Male factors contribute to 50%of infertility cases,with 20%–30%of cases being solely attributed to male infertility.Helicase for meiosis 1(HFM1)plays a crucial role in ensuring proper crossover formation and synapsis...Male factors contribute to 50%of infertility cases,with 20%–30%of cases being solely attributed to male infertility.Helicase for meiosis 1(HFM1)plays a crucial role in ensuring proper crossover formation and synapsis of homologous chromosomes during meiosis,an essential process in gametogenesis.HFM1 gene mutations are associated with male infertility,particularly in cases of non-obstructive azoospermia and severe oligozoospermia.However,the effects of intracytoplasmic sperm injection(ICSI)in HFM1-related infertility cases remain inadequately explored.This study identified novel biallelic HFM1 variants through whole-exome sequencing(WES)in a Chinese patient with severe oligozoospermia,which was confirmed by Sanger sequencing.The pathogenicity of these variants was assessed using real-time quantitative polymerase chain reaction(RT-qPCR)and immunoblotting,which revealed a significant reduction in HFM1 mRNA and protein levels in spermatozoa compared to those in a healthy control.Transmission electron microscopy revealed morphological abnormalities in sperm cells,including defects in the head and flagellum.Despite these abnormalities,ICSI treatment resulted in a favorable fertility outcome for the patient,indicating that assisted reproductive techniques(ART)can be effective in managing HFM1-related male infertility.These findings offer valuable insights into the management of such cases.展开更多
Aim： To investigate the possible causes of oligozoospermia and azoospermia in infertile Thai men, and to find the frequencies of Y chromosome microdeletions and cytogenetic abnormalities in this group. Methods： From...Aim： To investigate the possible causes of oligozoospermia and azoospermia in infertile Thai men, and to find the frequencies of Y chromosome microdeletions and cytogenetic abnormalities in this group. Methods： From June 2003 to November 2005, 50 azoospermic and 80 oligozoospermic men were enrolled in the study. A detailed history was taken for each man, followed by general and genital examinations. Y chromosome microdeletions were detected by multiplex polymerase chain reaction （PCR） using 11 gene-specific primers that covered all three regions of the azoospermic factor （AZFa, AZFb and AZFc）. Fifty men with normal semen analysis were also studied. Karyotyping was done with the standard G- and Q-banding. Serum concentrations of follicle stimulating hormone （FSH）, luteinizing hormone （LH）, prolactin （PRL） and testosterone were measured by electrochemiluminescence immunoassays （ECLIA）. Results： Azoospermia and oligozoospermia could be explained by previous orchitis in 22.3%, former bilateral cryptorchidism in 19.2%, abnormal karyotypes in 4.6% and Y chromosome microdeletions in 3.8% of the subjects. The most frequent deletions were in the AZFc region （50%）, followed by AZFb （33%） and AZFbc （17%）. No significant difference was detected in hormonal profiles of infertile men, with or without microdeletions. Conclusion： The frequencies of Y chromosome microdeletions and cytogenetic abnormalities in oligozoospermic and azoospermic Thai men are comparable with similarly infertile men from other Asian and Western countries.展开更多
Aim： To detect the expression of VASA in human ejaculated spermatozoa, and to compare the expression of VASA between normozoospermic men and patients with oligozoospermia. Methods： Ejaculated spermatozoa were collec...Aim： To detect the expression of VASA in human ejaculated spermatozoa, and to compare the expression of VASA between normozoospermic men and patients with oligozoospermia. Methods： Ejaculated spermatozoa were collected from normozoospermic men and patients with oligozoospermia by masturbation, and subsequently segregated through a discontinuous gradient of Percoll to obtain the spermatozoa. Reverse transcription polymerase chain reaction （RT- PCR）, quantitative RT-PCR （QRT-PCR）, immunoflurescence and Western blotting were used to detect the expression of VASA in mRNA and protein levels. Results： VASA mRNA was expressed in the ejaculated spermatozoa. QRT-PCR analysis showed that VASA mRNA level was approximately 5-fold higher in normozoospermic men than that in oligozoospermic men. Immunofluorescence and Western blotting analysis showed that VASA protein was located on the cytoplasmic membrane of heads and tails of spermatozoa, and its expression was significantly decreased in oligozoospermic men, which is similar to the result of QRT-PCR. Conclusion： The expression of VASA mRNA and protein was significantly decreased in the sperm of oligozoospermic men, which suggested the lower expression of the VASA gene might be associated with pathogenesis in some subtypes of male infertility and VASA could be used as a molecular marker for the diagnosis of male infertility.展开更多
