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％ |