Showing posts with label Male factor. Show all posts
Showing posts with label Male factor. Show all posts
Traps from delicious foods? Eat right and have better sperm
December 15, 2017
Do you like wearing a tight pants or putting your laptop on your thighs? These habits may affect the quality of your sperm. Besides, five types of drinks/foods may harm your reproductive system. Let’s check and keep in mind!
According to <<Epicurious>>, if the quality of your sperm is not good, it may affect your family plan. To maintain the good quality of sperm, the uptakes of following drinks/foods must be controlled.
Alcohols dehydrates the water in our bodies, and increases the risk of obesity, and reduces the mobility of sperms. We suggest not drinking alcohol more than once per week, and therefore the bodies can metabolize the alcohol. But if you have severe reproductive problem, it is better to quit alcohol.
2. Processed meat products
Bacon, ham and burger are delicious, but these processed meat products usually contain high proportion of saturated fat and hormone residues, which harm the quality of sperm. If you like meat, have the “fresh” one.
3. Sweet Drinks
Bubble milk tea or other sweet drinks contain high proportion of sugar reduce both the quantity and quality of sperm. It’s better for us to drink water.
4. High-fat dairy products
Milk, cheese and other dairy products can provide protein, calcium and other nutrients. But the high fat contained in these products may harm male’s reproductive system. Also, pesticide or hormone residues should be concerned in some dairy products.
5. Fruits with pesticide residues
Some of the fruits or vegetables may have pesticide residues, especially apples, grapes, strawberries, spinach, cucumbers, etc. We suggest choosing organic fruits and vegetables to decrease the risk.
Stay away from bad habits and unhealthy foods/drinks. Get your sperm good!
What should we know about male infertility
September 30, 2017
Like the infertility issues in females,
male fertility correlates with the age, lifestyle, and individual background.
If you are aware of these factors,
you may know more about your own body state.
1. Should semen analysis be routinely clinical testing?
Reproductive potential gradually declines with advanced paternal age, but the declining speed is not as fast as maternal ovaries. The semen analysis is the most common method to check the general sperm quality. Some studies indicated that there is significant decrease in semen volume, sperm concentration, sperm motility and sperm morphology among older men. The pregnancy rate in the men at 40s displayed 10% down than that in the men at 30s. Thus the males with advanced age and abnormal semen parameters have higher risk for the infertility issue. Should the semen analysis be routine testing? Maybe NOT. Only the couple who has failed to conceive for ≧1 year is recommended.
2. Should PGS (preimplantation genetic screening) be performed in the men at advanced age?
The rate of aneuploid embryo is higher in women at advanced age (≧36 years old), and thus PGS becomes an option for them to choose the embryo with normal chromosomal dosage. Is it possible that the aneuploid embryo derived from the sperm with advanced paternal age ? Hassold et al. demonstrated that one of the cause for trisomy 21 is paternal chromosome nondisjunction, and it accounted for 20% of the entire population with trisomy 21. A more-recently scientific article showed that significantly increasing aneuploid rate in embryos from the older men and men with oligozoospermia. It appears that suboptimal sperm can be a source of embryo aneuploidy. However, the correlation of paternal age and embryo aneuploidy is not as strong as that of maternal age. For those with partner at advanced maternal age, or with the recurrent miscarriage history or family inherited disease, PGS/PGD is recommended. Generally, the paternal age is not the sole indication for PGS.
3. What should the older father know?
Several reports showed the children with older fathers are more likely to develop certain pathologies, such as the schizophrenia. The rate of autism spectrum disorders slightly increases as well. For the father themselves, some medical comorbidities do affect the fertility, like heart disease and chronic medicines of hypertension. It could lead to erectile dysfunction and benign prostatic hypertrophy.
4. Should males cryopreserve their sperm for social reason?
The sperm motility could be halved after cryopreservation. For men with known fertile issue, cryopresevation may induce sperm DNA damage. Since the correlation between fertility and male age is not as strong as the female age, there is no need to cryopreserve sperm for the social reason, and the state of frozen sperm is not comparable to the fresh sperm.
Beyond examinations, healthy diet and lifestyle do help the fertility. It's not necessary to cryopreserve sperm at young age. If the body stays good, the quality of sperm may remain for a long time.
Hyaluronan(HA) binding assay: a good matchmaker to sperm
December 08, 2016
For in-vitro fertilization, the oocytes attract the sperms with better maturation status by hyaluronic acid of the surrounding cumulus cells.
