Sperm Function Tests Beyond the Semen Analysis
|
|
- Valentine Phillips
- 6 years ago
- Views:
Transcription
1 Sperm Function Tests Beyond the Semen Analysis Edmund Sabanegh, Jr., M.D. Chairman, Department of Urology Glickman Urological and Kidney Institute Cleveland Clinic
2 Routine Semen Analysis: Gap in Knowledge?
3 Evolution of WHO semen standards Parameters Volume (ml) ND Sperm count (10 6 /ml) Total sperm count (10 6 ) ND Motility (%) Progressive motility 2 25% 25% (a) 25% (a) Vitality (%) ND Morphology (%) >14* Leukocyte count (10 6 /ml) < 4.7 < 1.0 < 1.0 < 1.0 *Strict (Tygerberg) criterion
4 Evolution of WHO semen standards Parameters Volume (ml) ND Sperm count (10 6 /ml) Total sperm count (10 6 ) ND Motility (%) Progressive motility 2 25% 25% (a) 25% (a) 32% (a+b) Vitality (%) ND Morphology (%) >14* 4* Leukocyte count (10 6 /ml) < 4.7 < 1.0 < 1.0 < 1.0 < 1.0 *Strict (Tygerberg) criterion
5 Overlap Ranges of Sperm Characteristics Overlap range (cut off values) % of Overlap Lower Higher fertile infertile Count (million) Motility (%) Morphology (%) WHO Strict criteria Nallella et al, Fertil Steril 85:629-34, 2006
6 Overlap Ranges of Sperm Characteristics Overlap range (cut off values) % of Overlap Lower Higher fertile infertile Count (million) Motility (%) Morphology (%) Not helpful WHO Strict criteria Nallella et al, Fertil Steril 85:629-34, 2006
7 Overlap Ranges of Sperm Characteristics Overlap range (cut off values) % of Overlap Lower Higher fertile infertile Count (million) More helpful Motility (%) Morphology (%) WHO Strict criteria Nallella et al, Fertil Steril 85:629-34, 2006
8 Overlap Ranges of Sperm Characteristics Overlap range (cut off values) % of Overlap Lower Higher fertile infertile Count (million) Motility (%) Morphology (%) WHO Strict criteria Most helpful Nallella et al, Fertil Steril 85:629-34, 2006
9 Variability in Sperm Concentration WHO 4 th Edition, 1999
10 Count and Conception Time to conception correlates with total sperm numbers and sperm concentration Zinaman (2000)- 200 couples off contraception for 12 months Longitudinal Investigation of Fertility and Environment (LIFE) Study (2014)- 473 couples off contraception for 12 months -Select morphology (head width) and sperm count were associated with shorter time to pregnancy -Overall strict morphology and kinetic parameters were not associated with improved time to conception
11 Routine Semen Analysis: Gap in Knowledge Lacks information on sub cellular / molecular changes in spermatozoa Need for tests to evaluate/stratify interventions
12 Limitations of Current Semen Testing Poor prediction of fertility since 50% of infertile men have normal semen parameters High inter and intra observer variability Morphology in particular is poorly correlated with outcomes The dilemma Men with abnormal semen analyses can be fertile and infertile men can have normal parameters
13 Ideal Sperm Function Test 1. Specific diagnosis of sperm dysfunction 2. Prediction of fertilization/pregnancy rate 3. Suggest targeted therapy to reverse infertility
14 Sperm DNA Sperm chromatin tightly packed due to cross linkages Sperm DNA fragmentation (DFI)- first described in 1993 Correlates with poor semen parameters, leukocytospermia, elevated oxidative stress Associated with unexplained infertility, recurrent miscarriage Sperm DNA integrity and morphology- poor correlation (Avendano, 2010) DNA sperm integrity correlates with reproductive success Elevated DFI- lower spontaneous pregnancy and assisted reproduction success rates
15 Causes of Impaired DNA Integrity Age replication errors Idiopathic Exposure to xenobiotics (Lifestyle, meds, occupational) DNA Damage Exposure to radiofrequency radiation Exposure to scrotal heat stress Defects of spermatogenesis associated with poor or aberrant protamination Assisted conception IVF ICSI Normal embryogenesis Normal DNA repair Abnormal Abnormal development Failed implantation Miscarriage Abnormalities in offspring?
