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Sperm Retrieval (sperm + retrieval)
Selected AbstractsComparison of the outcome of intracytoplasmic sperm injection in obstructive and non-obstructive azoospermia in the first cycle: a report of case series and meta-analysisINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 1 2005MOHAMED GHANEM Summary To investigate the outcome of intracytoplasmic sperm injection with fresh and cryopreserved-thawed testicular spermatozoa in the first cycle in patients with obstructive azoospermia (OA) and non-obstructive azoospermia (NOA), a total of 90 cases, 48 OA and 42 NOA were studied. All patients underwent sperm retrieval by testicular sperm extraction (TESE) while their wives received conventional ovarian hyperstimulation. The hormone levels, testicular histology, the rates of sperm retrieval, fertilization, implantation and pregnancy were analysed and evaluated. This study and other four similar studies were subjected to meta-analysis. Sperm retrieval was successful in 100% OA and 61% NOA. Fresh spermatozoa were used in 87.5% and 92.4% of OA and NOA cases respectively; while cryopreserved-thawed spermatozoa were used in 12.5% and 7.6% of OA and NOA, respectively. The fertilization, implantation and clinical pregnancy rates were 65.5%, 15% and 25% respectively in OA group, and 54.2%, 5% and 23.1% respectively in NOA group. Sperm status (fresh or thawed), male partner's age, female age and male serum follicle-stimulating hormone had no significant effect upon fertilization rate, implantation rate, or pregnancy rate per embryo transfer. The results of meta-analysis indicate that there is no statistically significant difference in clinical pregnancy rates between the two groups. There was a significantly higher fertilization rate among OA patients in all analysed studies (95% CI = 14.29,15.71, d.f. 832, T = 1.96). In conclusion, although the fertilization rate was significantly higher in the OA group in our study and from the given meta-analysis, there were some differences as regards pregnancy rates. Although the overall effect was more or less similar pregnancy rates in both subtypes of azoospermia, this may not be true if non-male infertility variables were controlled for in all studies. [source] Clinical analysis of patients with azoospermia factor deletions by microdissection testicular sperm extractionINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 2 2004Akira Tsujimura Summary Microdeletions of the azoospermia factor (AZF) locus on the Y chromosome have been implicated as a major genetic component of idiopathic male infertility, and the incidence of AZF deletions has been reported to be 15,20% in men with non-obstructive azoospermia (NOA). Numerous studies have described AZF deletion rates in patients with azoospermia; however, a clinical comparison of azoospermic patients with AZF deletion and those with no deletion has not been reported well. A new technique for testicular sperm extraction, microdissection testicular sperm extraction (TESE), has been used widely on NOA patients. Although testicular spermatozoa are reliably detected and retrieved from NOA patients by microdissection TESE, sperm retrieval rates for patients with AZF deletions are not well known. Therefore, characteristics of NOA patients with AZF deletion were investigated. Six of 60 patients (10%) who underwent microdissection TESE were found to have AZF deletions by genomic polymerase chain reaction. Testicular data, outcome of sperm retrieval and endocrinological profiles, were compared between patients with AZF deletions (n = 6) and those with no deletions (n = 54). Testicular size, varicocele rates and testicular histology were similar between the groups. Significant differences were not detected in the endocrinological profiles. Sperm retrieval rates were not significantly different between the groups. In conclusion, AZF deletions do not appear to confer specific characteristics to NOA patients. [source] Penile vibratory stimulation and electroejaculation in the treatment of ejaculatory dysfunction,INTERNATIONAL JOURNAL OF ANDROLOGY, Issue 6 2002JENS SØNKSEN Summary The purpose of this review is to present the current understanding of penile vibratory stimulation (PVS) and electroejaculation (EEJ) procedures and its clinical use in men with ejaculatory dysfunction. Unfortunately, the record of treating such individuals has been quite poor, but within recent years development and refinement of PVS and EEJ in men with spinal cord injury (SCI) has significantly enhanced the prospects for treatment of ejaculatory dysfunction. The majority of spinal cord injured men are not able to produce antegrade ejaculation by masturbation or sexual stimulation. However, approximately 80% of all spinal cord injured men with an intact ejaculatory reflex arc (above T10) can obtain antegrade ejaculation with PVS. Electroejaculation may be successful in obtaining ejaculate from men with all types of SCI, including men who do not have major components of the ejaculatory reflex arc. Because vibratory stimulation is very simple in use, non-invasive, it does not require anaesthesia and is preferred by the patients when compared with EEJ, PVS is recommended to be the first choice of treatment in spinal cord injured men. Furthermore, EEJ has