In the 2016 annual meeting of Taiwan Society of Reproductive Medicine, Dr. Dionisios Sakkas from Boston IVF center, US, shared his experiences in semen processing and sperm selection,
1. Density：Gradient separation
2. Surface Charge：Electrophoresis
3. Morphological Characteristics: IMSI (intracytoplasmic morphologically-selected sperm injection)
4. Motility Characteristics： Microfluidics
5. Membrane Integrity：Hyaluronan(HA)-binding
According to the previously published articles, the performance of HA binding assay remains controversy. In 2016, a systemic review in Reproductive BioMedicine Online analyzed the sperms undergone HA binding assay and then used in ICSI. It demonstrated that the fertilization rate and clinical pregnancy rate showed no difference between the HA binding plus ICSI group and ICSI merely group. In contrast, Dr. Sakkas displayed several articles to show better good blastocyst rate (grading over BC) in the HA binding plus ICSI group.
In summary, different methods for sperm selection may be appropriate for the individualized concern. Of HA binding assay, both the cost and technical requirement were comparably lower than the other mentioned methods. It provided a simulation of in vivo fertilization to select the sperm with better maturation status.
Refereces:
· 2016 TSRM－ICSI for all? Selecting the best sperm!
· Clinical benefit using sperm hyaluronic acid binding technique in ICSI cycles: a systematic review and meta-analysis.Reproductive BioMedicine Online (2016) 32, 286–298
The clinical outcomes of donor sperm bank
September 08, 2016The percentage of Stork Fertility Center sperm donation cycles to the total sperm donation cycles in Taiwan:
*The sky-blue bar represents the percentage of SFC oocyte donation cycle, and the sky-blue plus apricot represents the total oocyte donation cycles in Taiwan.
* BT= blastocyst transfer
* FBT = frozen (and then thawed) blastocyst transfer
The clinical outcomes of embryo transfer in the donated-oocyte recipients:
* BT= blastocyst transfer
* FBT = frozen (and then thawed) blastocyst transfer
Oocyte activation
January 07, 2016
We just discussed one issue of male factors in the infertility realm—azoospermia. Actually the entire proportion of male factors in the infertility indications is around 35-40%, and they were divided into the following groups.
By using several assisted reproductive techniques, such as intracytoplasmic sperminjection (ICSI) and intracytoplasmic morphologically selected sperm injection (IMSI), the average fertilization rate was raised up to 70%-80%. However, complete fertilization failure or very-low fertilization rate still occurred in around 1-5% of IVF-ICSI cycles. In this case, the issue of incomplete oocyte activation was concerned. The interactions between oocyte and sperm during fertilization was displayed as follows.
As the figure illustrated, the signal transduction began from the acrosome (sperm head) reaction. The phospholipase C zeta (PLCζ) was released from acrosome into the oocytoplasm, and thus the phosphotidylinositol 4,5-bisphosphate (PIP2) was decomposed as diacylglycerol (DAG) and inositol trisphosphate (IP3). Then the IP3 combined to the IP3 receptors on the endoplasmic reticulum and induced the release of stored calcium ions (Ca2+). The released Ca2+ flows activated the oocyte and turned on its cell cycle.
Globozoospermia (sperms with round head) is one of common causes in complete fertilization failure. It was because that round-head sperms lack acrosomes, and then no PLCζ turn on the pathway of oocyte activation.
Comparing the Ca2+ oscillation between the sperms resulted in higher and lower fertilization rate in the ICSI cycles, a Ca2+ oscillation with higher amplitude and frequency was induced by the sperms resulted in higher fertilization rate. In contrast, the sperms with lower fertilization rate either was unable to induce the oscillation, or induced an oscillation with weaker amplitude and frequency only.
Artificial oocyte activation (AOA) was reported as one way to solve the complete fertilization failure. This procedure can be done by three different methods:
1. Chemical AOA: Ca2+ ionophores (A23187), ionomycin, puromycin, and so on. (most common)
2. Electric AOA: using electric shock to induce the Ca2+ oscillation
3. Mechanic AOA: injection of Ca2 into the oocyte directly. (less common)
References:
· Kashir J, Heindryckx B, Jones C, De Sutter P, Parrington J, Coward K. Oocyte activation, phospholipase C zeta and human infertility. Hum Reprod Update. 2010 Nov-Dec;16(6):690-703.
