Male Infertility Diagnosis and Treatment in the Era of In Vitro Fertilization and Intracytoplasmic Sperm Injection

Pan, Michael; Hockenberry, Mark; Kirby, E. Will; Lipshultz, Larry I.

doi:10.1016/j.mcna.2017.10.008

Cited by 58 publications

(40 citation statements)

References 36 publications

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“…Each year, approximately 15-20% of couples suffer from the inability to have child. Based on recent data, we can estimate that a male factor (coexisting with a female factor) contributes to half of these issues, and approximately 30% of these cases are related to isolated male factor [1,2]. Furthermore, male factors may be responsible for fertilization and embryo development failure, increases in the risk of idiopathic recurrent miscarriages and autosomal dominant diseases and neurobehavioural disorders in offspring, especially when the paternal age is taken into consideration [3,4].…”

Section: Introductionmentioning

confidence: 99%

The higher risk for sperm DNA damage in infertile men

et al. 2019

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Objectives: Supplementary assays are needed for determination of relationships between sperm biomarkers and fertility potential. Therefore, our research was designed to determine the extent of sperm DNA fragmentation (SDF) and establish a discriminating threshold of SDF for fertility potential. Material and methods: Semen characteristics were evaluated according to World Health Organization recommendations, and SDF was assessed by sperm chromatin dispersion test on ejaculated spermatozoa from infertile and healthy normozoospermic men. Results: A higher proportion of SDF was noted in infertile men (median 23.00%) than normozoospermic (median 14.00%). Significantly less subjects (17.03%) with low SDF level (≤ 15%) and more (35.17%) with high SDF level (> 30%) were found for the infertile group vs the normooospermic (57.90% and 5.26%, respectively). Infertile group had significantly lower odds ratio (OR) for having a low SDF level (OR: 0.1493) and higher OR for having a high SDF level (OR: 9.7627). Receiver operating characteristic analysis [area under curve (AUC) = 0.785] revealed that 20% SDF is predictive value for discriminating between infertile and normozoospermic subjects. SDF was negatively correlated with the sperm number, morphology, progressive motility and vitality but positively with the teratozoospermia index. Conclusions: Our study demonstrates: (1) a significant difference in the extent of SDF and in the risk for having damaged sperm DNA between infertile and normozoospermic men, (2) > 20% SDF has negative predictive value for fertility potential, (3) coexistence of abnormal standard sperm parameters with sperm chromatin damages. Therefore, SDF should be considered as a highly valuable indicator of male fertility potential.

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Section: Introductionmentioning

confidence: 99%

The higher risk for sperm DNA damage in infertile men

et al. 2019

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“…These analyses, based on measurements of sperm concentration, motility and morphology, are difficult to standardise among different laboratories (Pacey, ), and thus, thresholds have been agreed by WHO (). Unfortunately, many men with results within “acceptable limits” remain diagnosed as idiopathically infertile even when using ART, that is no clear cause of the infertility has been found in either the women or the man (Pan, Hockenberry, Kirby, & Lipshultz, ). This indicates that sperm dysfunction is not fully diagnosed by the WHO‐recommended methods, which are unable to determine neither the potential fertilising capacity nor provide prognosis of the (in)‐fertility potential of the couple (Agarwal, Cho, & Esteves, ; Lewis et al, ).…”

Section: Introductionmentioning

confidence: 99%

Diagnostics of DNA fragmentation in human spermatozoa: Are sperm chromatin structure analysis and sperm chromatin dispersion tests (SCD‐HaloSpermG2 ^® ) comparable?

et al. 2019

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Men affected with idiopathic infertility often display basic spermiogramme values similar to fertile individuals, questioning the diagnostic impact of the World Health Organization (WHO) thresholds used. This study explored sperm DNA fragmentation in single ejaculates from 14 fertile donors and 42 patients with idiopathic infertility providing semen for assisted reproductive techniques in a university fertility clinic. Each ejaculate was simultaneously studied for sperm DNA fragmentation by the flow cytometer‐based sperm chromatin structure analysis (SCSA) and the new light‐microscopy‐based sperm chromatin dispersion assay (SCD‐HaloSpermG2®), before and after sperm selection for in vitro fertilisation with a colloid discontinuous gradient. The WHO semen variables did not differ between groups, but DNA fragmentation after SCSA (DFI) or SCD (SDF) was significantly (p < 0.05) higher in patients (DFI: 40.2% ± 3.0 vs. SDF: 40.3% ± 1.4) than in fertile donors (DFI: 17.1% ± 2.1 vs. SDF: 20.9% ± 2.5). Sperm selection led to lower proportions of DNA‐fragmented spermatozoa (DFI: 11.9 ± 1.7 vs. SCD: 10.0 ± 0.9, p < 0.05). The techniques output correlated highly and significantly (r2 = 0.82). DNA fragmentation is confirmed as a relevant variable for scrutinising patients with idiopathic infertility, beyond the evidently insufficient WHO semen analyses. Since both techniques yielded similar results, the reduced necessity of complex equipment when running SCD ought to be considered for a clinical setting.