been successfully used to induce ejaculation in men with multiple sclerosis and diabetic neuropathy. Any other conditions which affect the ejaculatory mechanism of the central and/or peripheral nervous system including surgical nerve injury may be treated successfully with EEJ. Finally, for sperm retrieval and sperm cryopreservation before intensive anticancer therapy in pubertal boys, PVS and EEJ have been successfully performed in patients who failed to obtain ejaculation by masturbation. Nearly all data concerning semen characteristics in men with ejaculatory dysfuntion originate from spinal cord injured men. Semen analyses demonstrate low sperm motility rates in the majority of spinal cord injured men. The data give evidence of a decline in spermatogenesis and motility of ejaculated spermatozoa shortly after (few weeks) an acute SCI. Furthermore, it is suggested that some factors in the seminal plasma and/or disordered storage of spermatozoa in the seminal vesicles are mainly responsible for the impaired semen profiles in men with chronic SCI. Home insemination with semen obtained by penile vibratory and introduced intravaginally in order to achieve successful pregnancies may be an option for some spinal cord injured men and their partners. The majority of men will further enhance their fertility potential when using either penile vibratory or EEJ combined with assisted reproduction techniques such as intrauterine insemination or in-vitro fertilization with or without intracytoplasmic sperm injection. [source] Erectile function and male reproduction in men with spinal cord injury: a reviewANDROLOGIA, Issue 3 2010F. Dimitriadis Summary Spinal cord injury (SCI) in men results in defects in erectile function, ejaculatory process and male reproductive potential. There are alterations in the capacity of men with SCI to achieve reflexogenic, psychogenic and nocturnal erections. The sexual function in different stages after SCI and the types of erections depend mainly on the completeness of the injury and the level of neurological damage. Furthermore, most of the SCI men demonstrate defects concerning the entrance of semen into the posterior urethra and the expulsion of the semen through the penile urethra and the urethral orifice. In addition, SCI men develop defects in the secretory function of the Leydig cells, Sertoli cells and the male accessory genital glands. The overall result is a decreased quality of the semen is recovered either with penile vibratory stimulation (PVS) or with electroejaculation. Nowadays the therapeutic andrological approach of SCI men focuses on achievement of erectile function, recovery of spermatozoa and assisted reproductive technology. The first line of therapy recommended for infertility in SCI men is collection of semen via PVS with concomitant evaluation of total motile sperm yields for assisted conception which may include intravaginal insemination, intrauterine insemination, or in vitro fertilisation/intracytoplasmic sperm injection. Patients failing PVS may be referred for electroejaculation or surgical sperm retrieval. [source] Age as only predictive factor for successful sperm recovery in patients with Klinefelter's syndromeANDROLOGIA, Issue 2 2009K. Ferhi Summary The study was performed to determine factors affecting successful sperm retrieval by testicular sperm extraction in patients with nonmosaic Klinefelter's syndrome (KS). From May 2001 to February 2007, 27 azoospermic patients were diagnosed as having nonmosaic KS. All patients underwent sperm testicular extraction. Patient's age, testicular volume, serum follicle-stimulating hormone (FSH) and inhibin B were assessed as predictive factors for successful sperm recovery. Of the 27 Klinefelter's patients examined, eight (29.6%) had successful sperm recovery. The comparisons of serum FSH, inhibin B and testicular volume between patients with and without successful sperm retrieval did not show any statistical significance. The patients with successful sperm recovery were significantly younger (28.6 ± 3.11 years) than those with failed attempts (33.9 ± 4.5 years, P = 0.002). The rate of positive sperm retrieval was significantly higher in patients younger than 32 years compared with patients older than 32 years (P = 0.01, chi-squared test). The study showed that clinical parameters such as FSH, inhibin B and testicular volume do not have predictive value for sperm recovery in patients with KS. The mean age of our patients with successful sperm recovery was significantly lower than that of men with unsuccessful results. Testicular sperm extraction or testicular sperm aspiration should be performed before the critical age of 32 years. [source] Morphological and morphometric attributes of epididymal and testicular spermatozoa following surgical sperm retrieval for obstructive and nonobstructive azoospermiaANDROLOGIA, Issue 6 2003Dr. S. Wood Summary. Whilst the morphological (shape) and morphometric (sperm head size) attributes of ejaculated spermatozoa have been well studied, the morphological and morphometric qualities of testicular and epididymal spermatozoa retrieved from males with obstructive and nonobstructive azoospermia is much less documented. We wished to examine the effect of aetiology of azoospermia and site of retrieval on the attributes of retrieved