16 Sperm DNA Assessment Sperm karyotyping Sperm FISH analysis Sperm DNA fragmentation tests
17 Methodology Fluorescent labeling of specific chromosome (5+probes) automated image analysis Sperm FISH Analysis Aneuploidy detection noted in 7% of normal men but much higher rates with oligospermic men and those with reciprocal or Robertsonian translocations
18 Sperm FISH Analysis Ramasamy, Fert Steril, Dec 2014
19 Sperm FISH Analysis Widely accepted indications -Men with normal semen analysisunexplained infertility -Partners with recurrent pregnancy loss -Repeated IVF failure -Screening tool to counsel couples regarding potential outcomes from reproductive options Ramasamy, Fert Steril, Dec 2014
20 Sperm DNA Testing COMET Assay TUNEL Assay Sperm with fragmented DNA Sperm with intact DNA The use of the acridine orange test and the TUNEL assay to assess the integrity of freeze-dried bovine spermatozoa DNA C.F. Martins1,2, M.N. Dode1, S.N. Báo2 and R. Rumpf1; Gen Mol Research, 2007
21 Sperm DNA Fragmentation and Pregnancy Natural Conception 7 times more likely to achieve pregnancy if DFI <30% (n = 362, P = ) Evenson, 2006; Greco, 2005
22 Sperm DNA Fragmentation and Pregnancy Natural Conception 7 times more likely to achieve pregnancy if DFI <30% (n = 362, P = ) Intrauterine insemination 7.3 times more likely to achieve pregnancy if DFI was <30% (n = 518, P = ) Evenson, 2006; Greco, 2005
23 Sperm DNA Fragmentation and Pregnancy Natural Conception 7 times more likely to achieve pregnancy if DFI <30% (n = 362, P = ) Intrauterine insemination Bottom line- DFI>30% and reproductive failure-consider 7.3 times more likely to achieve pregnancy if DFI was <30% (n = 518, P = ) ICSI and possible testicular sperm extraction (lower DNA IVF/ICSI fragmentation in testis vs ejaculated sperm) Infertile couples - 2 times more likely to become pregnant if DFI was <30% (n = 381, P = 0.03) Controversial since paternal genome not expressed until four-cell embryo Varicocele repair prior to ICSI may improve outcomes (Esteves, 2010) Evenson, 2006; Greco, 2005
24 DNA Fragmentation and IVF/ICSI Success Meta-analysis of IVF and ICSI outcomes IVF- High DFI- lower live birth rate ICSI- High DFI- no difference in live birth rates Higher spontaneous abortion rates in IVF and ICSI with high DFI Osman,2015
25 Outcome of Pregnancies with Elevated Sperm DNA Fragmentation High DFI associated with oligospermia and advanced paternal age No effect on intrauterine growth, postnatal physicial development or mental status of offspring of high DFI sperm Elevated sperm dna fragmentation occurs regularly and the machinery of a healthy oocyte might come to the rescue Palermo, Fert Steril, 2014
26 Indications for Sperm DNA Testing Unexplained infertility Recurrent pregnancy loss Prediction of ART outcome Assessment of genetic integrity Post-chemotherapy Advanced paternal age
27 Sperm DNA Challenges Lack of standardization of assays Significant intra-individual variation Technology does not allow individual sperm assessment for ICSI and sperm separation methods are not consistently effective in separating good DNA sperm population from compromised Predictive value for ART may improve if study DFI of motile portion of ejaculate (Palermo, 2014) ASRM (2013) and AUA Best Practice (2011) guidelines- not enough data to recommend routine sperm DNA testing
28 Oxidative Stress What is it : When oxidants outnumber antioxidants Reactive oxygen species (ROS) Generated by seminal leukocytes and sperm React with lipids, proteins and nucleic acids Neutrophils Macrophage Physiological Role: Induces acrosome reaction Mediates activation and capacitation Needed for membrane fluidity Spermatozoa are susceptible to oxidative stress: High concentration of polyunsaturated fatty acids Little capacity for membrane repair Limited cytoplasmic defensive enzymes