The aim of the present work was to present the outcomes of the patients with Y-chromosome microdeletions treated by intracytoplasmic sperm injection （ICSI）, either using fresh （TESE） or frozen-thawed （TESE-C） te...The aim of the present work was to present the outcomes of the patients with Y-chromosome microdeletions treated by intracytoplasmic sperm injection （ICSI）, either using fresh （TESE） or frozen-thawed （TESE-C） testicular sperm and ejaculated sperm （EJAC）. The originality of this work resides in the comparisons between the different types of Y-microdeletions （AZFa, AZFb, and AZFc） and treatments, with detailed demographic, stimulation, embryological, clinical, and newborn （NB） outcomes. Of 125 patients with Y-microdeletions, 33 patients presented severe oligozoospermia （18 performed ICSI with ejaculated sperm） and 92 secretory azoospermia （65 went for TESE with 40 having successful sperm retrieval and performed ICSI）. There were 51 TESE treatment cycles and 43 TESE-C treatment cycles, with a birth of 19 NB （2 in AZFa/TESE-C, 12 in AZFc/TESE, and 5 in AZFc/TESE-C）. Of the 29 EJAC cycles, there was a birth of 8 NB （in AZFc）. In TESE and EJAC cycles, there were no significant differences in embryological and clinical parameters. In TESE-C cycles, there was a significant lower oocyte maturity rate, embryo cleavage rate and mean number of embryos transferred in AZFb, and a higher mean number of oocytes and lower fertilization rate in AZFc. In conclusion, although patients with AZFc microdeletions presented a high testicular sperm recovery rate and acceptable clinical outcomes, cases with AZFa and AZFb microdeletions presented a poor prognosis. Due to the reported heredity of microdeletions, patients should be informed about the infertile consequences on NB and the possibility of using preimplantation genetic diagnosis for female sex selection.展开更多
Patients with extremely severe oligozoospermia （ESO） and cryptozoospermia （CO） are suitable using intracytoplasmic sperm injection （ICSI） as an infertility treatment. However, some andrologists are confused to d...Patients with extremely severe oligozoospermia （ESO） and cryptozoospermia （CO） are suitable using intracytoplasmic sperm injection （ICSI） as an infertility treatment. However, some andrologists are confused to distinguish ESO and CO in clinic diagnose. This study was designed for the first time to evaluate and compare patients with ESO and CO to determine whether these are useful clinical distinctions. A total of 270 infertile men in our center were classified into four groups as Group nonobstruction azoospermia （NOA, n = 44）, Group ESO （n = 78）, Group CO （n = 40）, and Group obstruction azoospermia （OA, n = 108）. Comparisons of the volume of bilateral testes, the level of follicle stimulating hormone （FSH） and inhibin B were obtained in four groups. Then comparisons of fertilization rates, cleavage rate, and excellent embryos rate were obtained when couples performed ICSh All indexes （volume of bilateral testis, level of FSH and inhibin B） in Groups ESO and CO were no difference, while Groups OA versus NOA, OA versus ESO, and OA versus CO were significant differences （P 〈 0.05）. The rates of fertilization were no differences in Groups ESO and CO while Groups OA versus ESO, OA versus CO were significant differences （P 〈 0.05）. Therefore, the spermatogenic functions in patients with CO and ESO were similar, better than NOA but worse than OA. However, it would be helpful to evaluate their spermatogenesis using testicular biopsies, especially accompanied azoospermia in clinical practice.展开更多
Varicocele has been implicated as a cause in 35%-50% of patients with primary infertility and up to 81% of men with secondary infertility. Although a large number of reports have shown improvement in the semen paramet...Varicocele has been implicated as a cause in 35%-50% of patients with primary infertility and up to 81% of men with secondary infertility. Although a large number of reports have shown improvement in the semen parameters after correction of varicocele, other studies have suggested no benefit. We report the first case of azoospermia after surgery in a young infertile male patient with left-sided varicocele and severe oligozoospermia undergoing laparoscopic varicocelectomy. A pregnancy was only achieved with assisted reproductive technology because semen cryopreservation was performed before surgery. In the light of the above, the deterioration of sperm count after varicocele repair in patients with severe oligozoospermia could be due to irreversible impairment of spermatogenesis of such patients, together with the possible temporary damage of the surgical repair. This possible complication could therefore turn the severe oligozoospermia into an indication to perform cryopreservation before surgery, on both clinical and medico-legal grounds. Further research is needed before drawing definitive conclusions regarding the management of varicocele-related severe oligozoospermia.展开更多
Objective:To compare the therapeutic effects of Shengjing Zhongzi Tang(生精种子汤Decoction for Generating Sperms) and Wuzi Yanzong Wan(五子衍宗丸Pills for Reproduction) for asthenospermia and oligozoospermia.Methods:S...Objective:To compare the therapeutic effects of Shengjing Zhongzi Tang(生精种子汤Decoction for Generating Sperms) and Wuzi Yanzong Wan(五子衍宗丸Pills for Reproduction) for asthenospermia and oligozoospermia.Methods:Seventy patients with asthenospermia and oligozoospermia were divided into a treatment group of 35 cases treated with Shengjing Zhongzi Tang and a control group of 35 cases treated with Wuzi Yanzong Wan for 3 months respectively.The therapeutic effects were evaluated,the semen parameters were analyzed and the spermatic morphology was judged before and after treatment.Results:In the treatment group,the total effective rate was 91.4% with a pregnant rate of 8.6% spouses,and the markedly effective rate was 65.7%.In the control group,the total effective rate was 85.7% with a pregnant rate of 5.7% spouses,and the markedly effective rate was 54.3%.Both the total effective rate and the markedly effective rate were higher in the treatment group than those in the control group,but with no significant statistical difference(P>0.05).The spermatic density,spermatic motility and the percentage of normal spermatic morphology were obviously enhanced in the two groups with the indexes in the treatment group superior to those in the control group(P<0.05 or P<0.01).Conclusion:Shengjing Zhongzi Tang with obvious therapeutic effects for asthenospermia and oligozoospermia can significantly enhance the spermatic density and motility,and raise the pregnant rate in spouses.展开更多
