The contribution of a hidden male factor to unexplained infertility

Mackenna, Antonio; Barratt, Christopher L.R.; Kessopoulou, Efrossini; Cooke, I. D.

doi:10.1016/s0015-0282(16)55685-4

Cited by 32 publications

(5 citation statements)

References 22 publications

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“…There are, however, many diagnostic loopholes resulting in cases of idiopathic or poorly explained infertility. Recent evidence has suggested that an inability or decreased ability of spermatozoa to bind the zona pellucida (ZP) may be at the origin of such cases of infertility [ 12,191. The treatment of infertility therefore requires that this condition be distinguished from other causes of male infertility.…”

mentioning

confidence: 99%

Binding of Human Spermatozoa to Lectin-Coated Agarose Microbeads

Gabriel

Franken

1997

Archives of Andrology

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confidence: 99%

Binding of Human Spermatozoa to Lectin-Coated Agarose Microbeads

Gabriel

Franken

1997

Archives of Andrology

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“…Of the remaining 375 papers, 117 did not classify a definition of unexplained infertility. As a result, a total of 258 primary research papers with full text available were included …”

Section: Resultsmentioning

confidence: 99%

The definition of unexplained infertility: A systematic review

Raperport,

Desai,

Qureshi

et al. 2023

BJOG

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BackgroundThere is no consensus on tests required to either diagnose unexplained infertility or use for research inclusion criteria. This leads to heterogeneity and bias affecting meta‐analysis and best practice advice.ObjectivesThis systematic review analyses the variability of inclusion criteria applied to couples with unexplained infertility. We propose standardised criteria for use both in future research studies and clinical diagnosis.Search strategyCINAHL and MEDLINE online databases were searched up to November 2022 for all published studies recruiting couples with unexplained infertility, available in full text in the English language.Data collection and analysisData were collected in an Excel spreadsheet. Results were analysed per category and methodology or reference range.Main resultsOf 375 relevant studies, only 258 defined their inclusion criteria. The most commonly applied inclusion criteria were semen analysis, tubal patency and assessment of ovulation in 220 (85%), 232 (90%), 205 (79.5%) respectively. Only 87/220 (39.5%) studies reporting semen analysis used the World Health Organization (WHO) limits. Tubal patency was accepted if bilateral in 145/232 (62.5%) and if unilateral in 24/232 (10.3%). Ovulation was assessed using mid‐luteal serum progesterone in 115/205 (56.1%) and by a history of regular cycles in 87/205 (42.4%). Other criteria, including uterine cavity assessment and hormone profile, were applied in less than 50% of included studies.ConclusionsThis review highlights the heterogeneity among studied populations with unexplained infertility. Development and application of internationally accepted criteria will improve the quality of research and future clinical care.

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“…The presence of defective sperm-ZP binding in infertile men with normal semen parameters may be due to either a defective signal transduction pathways upstream of protein kinases A and C, or downstream disorders, structural defects, or absence of sperm receptors for ZP binding [12]. Such defects are not identified unless specialized sperm function tests are used [41].…”

Section: Fertilization Defectsmentioning

confidence: 99%

“…Irrespective of the method, the number of spermatozoa bounded to the zona is counted and results are expressed as a ratio of the number of test sperm to that of control, with less than 30 % considered abnormal [18]. These tests are clinically useful in cases of UI and low or failed fertilization after conventional IVF [12,62,68]. Level …”

Section: Assessment Of Sperm Binding Using Human Zp Assaysmentioning

confidence: 99%

“…A significant decrease in the percentage of hyperactivated sperm was observed in infertile men compared with sperm from fertile donors [63]. Moreover, computerized assessment of follicular fluid (FF)-induced HA was shown to be significantly lower in patients with UI in comparison with normal fertile men [74]. In fact, the absence of HA after the addition of FF was observed in 39 % of patients with UI.…”

Section: Assessment Of Sperm Capacitation By Hyperaticvation Motilitymentioning

confidence: 99%

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