· Yoon SY, Jellerette T, Salicioni AM, Lee HC, Yoo MS, Coward K, Parrington J, Grow D, Cibelli JB, Visconti PE et al. Human sperm devoid of PLC, zeta 1 fail to induce Ca2+ release and are unable to initiate the first step of embryo development. J Clin Invest 2008; 118:3671–3681.
· Mohammad Hossein Nasr-Esfahani, Mohammad Reza Deemeh, Marziyeh Tavalaee. Artificial oocyte activation and intracytoplasmic sperm injection. Fertility and Sterility, Published online: April 27 2009.
· John Zhang, Chia-Woei Wang, Anna Blaszcyzk, James A Grifo, Jean Ozil, Elisa Haberman, Alexis Adler, Lewis C Krey. Electrical activation and in vitro development of human oocytes that fail to fertilize after intracytoplasmic sperm injection. Fertility and Sterility, Published in issue: September 1999.
Stork Fertility Center:
1. Complete fertilization failure occurs around 1% or lower in the clinical patients with indications of male-factor according to our records. Most of these patients have limited amount of available oocytes (MII) to be fertilized. The real percentage of patients with oocyte inactivation is even lower than 1%.
2. The general procedures of ICSI include two steps to assist oocyte activation: immobilization of sperm by pressing its tail; sucking and penetration of the oocyte membrane. By this procedure, the sperm cytosolic factor is released and injected into the oocytoplasm to induce the Ca2+ oscillation. However, if globozoospermia (no sperm cytosolic factor inside) or abnormal receptor expression or Ca2+ concentration in the oocyte, the artificial oocyte activation is then recommended.
3. Indeed the fertilization rate increased by using of AOA, but several scientific reports also demonstrated that the rate of following embryo arrest during culture and abortion rate after transfer also correlated with the treatment of AOA. The benefits of AOA remains controversial.
Azoospermia
December 22, 2015
Male factor is one of the important issues in the infertility. Azoospermia is one of the tricky things in the male infertility. If a problem occurred in the procedure of spermatogenesis (sperm production) or sperm transport, it results in azoospermia, which means no sperms found in the ejaculated semen.
In the patients with non-obstructive azoospermia, testicular sperm extraction (TESE) is required to obtain the sperms for IVF.
Conducting the diagnostic testic biopsy can help to evaluate the possibility of finding available sperms on the day of TESE. If it results in either normal or hypo-spermatogenesis, the possibility increases; if it results in maturation arrest or sertoli-cell-only, the possibility decreases.
Now the microdissection-TESE(micro-TESE) has been more prevalent in the treatment of patients with Klinefelter's syndrome. Selecting the available seminiferous tubule can be performed under the microscopy. Generally, a seminiferous tube with diameter ≧300μm is more promising.
Sometimes, the touch-print-smear is conducted with the micro-TESE. It may help the diagnosis.
The sperm retrieval rate of touch-print smear:
Hypospermatogenesis | 100％ |
Maturation arrest | 50％ |
Leydig cell predominant and tubular hyalinization | 23.8％ |
Sertoli cell only | 33.3％ |
Are you afraid of testicular sperm extraction (TESE)?
September 02, 2015
Before starting the IVF program, the diagnostic microdissection testicular sperm extraction can improve the success rate of surgical sperm extraction on the oocyte retrieval day. It would be a great news in the couples with azoospermia.
Azoospermia is a severe male factor in the infertility, and the occurrence is around 15% in the infertile men. There are two types of azoospermia,—obstructive and non-obstructive. In the patients with the obstructive azoospermia, the testes are able to produce functional sperms (spermatozoa), but the duct is blocked. In the patients with the non-obstructive azoospermia, the testes are unable to produce functional sperms, and the original cause have not been identified yet in 76% of the patients. The fertility specialist generally recommended these patients to take microsurgical epididymal sperm aspiration (MESA; in the patients with obstructive azoospermia) or testicular sperm extraction (TESE; in the patients with non-obstructive azoospermia) combing with intracellular single sperm injection (ICSI) in the IVF program.
The microdissection testicular sperm extraction (micro-TESE) has the advantages avoiding the damage of testes blood supply or larger trauma. It makes a small incision (4~5cm) on the scrotum to take testes out. After cutting the tunica albuginea along the equatorial plane, the seminiferous tubule can be examined and then be biospied under the operating microscope. If the diameter of a particular seminiferous tubule is over 300μm, the sperm retrieval rate could be significantly increased.