29 Clinical Implications of ROS Potential common pathway of injury- cryptorchidism, infection, aging, environmental exposures, cancer (Ko, 2014) Varicocele Increased ROS levels in serum, testes, semen (Sabanegh, 2009) Varicocelectomy increases seminal antioxidant levels and improves bulk semen parameters (Mostafa, 2001) Tobacco Smoking associated with poorer sperm quality (Kunzle, 2003; Raghed, 2009) Infertile smokers- higher levels of seminal oxidative stress than infertile nonsmokers (Saleh, 2002) Smoking cessation- improve semen quality, lowers ROS levels
30 Antioxidant therapy Scavenger: vitamins E and C, lycopene, carnitine, etc. Fertility outcomes Vit E+C supplementation- decreased semen ROS (DeFoor, 2004) Vit C ( mg/day)- increased sperm counts in infertile males (Dawson, 1987) Randomized crossover study of Vit E (600IU q day)-improved zona binding
31 Emerging Technologies Microarray Analyzes transcriptome of cells- comparison at different stages of spermatogenesis Proteomics Seminal fluid has >1000 different proteins and at least 20 have had altered expression in infertile men (Pilch,2006; Pixton, 2004) Genetics and Epigenetics Spermatozoal epigenetic disorders (Boissonnas, 2013; Gannon, 2014; Klaver, 2014) RNA defects (De Mateo, 2014; Jodar, 2013)
32 Proteomics and Male Infertility Study Subjects Sample size Source Technique Main finding Reference Varicocele Varicocele Control (n = 20) (n=20) Spermatozoa 2 DE; MALDI-TOF MS 15 proteins; 4 reduced in varicocele group; 11 overexpressed ; HSP60 and HSP 90 upregulated in varicocele group Chan et al Varicocele Pre-varicocelectomy Post-varicocelectomy (n = 18) Seminal plasma LC/MS 316 proteins; 53 in pre- and 38 in post varicocelectomy; 68 in both groups Camargo et al Oxidative stress Controls Infertile men ROS + and ROS - ( n = 20) ( n = 32) spermatozoa 2-DIGE; LC-MS 1,343 spots in ROS and 1,265 spots in ROS+ samples. 31 spots differentially expressed; 6 spots increased and 25 decreased in ROS- samples. Hamada et al Oxidative stress Controls Infertile men ROS + and ROS - ( n = 20) ( n = 32) Seminal fluid LC-MS 14 proteins; 7 common and 7 unique in both ROS+ and ROS grp. Sharma et al Idiopathic asthenozoospermia Donors Patients (n = 30) (n= 30) 2DE; Tandem mass spectrometry; MALDI-TOF 33 DEP; 15 unique proteins Shen et al Sperm motility proteins Fertile men Asthenozoospermic men (n = 8) (n = 8) spermatozoa 2 DE; MALDI-TOF 14 spots; 10 proteins; Energy metabolism proteins Zhao et al NOA Control NOA Post vasectomy (n =5) (n =5) (n = 5) Seminal plasma Spectral counts 2048 proteins in NOA; Batruch et al Asthenozoospermia Controls Asthenozoospermic men (n = 10) ( n= 20) Spermatozoa 2 DE; 17 protein spots; 8 decreased; 9 increased in asthenozoospermic men Martınez-Heredia et al Asthenozoospermia Controls Asthenozoospermic men (n = 20) (n = 38) Seminal plasma SDS PAGE; LC- MS/MS 741 proteins; 45 upregulated; 56 downregulateddj-11 downregulated in asthenozoospermic gp. Wang et al DE = 2 dimensional gel electrophoresis; MALDI-TOF = matrix assisted laser; LC-MS liquid chromatography mass spectrometry; ROS = reactive oxygen species; 2-DIGE = 2 dimensional in gel electrophoresis
33 Complexity of Proteomics Sharma, 2015
34
By Dr.Burde Kaustubh Girish DNB Narayana Hrudayalaya
By Dr.Burde Kaustubh Girish DNB Narayana Hrudayalaya The DNA is packed in sperm in a volume that is less than 10% somatic cell nucleus During spermatogenesis, DNA is initially packaged by histones Following
More informationBank your future: Insemination and semen cryopreservation. Disclosure. Lecture objectives
Bank your future: Insemination and semen cryopreservation Roelof Menkveld, PhD Andrology Laboratory, Department of Obstetrics and Gynaecology, Tygerberg Academic Hospital and University of Stellenbosch.