Tamoxifen citrate, as the first line of treatment for infertile men with idiopathic oligozoospermia, was proposed by the World Health Organization （WHO）, and testosterone undecanoate has shown benefits in semen valu...Tamoxifen citrate, as the first line of treatment for infertile men with idiopathic oligozoospermia, was proposed by the World Health Organization （WHO）, and testosterone undecanoate has shown benefits in semen values. Our objective was to assess the effectiveness of treatment with tamoxifen citrate and testosterone un- decanoate in infertile men with idiopathic oligozoospermia, and whether the results would be affected by polymor- phisms of CYP2D6＊10. A total of 230 infertile men and 147 controls were included in the study. Patients were treated with tamoxifen citrate and testosterone undecanoate. Sex hormone, sperm parameters, and incidence of spontaneous pregnancy were detected. There were no significant differences between the control and patient groups with respect to CYP2D6＊10 genotype frequencies （P〉0.05）. The follicle-stimulation hormone （FSH）, luteinizing hormone （LH）, and testosterone （T） levels were raised, and sperm concentration and motility were increased at 3 months and became significant at 6 months, and they were higher in the wild-type allele （C/C） than in the heterozygous variant allele （C/T） or homozygous variant allele （T/T） subgroups （P〈0.05）. In addition, the percentage of normal morphology was raised at 6 months, and represented the highest percentage in the C/C subgroup （P〈0.05）. The incidence of spontaneous pregnancy in the C/C subgroup was higher than that in the C/T or T/T subgroups （P〈0.01）. This study showed that the CYP2D6＊10variant genotype demonstrated worse clinical effects in infertile men with idiopathic oligozoospermia.展开更多
Objective To assess the effect of treatment with a combination of the tamoxifen citrate and testosterone undecanoate on sperm variables in men with idiopathic azoospermia or oIigozoospermia. Methods Four men with idio...Objective To assess the effect of treatment with a combination of the tamoxifen citrate and testosterone undecanoate on sperm variables in men with idiopathic azoospermia or oIigozoospermia. Methods Four men with idiopathic azoospermia and 8 men with idiopathic oligozoospermia were collected in this retrospective and self control trial. All patients were treated with testosterone undecanoate of 80 mg/d and tamoxifen citrate of 20 mg/d. Sperm characteristics and pregnancy incidence were measured every month during 4 months medication. Results Tamoxifen citrate plus testosterone undecanoate treatment produced a satisfactory improvement of total sperm number, motility after 2 and 3 months whereas serum FSH, LH levels increased after 2 or 3 months. Conclusion The combination of tamoxifen citrate with testosterone undecanoate could improve significantly sperm count. The combination could be used in men with idiopathic azoospermia or serious oligozoospermia.展开更多
To investigate the relation of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and Testosterone serum levels with partial deletions in the AZFc region in Iranian oligozoospermia males. Material and method...To investigate the relation of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and Testosterone serum levels with partial deletions in the AZFc region in Iranian oligozoospermia males. Material and methods: thirty infertile oligozoospermia and 52 Iranian fertile men included. The hormonal assays were measured by the Radioimmunoassay (RIA). Multiplex polymerase chain reaction (M-PCR) using eight sequence-tagged site (STS) markers were measured on the Yq11 chromosome. Results: The mean of FSH and LH levels in all oligozoospermia males were higher than fertile men (p < 0.001) and testosterone was lower significantly (p < 0.001). Five patients showed partial deletions in AZFc region (four had gr/gr and one had b2/b3 deletions). Six fertile men showed partial deletions (five gr/gr and one b2/b3) with higher level of FSH, LH in their group (p < 0.05). Conclusion: According to high incidence of partial deletions in the AZFc region among Iranian oligozoospermia males, hormonal assay and molecular screening should be advised before considering for ART treatments.展开更多