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“…Male subfertility is a significant factor in approximately 50% of all couples experiencing a period of infertility 1 . Despite widespread concern about reported but disputed declines in semen quality and more specifically total sperm count, 2,3 few modifiable factors of semen quality have so far been identified (eg 4‐6).…”

Section: Introductionmentioning

confidence: 99%

Phytoestrogen intake and other dietary risk factors for low motile sperm count and poor sperm morphology

Povey¹,

Clyma²,

McNamee³

et al. 2020

Andrology

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Background Few potentially modifiable risk factors of male infertility have been identified, and while different diets and food groups have been associated with male infertility, evidence linking dietary factors including phytoestrogens and semen quality is limited and contradictory. Objectives To study the associations between phytoestrogen intake and other dietary factors and semen quality. Materials and Methods A case‐referent study was undertaken of the male partners, of couples attempting conception with unprotected intercourse for 12 months or more without success, recruited from 14 UK assisted reproduction clinics. A total of 1907 participants completed occupational, lifestyle and dietary questionnaires before semen quality (concentration, motility and morphology) were assessed. Food intake was estimated by a 65‐item food frequency questionnaire (FFQ) covering the 12 months prior to recruitment. Analyses of dietary risk factors for low motile sperm concentration (MSC: <4.8 × 106/mL) and poor sperm morphology (PM: <4% normal morphology) used unconditional logistic regression, accounting for clustering of subjects within the clinics, first without, and then with, adjustment for confounders associated with that outcome. Results High consumption of daidzein (≥13.74 μg/d), a phytoestrogen found in soy products, was a protective factor for MSC with an odds ratio (95%CI) of 0.58 (0.42‐0.82) after adjustment for clustering and potential confounding. Dietary risk factors for PM after similar adjustment showed that drinking whole milk (OR 0.67, 95%CI 0.47‐0.96) and eating red meat were protective with an OR 0.67 (0.46‐0.99) for eating red meat >3 times/wk. Discussion In this case‐referent study of men attending an infertility clinic for fertility diagnosis, we have identified that low MSC is inversely associated with daidzein intake. In contrast, daidzein intake was not associated with PM but eating red milk and drinking whole milk were protective. Conclusions Dietary factors associated with semen quality were identified, suggesting that male fertility might be improved by dietary changes.

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Male Infertility Diagnosis and Treatment in the Era of In Vitro Fertilization and Intracytoplasmic Sperm Injection

Cited by 58 publications

References 36 publications

The higher risk for sperm DNA damage in infertile men

The higher risk for sperm DNA damage in infertile men

Diagnostics of DNA fragmentation in human spermatozoa: Are sperm chromatin structure analysis and sperm chromatin dispersion tests (SCD‐HaloSpermG2 ^® ) comparable?

Phytoestrogen intake and other dietary risk factors for low motile sperm count and poor sperm morphology

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Male Infertility Diagnosis and Treatment in the Era of In Vitro Fertilization and Intracytoplasmic Sperm Injection

Cited by 58 publications

References 36 publications

The higher risk for sperm DNA damage in infertile men

The higher risk for sperm DNA damage in infertile men

Diagnostics of DNA fragmentation in human spermatozoa: Are sperm chromatin structure analysis and sperm chromatin dispersion tests (SCD‐HaloSpermG2 ® ) comparable?

Phytoestrogen intake and other dietary risk factors for low motile sperm count and poor sperm morphology

Contact Info

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Diagnostics of DNA fragmentation in human spermatozoa: Are sperm chromatin structure analysis and sperm chromatin dispersion tests (SCD‐HaloSpermG2 ^® ) comparable?