spermatozoa. This was a prospective observational study of 30 consecutive successful sperm retrievals, six for nonobstructive azoospermia and 24 for obstructive, of which five were retrieved from the epididymis and the remainder from the testis. The proportion of morphologically normal testicular spermatozoa in patients with obstructive and nonobstructive azoospermia was not significantly different (7% versus 7.6%, P = 0.97). Testicular spermatozoa from males with obstructive azoospermia showed an increase in frequency of sperm with small heads [47/180 (26%) versus 97/909 (11%), P = 0.036] as well as small acrosome and increasing vacuole formation over nonobstructive spermatozoa. Similarly, there was a significant increase in tail deformities and decreases in tail lengths in sperm from males with nonobstructive azoospermia. Epididymal spermatozoa showed significantly greater proportion of morphologically normal spermatozoa than testicular (20% versus 13%, P = 0.001) as well as a significant increase in acrosome vacuoles. Furthermore, morphometrically epididymal spermatozoa displayed with smaller head length, width and area than testicular spermatozoa. Testicular spermatozoa from obstructive azoospermia displayed significantly less tail defects (35% versus 57%, P = 0.003) as well as significantly longer tail lengths (30.6 ,m versus 10.7 ,m). These morphological and morphometric differences between epididymal and testicular and obstructive and nonobstructive spermatozoa may represent part of the natural maturation process. There were no associations between any morphological or morphometric abnormality with any significant parameter in subsequent use in ICSI. [source] Possible predictive factors for ICSI?ANDROLOGIA, Issue 4 2003Molecular biology techniques in combination with therapeutic testicular biopsies Summary. Applying intracytoplasmic sperm injection (ICSI), the selection of an unsuccessful spermatozoon results in great emotional consequences for the couple. Therefore, there is a need for a prognostic parameter to estimate their chances for successful fertility treatment. This review summarizes both the main reasons for spermatogenic impairment, and possible predictive factors for successful sperm retrieval applying testicular sperm extraction and outcome of ICSI. While basic sperm parameters, aetiology and type of spermatozoa, and serum follicle-stimulating hormone and inhibin levels have been shown to be unrelated to the outcome of ICSI, Y-chromosome microdeletions are known to have a negative influence on the fertilizing capacity of spermatozoa. Recently, a significant correlation has been reported between the protamine-1 to protamine-2 mRNA ratio in haploid spermatids of testicular biopsies and the ability of spermatozoa for successful fertilization of an oocyte. In future, both the outstanding role of the haploid spermatids and the involvement of molecular biological techniques will improve the role of therapeutic testicular biopsies. [source] Morphological and morphometric attributes of epididymal and testicular spermatozoa following surgical sperm retrieval for obstructive and nonobstructive azoospermiaANDROLOGIA, Issue 6 2003Dr. S. Wood Summary. Whilst the morphological (shape) and morphometric (sperm head size) attributes of ejaculated spermatozoa have been well studied, the morphological and morphometric qualities of testicular and epididymal spermatozoa retrieved from males with obstructive and nonobstructive azoospermia is much less documented. We wished to examine the effect of aetiology of azoospermia and site of retrieval on the attributes of retrieved spermatozoa. This was a prospective observational study of 30 consecutive successful sperm retrievals, six for nonobstructive azoospermia and 24 for obstructive, of which five were retrieved from the epididymis and the remainder from the testis. The proportion of morphologically normal testicular spermatozoa in patients with obstructive and nonobstructive azoospermia was not significantly different (7% versus 7.6%, P = 0.97). Testicular spermatozoa from males with obstructive azoospermia showed an increase in frequency of sperm with small heads [47/180 (26%) versus 97/909 (11%), P = 0.036] as well as small acrosome and increasing vacuole formation over nonobstructive spermatozoa. Similarly, there was a significant increase in tail deformities and decreases in tail lengths in sperm from males with nonobstructive azoospermia. Epididymal spermatozoa showed significantly greater proportion of morphologically normal spermatozoa than testicular (20% versus 13%, P = 0.001) as well as a significant increase in acrosome vacuoles. Furthermore, morphometrically epididymal spermatozoa displayed with smaller head length, width and area than testicular spermatozoa. Testicular spermatozoa from obstructive azoospermia displayed significantly less tail defects (35% versus 57%, P = 0.003) as well as significantly longer tail lengths (30.6 ,m versus 10.7 ,m). These morphological and morphometric differences between epididymal and testicular and obstructive and nonobstructive spermatozoa may represent part of the natural maturation process. There were no associations between any morphological or morphometric abnormality with any significant parameter in subsequent use in ICSI. [source] | ||||||||||