Objective: To assess the effect of electroacupuncture(EA) on expression of cytoskeletal proteins from Sertoli cells(SCs) and spermatogenesis in rats with oligozoospermia of insufficiency of Shen(Kidney)essence syndrom...Objective: To assess the effect of electroacupuncture(EA) on expression of cytoskeletal proteins from Sertoli cells(SCs) and spermatogenesis in rats with oligozoospermia of insufficiency of Shen(Kidney)essence syndrome(OIKES).Methods: Twenty healthy male Sprague-Dawley rats were randomly assigned to four groups using a random number table: control,tripterygium glycosides(TG) treatment,sham and EA groups(n=5 in each group).A rat model of OIKES was established by oral gavage with TG.The EA group was treated with TG and received EA at Shenshu(BL 23) and Zusanli(ST 36) acupoints for 20 min,once daily for 30 days,while the sham group received EA at identical acupoints with skin penetration without stimulation.After 30 days,the ?nal body weight and coef?cients for the testis and epididymis were calculated and sperm parameters were measured.Immunohistochemical analyses were performed to detect expression of vimentin and α-tubulin in SCs and proliferating cell nuclear antigen(PCNA) immunoreactivity in germ cells.Apoptosis in germ cells was quanti?ed by the transferase biotin-dUTP nick end labeling assay.Results: Compared with the control group,the final body weight and testis/epididymis coefficients of rats in the TG-treated group were not significantly different,but the sperm count and motility were lower(P<0.05).Expressions of vimentin and α-tubulin were also signi?cantly weaker(P<0.01).The PCNA immunoreactivity of germ cells was decreased(P=0.059),whereas the apoptotic index of germ cells was increased signi?cantly(P<0.01).In contrast,EA at BL 23 and ST 36 acupoints signi?cantly improved the ?nal body weight as well as the sperm count,concentration and motility(P<0.01 or P<0.05).EA increased expression of vimentin and α-tubulin in SCs markedly,and signi?cantly enhanced PCNA immunoreactivity with decreased apoptosis in germ cells(P<0.01 or P<0.05).Conclusions: EA at BL 23 and ST 36 acupoints has protective effects on spermatogenesis in rats with OIKES.This effect seems to be achieved by attenuating TG-induced disruption of cytoskeletal protein in SCs.展开更多
Objective:This study investigated the outcomes of microsurgical subinguinal varicocelectomy(MSV)on semen and hormonal parameters in cases with isolated sperm defects(oligozoospermia,asthenozoospermia,or teratozoosperm...Objective:This study investigated the outcomes of microsurgical subinguinal varicocelectomy(MSV)on semen and hormonal parameters in cases with isolated sperm defects(oligozoospermia,asthenozoospermia,or teratozoospermia).Methods:A retrospective review of charts of patients who underwent MSV for clinically palpable varicocele between January 1,2011 and January 1,2019 at Hamad Medical Corporation was undertaken.All patients diagnosed with isolated oligozoospermia,asthenozoospermia,or teratozoospermia in the preoperative semen analysis were included.Men with multiple sperm defects,genetic abnormalities,azoospermia,history of genitourinary infection,exposure to chemotherapy or radiotherapy,or prior use of peri-operative fertility treatment were excluded.Data extracted from the electronic medical records included(collected before MSV and up to 6 months postoperatively):demographics(age),clinical data(fertility-related medical history and surgical interventions),family history(consanguinity and infertility),physical examination findings from general and local genital exam(varicocele side and grade),laboratory data such as semen analysis,sperm DNA fragmentation tests,and hormone levels(follicle-stimulating hormone,luteinizing hormone,total testosterone,estradiol,and prolactin),and imaging(scrotal color Doppler ultrasound).Results:A total of 331 patients with isolated sperm defects were included.Postoperatively,83.3%of patients showed an improvement in sperm concentration with a median increase of 7 millions/mL.Postoperatively,76.7%of isolated asthenozoospermic patients showed an improvement in total motility and 66.0%had an improvement in progressive motility with median increases of 15.0%and 7.5%,respectively.Postoperatively,70.0%of the teratozoospermic patients showed an improvement in normal sperm morphology with a median increase of 6%.No changes were observed in other semen or hormone parameters that were examined.Conclusion:MSV is a valid and effective treatment modality for patients with isolated sperm defects that significantly corrects their respective semen abnormality and improves their chances of natural conception.展开更多
Background:Testicular sperm aspiration(TESA)is a minimally invasive testicular sperm retrieval technique that has been utilized in the treatment of male factor infertility.We sought to evaluate sperm retrieval outcome...Background:Testicular sperm aspiration(TESA)is a minimally invasive testicular sperm retrieval technique that has been utilized in the treatment of male factor infertility.We sought to evaluate sperm retrieval outcomes of primary and redo TESA in men with severe oligoasthenoteratozoospermia(OAT)and obstructive azoospermia(OA).Methods:This is a retrospective analysis of consecutive TESAs(primary and redo)for men with severe OAT and OA performed between January 2011 and August 2022 at a high-volume infertility center.We compared TESA outcomes in men with severe OAT to those with OA and compared outcomes of men who underwent primary and redo TESA on the same testicular unit.Results:439 TESAs(366 primary and 73 redo)in men with severe OAT(n=133)and OA(n=306)were included.Men with OA had significantly higher sperm retrieval rate(SRR)and motile SRR compared to men with severe OAT(99%vs.95%and 98%vs.83%,respectively,p<0.05).The requirement for multiple biopsies and the total number of aspirates were significantly lower in men with OA compared to those with severe OAT(15%vs.32%and 1.2±0.5 vs.1.4±0.7,respectively,p<0.05).In both groups,SRR,motile SRR,the requirement for multiple biopsies,and the total number of aspirates were not significantly different in primary compared to redo cases.Conclusion:Our data demonstrate that TESA retrieval rates are significantly higher in men with OA compared to those with severe OAT.The data also demonstrate that a redo TESA in these men is as effective as a primary TESA,suggesting that areas of active spermatogenesis are preserved 6 months after TESA.展开更多
