associated with NOA in Han Chinese through genome-wide association studies (GWAS) and to establish their possible functional relevance in the development of specific SpF patterns. MATERIALS AND METHODS: We genotyped 674 Iberian infertile men (including 480 NOA and 194 SO patients) and 1058 matched unaffected controls for the GWAS-associated variants PRMT6-rs12097821, PEX10-rs2477686, CDC42BPA-rs3000811, IL17A-rs13206743, ABLIM1-rs7099208, and SOX5-rs10842262. Their association with SpF, SO, NOA, and different NOA phenotypes was evaluated by logistic regression models, and their functional relevance was defined by comprehensive interrogation of public resources. RESULTS: ABLIM1-rs7099208 was associated with SpF under both additive (OR = 0.86, p = 0.036) and dominant models (OR = 0.78, p = 0.026). The CDC42BPA-rs3000811 minor allele frequency was significantly increased in the subgroup of NOA patients showing maturation arrest (MA) of germ cells compared to the remaining NOA cases under the recessive model (OR = 4.45, p = 0.044). The PEX10-rs2477686 SNP was associated with a negative testicular sperm extraction (TESE) outcome under the additive model (OR = 1.32, p = 0.034). The analysis of functional annotations suggested that these variants affect the testis-specific expression of nearby genes and that lincRNA may play a role in SpF. CONCLUSIONS: Our data support the association of three previously reported NOA risk variants in Asians (ABLIM1-rs7099208, CDC42BPA-rs3000811, and PEX10-rs2477686) with different manifestations of SpF in Iberians of European descent, likely by influencing gene expression and lincRNA deregulation.

Evaluation of Male Fertility-Associated Loci in a European Population of Patients with Severe Spermatogenic Impairment.

Infertility is a growing concern in developed societies. Two extreme phenotypes of male infertility are non-obstructive azoospermia (NOA) and severe oligospermia (SO), which are characterized by severe spermatogenic failure (SpF). We designed a genetic association study comprising 725 Iberian infertile men as a consequence of SpF and 1058 unaffected controls to evaluate whether five single-nucleotide polymorphisms (SNPs), previously associated with reduced fertility in Hutterites, are also involved in the genetic susceptibility to idiopathic SpF and specific clinical entities. A significant difference in the allele frequencies of USP8-rs7174015 was observed under the recessive model between the NOA group and both the control group (p = 0.0226, OR = 1.33) and the SO group (p = 0.0048, OR = 1.78). Other genetic associations for EPSTI1-rs12870438 and PSAT1-rs7867029 with SO and between TUSC1-rs10966811 and testicular sperm extraction (TESE) success in the context of NOA were observed. In silico analysis of functional annotations demonstrated cis-eQTL effects of such SNPs likely due to the modification of binding motif sites for relevant transcription factors of the spermatogenic process. The findings reported here shed light on the molecular mechanisms leading to severe phenotypes of idiopathic male infertility, and may help to better understand the contribution of the common genetic variation to the development of these conditions.

[Compound Amino Acid Capsules combined with clomiphene for severe oligospermia].

OBJECTIVE: To study the effect of Compound Amino Acid Capsules (CAAC) combined with clomiphene in the treatment of severe oligospermia. METHODS: A total of 104 patients with severe oligospermia admitted to our Center of Reproductive Medicine from January to September 2018 were randomly assigned to a trial (n = 60) and a control group (n = 44), the former treated by oral administration of CAAC combined with clomiphene and the latter with clomiphene only, both for 12 weeks. Comparisons were made between the two groups of patients in the sperm concentration, and the percentages of progressively motile sperm (PMS) and total motile sperm (TMS) before and after 4, 8 and 12 weeks of medication as well as the pregnancy rate during the treatment. RESULTS: Compared with the baseline, the trial group showed significant elevation at 4, 8 and 12 weeks in sperm concentration (ï¼»3.13 ± 1.29ï¼½ vs ï¼»12.06 ± 2.24ï¼½, ï¼»22.10 ± 2.65ï¼½ and ï¼»28.13 ± 3.59ï¼½ ×106/ml, P < 0.01), PMS (ï¼»14.03 ± 2.49ï¼½% vs ï¼»21.05 ± 3.14ï¼½%, ï¼»29.08 ± 4.70ï¼½% and ï¼»35.08 ± 3.70ï¼½%, P < 0.01) and TMS (ï¼»20.10 ± 4.05ï¼½% vs ï¼»27.10 + 4.87ï¼½%, ï¼»36.09 ± 5.64ï¼½% and ï¼»45.04 ± 6.69ï¼½%, P < 0.01), and so did the control group in sperm concentration (ï¼»3.27 ± 1.46ï¼½ vs ï¼»10.21 ± 2.35ï¼½, ï¼»19.89 ± 2.74ï¼½ and ï¼»25.23 ± 3.69ï¼½ ×106/ml, P < 0.01), PMS (ï¼»13.32 ± 3.12ï¼½% vs ï¼»17.02 ± 3.26ï¼½%, ï¼»22.13 ± 3.70ï¼½% and ï¼»27.18 ± 2.54ï¼½%, P < 0.01) and TMS (ï¼»21.30 ± 4.87ï¼½% vs ï¼»24.22 ± 5.07ï¼½%, ï¼»30.03 ± 5.33ï¼½% and ï¼»35.05 ± 5.69ï¼½%, P < 0.01), even more significant in the trial than in the control group at the three time points after medication (P < 0.01). The pregnancy rate was markedly higher in the former than in the latter group at 4 (1.72% vs 0.53%, P < 0.01), 8 (4.21% vs 2.87%, P < 0.01) and 12 weeks (8.32% vs 6.32%, P < 0.01). No adverse reactions were observed in neither of the two groups during the treatment. CONCLUSIONS: CAAC combined with clomiphene can significantly improve the semen parameters of the patients with severe oligospermia, with no obvious adverse events.