Seminiferous tubule diameter(μm) | >300 |
Sperm retrieval rate(%) | 84 |
However, the micro-TESE may not work in 40-50% of the patients with non-obstructive azoospermia. It could happen that no extracted sperms can be used on the oocyte retrieval day, and the patients must cryopreserve their eggs instead.
Therefore, the diagnostic microdissection testicular sperm extraction (diagnostic mTESE) was developed. The diagnostic mTESE is doing the micro-TESE before the operation on the oocyte retrieval day. By conducting the Touch print smear (TPS), the biopsied sample can be stained to examine the existence of mature sperms with the freezing tissue-processing method. The site of found mature sperms would be recorded as references for the operation on the oocyte retrieval day.
During 2012 to 2014, 152 patients with non-obstructive azoospermia were recruited to evaluate the efficacy of the procedure. In the recruited cohort, the sperm retrieval rate with diagnostic mTESE was 45.3%, and then the rate on the oocyte retrieval day is almost 100%. It strongly proved that an advance diagnostic mTESE could improve the sperm retrieval rate on the oocyte retrieval day. It could prevent the unexpected egg-freezing in the IVF program, and also lessen the psychological stress in the patients.
References:
2015 Symposium, The Taiwanese Association of Andrology
Microdissection testicular sperm extraction:an update. Asian J Androl. 2013 Jan; 15(1): 35–39Should I use Intracytoplasmic Sperm Injection (ICSI)? (ICSI in Taiwan)
January 14, 2014
Due to the changes of global climate and general living style, the quality of male sperm, including the morphology and the mobility, has become worse and it also decreased the fertilization rate in the IVF realm. Nowadays, intracytoplasmic sperm injection is the most common technique at ART labs ...
(Source: http://www.goivf.com/treatment-options/ivf-process/male-factor-icsi-tese/ )
Traditional treatments to the fertility problems caused by male factors were limited before 1992. It takes about 74 days to generate mature sperms at testes, so these male patients also needed to take such the same time to receive stimulation injections or oral medications. Thus their patience and perseverance were really the challenges to whom were eager to be fathers. Things were dramatically changed in 1992. Belgium doctor, Dr. Gianpiero Palermo, successfully fertilized the oocytes through Intracytoplasmic Sperm Injection (ICSI) and brought all the IVF patients to another milestone.
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What is Intracytoplasmic Sperm Injection?
ICSI is to inject a single sperm with good shape and mobility into a mature egg (MII oocyte). Though this technique is developed for those with poor quality of sperms, it has become very popular for general IVF cases recently. Then many people may have the question about the appropriate conditions to use ICSI.
A. Unexplained or Idiopathic Infertility
About 20% IVF cases cannot find the reasons for their situations. It could be explained as the problems of sperm-egg attraction/recognition, deficient of sperm penetration, abnormal zona pellucida of oocytes ...etc, and all these issues could affect the fertilization and ongoing development of embryos. Intriguingly, recent reports showed that there were no statistically differences of fertilization rate, implantation rate and clinical pregnancy rate between the cases with using ICSI and those without. However, using ICSI increases the amount of embryos indeed.
B. Oocytes with poor quality
When the technician observed that the quality of retrieved oocytes were poor, including thick zona pellucida, rough cytoplasm or uneven shape, ICSI could be the better choice to increase the fertilization rate and the amount of available embryos.
(Source: http://humrep.oxfordjournals.org/content/24/11/2778/F2.expansion)
C. Advanced maternal age or fewer eggs
According to the previous researches, the thickness of zona pellucida is increased with maternal age. For the females with advanced age or poor remaining amount of eggs, ICSI comparatively ensures the amount of available embryos. However, the fertilization rate, implantation rate and clinical pregnancy rate are not absolutely improved after using ICSI.
D. Repeated IVF failures
The reasons for the failures have not been explained. Therefore, ICSI becomes more promising to the future programs.
E. Oocyte cryopreservation and In Vitro Maturation, IVM
The covered cumulus cells of the oocytes were generally removed before freezing the oocytes, so it may cause the fertilization problems after thawing them. For these frozen-thawed eggs, ICSI would be more available method.
In addition, the zona pellucida of immature oocytes easily get affected after retrieving. Thus ICSI are also the better choice to those IVM eggs.