基金supported by the National Natural Science Foundation of China(No.32288101,No.32370654,No.32100480,and No.32200485)Shanghai Municipal Science and Technology Major Project(No.2017SHZDZX01)。
文摘Male factors contribute to 50%of infertility cases,with 20%–30%of cases being solely attributed to male infertility.Helicase for meiosis 1(HFM1)plays a crucial role in ensuring proper crossover formation and synapsis of homologous chromosomes during meiosis,an essential process in gametogenesis.HFM1 gene mutations are associated with male infertility,particularly in cases of non-obstructive azoospermia and severe oligozoospermia.However,the effects of intracytoplasmic sperm injection(ICSI)in HFM1-related infertility cases remain inadequately explored.This study identified novel biallelic HFM1 variants through whole-exome sequencing(WES)in a Chinese patient with severe oligozoospermia,which was confirmed by Sanger sequencing.The pathogenicity of these variants was assessed using real-time quantitative polymerase chain reaction(RT-qPCR)and immunoblotting,which revealed a significant reduction in HFM1 mRNA and protein levels in spermatozoa compared to those in a healthy control.Transmission electron microscopy revealed morphological abnormalities in sperm cells,including defects in the head and flagellum.Despite these abnormalities,ICSI treatment resulted in a favorable fertility outcome for the patient,indicating that assisted reproductive techniques(ART)can be effective in managing HFM1-related male infertility.These findings offer valuable insights into the management of such cases.
文摘Aim： To investigate the possible causes of oligozoospermia and azoospermia in infertile Thai men, and to find the frequencies of Y chromosome microdeletions and cytogenetic abnormalities in this group. Methods： From June 2003 to November 2005, 50 azoospermic and 80 oligozoospermic men were enrolled in the study. A detailed history was taken for each man, followed by general and genital examinations. Y chromosome microdeletions were detected by multiplex polymerase chain reaction （PCR） using 11 gene-specific primers that covered all three regions of the azoospermic factor （AZFa, AZFb and AZFc）. Fifty men with normal semen analysis were also studied. Karyotyping was done with the standard G- and Q-banding. Serum concentrations of follicle stimulating hormone （FSH）, luteinizing hormone （LH）, prolactin （PRL） and testosterone were measured by electrochemiluminescence immunoassays （ECLIA）. Results： Azoospermia and oligozoospermia could be explained by previous orchitis in 22.3%, former bilateral cryptorchidism in 19.2%, abnormal karyotypes in 4.6% and Y chromosome microdeletions in 3.8% of the subjects. The most frequent deletions were in the AZFc region （50%）, followed by AZFb （33%） and AZFbc （17%）. No significant difference was detected in hormonal profiles of infertile men, with or without microdeletions. Conclusion： The frequencies of Y chromosome microdeletions and cytogenetic abnormalities in oligozoospermic and azoospermic Thai men are comparable with similarly infertile men from other Asian and Western countries.
基金We would like to thank Mr Jian-Rong Zhang, Mr Li-Bing Zhang and Dr Zhen-Dong Yu for technical assistance. This work was supported by grants from the National Natural Science Foundation of China （No. 30500543）, Ministry of Education ＂985 project＂ （No. 985-2-054-29）, and Shenzhen Foundation of Science ＆ Technology （JH200505270413B）.
文摘Aim： To detect the expression of VASA in human ejaculated spermatozoa, and to compare the expression of VASA between normozoospermic men and patients with oligozoospermia. Methods： Ejaculated spermatozoa were collected from normozoospermic men and patients with oligozoospermia by masturbation, and subsequently segregated through a discontinuous gradient of Percoll to obtain the spermatozoa. Reverse transcription polymerase chain reaction （RT- PCR）, quantitative RT-PCR （QRT-PCR）, immunoflurescence and Western blotting were used to detect the expression of VASA in mRNA and protein levels. Results： VASA mRNA was expressed in the ejaculated spermatozoa. QRT-PCR analysis showed that VASA mRNA level was approximately 5-fold higher in normozoospermic men than that in oligozoospermic men. Immunofluorescence and Western blotting analysis showed that VASA protein was located on the cytoplasmic membrane of heads and tails of spermatozoa, and its expression was significantly decreased in oligozoospermic men, which is similar to the result of QRT-PCR. Conclusion： The expression of VASA mRNA and protein was significantly decreased in the sperm of oligozoospermic men, which suggested the lower expression of the VASA gene might be associated with pathogenesis in some subtypes of male infertility and VASA could be used as a molecular marker for the diagnosis of male infertility.
文摘The aim of the present work was to present the outcomes of the patients with Y-chromosome microdeletions treated by intracytoplasmic sperm injection （ICSI）, either using fresh （TESE） or frozen-thawed （TESE-C） testicular sperm and ejaculated sperm （EJAC）. The originality of this work resides in the comparisons between the different types of Y-microdeletions （AZFa, AZFb, and AZFc） and treatments, with detailed demographic, stimulation, embryological, clinical, and newborn （NB） outcomes. Of 125 patients with Y-microdeletions, 33 patients presented severe oligozoospermia （18 performed ICSI with ejaculated sperm） and 92 secretory azoospermia （65 went for TESE with 40 having successful sperm retrieval and performed ICSI）. There were 51 TESE treatment cycles and 43 TESE-C treatment cycles, with a birth of 19 NB （2 in AZFa/TESE-C, 12 in AZFc/TESE, and 5 in AZFc/TESE-C）. Of the 29 EJAC cycles, there was a birth of 8 NB （in AZFc）. In TESE and EJAC cycles, there were no significant differences in embryological and clinical parameters. In TESE-C cycles, there was a significant lower oocyte maturity rate, embryo cleavage rate and mean number of embryos transferred in AZFb, and a higher mean number of oocytes and lower fertilization rate in AZFc. In conclusion, although patients with AZFc microdeletions presented a high testicular sperm recovery rate and acceptable clinical outcomes, cases with AZFa and AZFb microdeletions presented a poor prognosis. Due to the reported heredity of microdeletions, patients should be informed about the infertile consequences on NB and the possibility of using preimplantation genetic diagnosis for female sex selection.
文摘Patients with extremely severe oligozoospermia （ESO） and cryptozoospermia （CO） are suitable using intracytoplasmic sperm injection （ICSI） as an infertility treatment. However, some andrologists are confused to distinguish ESO and CO in clinic diagnose. This study was designed for the first time to evaluate and compare patients with ESO and CO to determine whether these are useful clinical distinctions. A total of 270 infertile men in our center were classified into four groups as Group nonobstruction azoospermia （NOA, n = 44）, Group ESO （n = 78）, Group CO （n = 40）, and Group obstruction azoospermia （OA, n = 108）. Comparisons of the volume of bilateral testes, the level of follicle stimulating hormone （FSH） and inhibin B were obtained in four groups. Then comparisons of fertilization rates, cleavage rate, and excellent embryos rate were obtained when couples performed ICSh All indexes （volume of bilateral testis, level of FSH and inhibin B） in Groups ESO and CO were no difference, while Groups OA versus NOA, OA versus ESO, and OA versus CO were significant differences （P 〈 0.05）. The rates of fertilization were no differences in Groups ESO and CO while Groups OA versus ESO, OA versus CO were significant differences （P 〈 0.05）. Therefore, the spermatogenic functions in patients with CO and ESO were similar, better than NOA but worse than OA. However, it would be helpful to evaluate their spermatogenesis using testicular biopsies, especially accompanied azoospermia in clinical practice.
文摘Varicocele has been implicated as a cause in 35%-50% of patients with primary infertility and up to 81% of men with secondary infertility. Although a large number of reports have shown improvement in the semen parameters after correction of varicocele, other studies have suggested no benefit. We report the first case of azoospermia after surgery in a young infertile male patient with left-sided varicocele and severe oligozoospermia undergoing laparoscopic varicocelectomy. A pregnancy was only achieved with assisted reproductive technology because semen cryopreservation was performed before surgery. In the light of the above, the deterioration of sperm count after varicocele repair in patients with severe oligozoospermia could be due to irreversible impairment of spermatogenesis of such patients, together with the possible temporary damage of the surgical repair. This possible complication could therefore turn the severe oligozoospermia into an indication to perform cryopreservation before surgery, on both clinical and medico-legal grounds. Further research is needed before drawing definitive conclusions regarding the management of varicocele-related severe oligozoospermia.