C. Advanced maternal age or fewer eggs
According to the previous researches, the thickness of zona pellucida is increased with maternal age. For the females with advanced age or poor remaining amount of eggs, ICSI comparatively ensures the amount of available embryos. However, the fertilization rate, implantation rate and clinical pregnancy rate are not absolutely improved after using ICSI.
D. Repeated IVF failures
The reasons for the failures have not been explained. Therefore, ICSI becomes more promising to the future programs.
E. Oocyte cryopreservation and In Vitro Maturation, IVM
The covered cumulus cells of the oocytes were generally removed before freezing the oocytes, so it may cause the fertilization problems after thawing them. For these frozen-thawed eggs, ICSI would be more available method.
In addition, the zona pellucida of immature oocytes easily get affected after retrieving. Thus ICSI are also the better choice to those IVM eggs.
Should I use Intracytoplasmic Sperm Injection (ICSI)? (ICSI in Taiwan)
January 14, 2014
Due to the changes of global climate and general living style, the quality of male sperm, including the morphology and the mobility, has become worse and it also decreased the fertilization rate in the IVF realm. Nowadays, intracytoplasmic sperm injection is the most common technique at ART labs ...
Traditional treatments to the fertility problems caused by male factors were limited before 1992. It takes about 74 days to generate mature sperms at testes, so these male patients also needed to take such the same time to receive stimulation injections or oral medications. Thus their patience and perseverance were really the challenges to whom were eager to be fathers. Things were dramatically changed in 1992. Belgium doctor, Dr. Gianpiero Palermo, successfully fertilized the oocytes through Intracytoplasmic Sperm Injection (ICSI) and brought all the IVF patients to another milestone.
What is Intracytoplasmic Sperm Injection?
ICSI is to inject a single sperm with good shape and mobility into a mature egg (MII oocyte). Though this technique is developed for those with poor quality of sperms, it has become very popular for general IVF cases recently. Then many people may have the question about the appropriate conditions to use ICSI.
A. Unexplained or Idiopathic Infertility
About 20% IVF cases cannot find the reasons for their situations. It could be explained as the problems of sperm-egg attraction/recognition, deficient of sperm penetration, abnormal zona pellucida of oocytes ...etc, and all these issues could affect the fertilization and ongoing development of embryos. Intriguingly, recent reports showed that there were no statistically differences of fertilization rate, implantation rate and clinical pregnancy rate between the cases with using ICSI and those without. However, using ICSI increases the amount of embryos indeed.
B. Oocytes with poor quality
When the technician observed that the quality of retrieved oocytes were poor, including thick zona pellucida, rough cytoplasm or uneven shape, ICSI could be the better choice to increase the fertilization rate and the amount of available embryos.
(Source: http://humrep.oxfordjournals.org/content/24/11/2778/F2.expansion)
C. Advanced maternal age or fewer eggs
According to the previous researches, the thickness of zona pellucida is increased with maternal age. For the females with advanced age or poor remaining amount of eggs, ICSI comparatively ensures the amount of available embryos. However, the fertilization rate, implantation rate and clinical pregnancy rate are not absolutely improved after using ICSI.
D. Repeated IVF failures
The reasons for the failures have not been explained. Therefore, ICSI becomes more promising to the future programs.
E. Oocyte cryopreservation and In Vitro Maturation, IVM
The covered cumulus cells of the oocytes were generally removed before freezing the oocytes, so it may cause the fertilization problems after thawing them. For these frozen-thawed eggs, ICSI would be more available method.
In addition, the zona pellucida of immature oocytes easily get affected after retrieving. Thus ICSI are also the better choice to those IVM eggs.
C. Advanced maternal age or fewer eggs
According to the previous researches, the thickness of zona pellucida is increased with maternal age. For the females with advanced age or poor remaining amount of eggs, ICSI comparatively ensures the amount of available embryos. However, the fertilization rate, implantation rate and clinical pregnancy rate are not absolutely improved after using ICSI.
D. Repeated IVF failures
The reasons for the failures have not been explained. Therefore, ICSI becomes more promising to the future programs.
E. Oocyte cryopreservation and In Vitro Maturation, IVM
The covered cumulus cells of the oocytes were generally removed before freezing the oocytes, so it may cause the fertilization problems after thawing them. For these frozen-thawed eggs, ICSI would be more available method.
In addition, the zona pellucida of immature oocytes easily get affected after retrieving. Thus ICSI are also the better choice to those IVM eggs.