文摘Objective:To compare the therapeutic effects of Shengjing Zhongzi Tang(生精种子汤Decoction for Generating Sperms) and Wuzi Yanzong Wan(五子衍宗丸Pills for Reproduction) for asthenospermia and oligozoospermia.Methods:Seventy patients with asthenospermia and oligozoospermia were divided into a treatment group of 35 cases treated with Shengjing Zhongzi Tang and a control group of 35 cases treated with Wuzi Yanzong Wan for 3 months respectively.The therapeutic effects were evaluated,the semen parameters were analyzed and the spermatic morphology was judged before and after treatment.Results:In the treatment group,the total effective rate was 91.4% with a pregnant rate of 8.6% spouses,and the markedly effective rate was 65.7%.In the control group,the total effective rate was 85.7% with a pregnant rate of 5.7% spouses,and the markedly effective rate was 54.3%.Both the total effective rate and the markedly effective rate were higher in the treatment group than those in the control group,but with no significant statistical difference(P>0.05).The spermatic density,spermatic motility and the percentage of normal spermatic morphology were obviously enhanced in the two groups with the indexes in the treatment group superior to those in the control group(P<0.05 or P<0.01).Conclusion:Shengjing Zhongzi Tang with obvious therapeutic effects for asthenospermia and oligozoospermia can significantly enhance the spermatic density and motility,and raise the pregnant rate in spouses.
基金supported by the National Natural Science Foundation of China(No.81300541)the Technology Project of Guizhou Province(No.QKHJZ[2013]2051)the Doctoral Fund of the Affiliated Hospital of Guiyang Medical College(No.C-2012-6),China
文摘Tamoxifen citrate, as the first line of treatment for infertile men with idiopathic oligozoospermia, was proposed by the World Health Organization （WHO）, and testosterone undecanoate has shown benefits in semen values. Our objective was to assess the effectiveness of treatment with tamoxifen citrate and testosterone un- decanoate in infertile men with idiopathic oligozoospermia, and whether the results would be affected by polymor- phisms of CYP2D6＊10. A total of 230 infertile men and 147 controls were included in the study. Patients were treated with tamoxifen citrate and testosterone undecanoate. Sex hormone, sperm parameters, and incidence of spontaneous pregnancy were detected. There were no significant differences between the control and patient groups with respect to CYP2D6＊10 genotype frequencies （P〉0.05）. The follicle-stimulation hormone （FSH）, luteinizing hormone （LH）, and testosterone （T） levels were raised, and sperm concentration and motility were increased at 3 months and became significant at 6 months, and they were higher in the wild-type allele （C/C） than in the heterozygous variant allele （C/T） or homozygous variant allele （T/T） subgroups （P〈0.05）. In addition, the percentage of normal morphology was raised at 6 months, and represented the highest percentage in the C/C subgroup （P〈0.05）. The incidence of spontaneous pregnancy in the C/C subgroup was higher than that in the C/T or T/T subgroups （P〈0.01）. This study showed that the CYP2D6＊10variant genotype demonstrated worse clinical effects in infertile men with idiopathic oligozoospermia.
文摘Objective To assess the effect of treatment with a combination of the tamoxifen citrate and testosterone undecanoate on sperm variables in men with idiopathic azoospermia or oIigozoospermia. Methods Four men with idiopathic azoospermia and 8 men with idiopathic oligozoospermia were collected in this retrospective and self control trial. All patients were treated with testosterone undecanoate of 80 mg/d and tamoxifen citrate of 20 mg/d. Sperm characteristics and pregnancy incidence were measured every month during 4 months medication. Results Tamoxifen citrate plus testosterone undecanoate treatment produced a satisfactory improvement of total sperm number, motility after 2 and 3 months whereas serum FSH, LH levels increased after 2 or 3 months. Conclusion The combination of tamoxifen citrate with testosterone undecanoate could improve significantly sperm count. The combination could be used in men with idiopathic azoospermia or serious oligozoospermia.
文摘To investigate the relation of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and Testosterone serum levels with partial deletions in the AZFc region in Iranian oligozoospermia males. Material and methods: thirty infertile oligozoospermia and 52 Iranian fertile men included. The hormonal assays were measured by the Radioimmunoassay (RIA). Multiplex polymerase chain reaction (M-PCR) using eight sequence-tagged site (STS) markers were measured on the Yq11 chromosome. Results: The mean of FSH and LH levels in all oligozoospermia males were higher than fertile men (p < 0.001) and testosterone was lower significantly (p < 0.001). Five patients showed partial deletions in AZFc region (four had gr/gr and one had b2/b3 deletions). Six fertile men showed partial deletions (five gr/gr and one b2/b3) with higher level of FSH, LH in their group (p < 0.05). Conclusion: According to high incidence of partial deletions in the AZFc region among Iranian oligozoospermia males, hormonal assay and molecular screening should be advised before considering for ART treatments.
基金Supported by the National Natural Science Foundation of China(No.81273767 and 81473690)
文摘Objective: To assess the effect of electroacupuncture(EA) on expression of cytoskeletal proteins from Sertoli cells(SCs) and spermatogenesis in rats with oligozoospermia of insufficiency of Shen(Kidney)essence syndrome(OIKES).Methods: Twenty healthy male Sprague-Dawley rats were randomly assigned to four groups using a random number table: control,tripterygium glycosides(TG) treatment,sham and EA groups(n=5 in each group).A rat model of OIKES was established by oral gavage with TG.The EA group was treated with TG and received EA at Shenshu(BL 23) and Zusanli(ST 36) acupoints for 20 min,once daily for 30 days,while the sham group received EA at identical acupoints with skin penetration without stimulation.After 30 days,the ?nal body weight and coef?cients for the testis and epididymis were calculated and sperm parameters were measured.Immunohistochemical analyses were performed to detect expression of vimentin and α-tubulin in SCs and proliferating cell nuclear antigen(PCNA) immunoreactivity in germ cells.Apoptosis in germ cells was quanti?ed by the transferase biotin-dUTP nick end labeling assay.Results: Compared with the control group,the final body weight and testis/epididymis coefficients of rats in the TG-treated group were not significantly different,but the sperm count and motility were lower(P<0.05).Expressions of vimentin and α-tubulin were also signi?cantly weaker(P<0.01).The PCNA immunoreactivity of germ cells was decreased(P=0.059),whereas the apoptotic index of germ cells was increased signi?cantly(P<0.01).In contrast,EA at BL 23 and ST 36 acupoints signi?cantly improved the ?nal body weight as well as the sperm count,concentration and motility(P<0.01 or P<0.05).EA increased expression of vimentin and α-tubulin in SCs markedly,and signi?cantly enhanced PCNA immunoreactivity with decreased apoptosis in germ cells(P<0.01 or P<0.05).Conclusions: EA at BL 23 and ST 36 acupoints has protective effects on spermatogenesis in rats with OIKES.This effect seems to be achieved by attenuating TG-induced disruption of cytoskeletal protein in SCs.
文摘Objective:This study investigated the outcomes of microsurgical subinguinal varicocelectomy(MSV)on semen and hormonal parameters in cases with isolated sperm defects(oligozoospermia,asthenozoospermia,or teratozoospermia).Methods:A retrospective review of charts of patients who underwent MSV for clinically palpable varicocele between January 1,2011 and January 1,2019 at Hamad Medical Corporation was undertaken.All patients diagnosed with isolated oligozoospermia,asthenozoospermia,or teratozoospermia in the preoperative semen analysis were included.Men with multiple sperm defects,genetic abnormalities,azoospermia,history of genitourinary infection,exposure to chemotherapy or radiotherapy,or prior use of peri-operative fertility treatment were excluded.Data extracted from the electronic medical records included(collected before MSV and up to 6 months postoperatively):demographics(age),clinical data(fertility-related medical history and surgical interventions),family history(consanguinity and infertility),physical examination findings from general and local genital exam(varicocele side and grade),laboratory data such as semen analysis,sperm DNA fragmentation tests,and hormone levels(follicle-stimulating hormone,luteinizing hormone,total testosterone,estradiol,and prolactin),and imaging(scrotal color Doppler ultrasound).Results:A total of 331 patients with isolated sperm defects were included.Postoperatively,83.3%of patients showed an improvement in sperm concentration with a median increase of 7 millions/mL.Postoperatively,76.7%of isolated asthenozoospermic patients showed an improvement in total motility and 66.0%had an improvement in progressive motility with median increases of 15.0%and 7.5%,respectively.Postoperatively,70.0%of the teratozoospermic patients showed an improvement in normal sperm morphology with a median increase of 6%.No changes were observed in other semen or hormone parameters that were examined.Conclusion:MSV is a valid and effective treatment modality for patients with isolated sperm defects that significantly corrects their respective semen abnormality and improves their chances of natural conception.
文摘Background:Testicular sperm aspiration(TESA)is a minimally invasive testicular sperm retrieval technique that has been utilized in the treatment of male factor infertility.We sought to evaluate sperm retrieval outcomes of primary and redo TESA in men with severe oligoasthenoteratozoospermia(OAT)and obstructive azoospermia(OA).Methods:This is a retrospective analysis of consecutive TESAs(primary and redo)for men with severe OAT and OA performed between January 2011 and August 2022 at a high-volume infertility center.We compared TESA outcomes in men with severe OAT to those with OA and compared outcomes of men who underwent primary and redo TESA on the same testicular unit.Results:439 TESAs(366 primary and 73 redo)in men with severe OAT(n=133)and OA(n=306)were included.Men with OA had significantly higher sperm retrieval rate(SRR)and motile SRR compared to men with severe OAT(99%vs.95%and 98%vs.83%,respectively,p<0.05).The requirement for multiple biopsies and the total number of aspirates were significantly lower in men with OA compared to those with severe OAT(15%vs.32%and 1.2±0.5 vs.1.4±0.7,respectively,p<0.05).In both groups,SRR,motile SRR,the requirement for multiple biopsies,and the total number of aspirates were not significantly different in primary compared to redo cases.Conclusion:Our data demonstrate that TESA retrieval rates are significantly higher in men with OA compared to those with severe OAT.The data also demonstrate that a redo TESA in these men is as effective as a primary TESA,suggesting that areas of active spermatogenesis are preserved 6 months after TESA.