More informationDNA FRAGMENTATION INDEX (DFI) OF HUMAN SEMEN BY MODIFIED ANILINE BLUE METHOD
DNA FRAGMENTATION INDEX (DFI) OF HUMAN SEMEN BY MODIFIED ANILINE BLUE METHOD *Patil P., Bambulkar S., Ajgaonkar S., Patil R., Patil A. and Nikam V. Department of Anatomy, D Y Patil Medical College and
More informationIndex. B Betalains, 183 Betanin, 182, 183
A Aberrant DNA methylation, 175 Acridine orange (AO), 106, 121 122, 143 Aneuploidy FISH analysis chromosome-specific DNA probe, 29 globozoospermia, 35 hormone treatment, 42 43 human chromosomes, 29 human
More informationNovel Technologies for Selecting the Best Sperm for IVF and ICSI
Novel Technologies for Selecting the Best Sperm for IVF and ICSI Denny Sakkas, Ph.D. Scientific Director, Boston IVF Waltham, MA, USA Testing The Sperm Population NOW Sperm DNA testing Although we are
More informationTestosterone Therapy-Male Infertility
Testosterone Therapy-Male Infertility Testosterone Therapy-Male Infertility Many men are prescribed testosterone for a variety of reasons. Low testosterone levels (Low T) with no symptoms, general symptoms
More informationMale infertility too often ignored & forgotten
Male infertility too often ignored & forgotten The journey 1. of the men A review of the guidelines Joo Teoh FRANZCOG MRCP(Ire) MRCOG MBBCh MSc(Lon) MD(Glasgow) SubspecialtyRepromed(UK) Consultant Obstetrician
More informationChapter 8 Effect of Varicocele Treatment
Chapter 8 Effect of Varicocele Treatment Although multiple pathophysiological derangements have been documented in varicocele, the central issue is whether or not repair of this condition improves fertility.
More informationUse of Testicular Sperm for ICSI in Non-Azoospermic Men: How Far Should we Go?
Use of Testicular Sperm for ICSI in Non-Azoospermic Men: How Far Should we Go? Armand Zini, MD, FRCSC McGill University Disclosure: Shareholder in YAD Tech Neutraceuticals Co. Sperm Retrieval: Overview
More informationSignificant decrease in sperm deoxyribonucleic acid fragmentation after varicocelectomy
Significant decrease in sperm deoxyribonucleic acid fragmentation after varicocelectomy Philip Werthman, M.D., FACS, a Regina Wixon, Ph.D., b Kay Kasperson, B.S., b and Donald P. Evenson, Ph.D. c a Center
More informationCommittee Paper SCAAC(05/09)01. ICSI guidance. Hannah Darby and Rachel Fowler
Committee Paper Committee: Scientific and Clinical Advances Advisory Committee Meeting Date: 12 May 2009 Agenda Item: 4 Paper Number: SCAAC(05/09)01 Paper Title: ICSI guidance Author: Hannah Darby and
More informationTime to improvement in semen parameters after microsurgical varicocelectomy in men with severe oligospermia
Time to improvement in semen parameters after microsurgical varicocelectomy in men with severe oligospermia Thomas A. Masterson; Aubrey B. Greer; Ranjith Ramasamy University of Miami, Miami, FL, United
More informationFertility What do GP s need to know? Richard Fisher Fertility Associates
Fertility 2010 What do GP s need to know? Richard Fisher Fertility Associates New Zealand Source: Max Planck Institute Average age of mother at first birth in New Zealand 35 30 25 20 15 10 5 0 Median Mean
More informationName of Policy: Laboratory Tests of Sperm Maturity, Function and DNA Integrity
Name of Policy: Laboratory Tests of Sperm Maturity, Function and DNA Integrity Policy #: 219 Latest Review Date: January 2009 Category: Laboratory Policy Grade: Active Policy but no longer scheduled for
More informationInformation Sheet. Male Infertility
Infertility National Public Awareness Campaign Information Sheet Male Infertility In approximately half of couples complaining of infertility part of the problem lies with the male. Male infertility has
More informationSpermComet DNA Test your results and what they mean
SpermComet DNA Test your results and what they mean Sperm DNA damage and why it is important for your fertility. You and your partner are each going to give some of your DNA to your baby, so the health
More informationSperm gamete screening
Sperm gamete screening Juan G. Alvarez, M.D, Ph.D Instituto Marquès, Barcelona Harvard Medical School, Boston Sperm screening Standard semen analysis Sperm capacitation Oocyte activating factor (PLC zeta
More informationEvaluation and Treatment of the Subfertile Male. Karen Baker, MD Associate Professor Duke University, Division of Urology
Evaluation and Treatment of the Subfertile Male Karen Baker, MD Associate Professor Duke University, Division of Urology Disclosures: None Off label uses: There are no oral medications approved by the
More informationAdoption and Foster Care
GLOSSARY Family building via Adoption and Foster Care October 2018 www.familyequality.org/resources A Anonymous Donor: A person who donated sperm or eggs with the intention of never meeting resulting children.
More informationAssessment of Sperm DNA Fragmentation for Patients Suffering from Varicocele
Assessment of Sperm DNA Fragmentation for Patients Suffering from Varicocele Saif H. Mohammed 1, Adib M. Al-Kazzaz 2, Usama S.Al- Nasiri 3 1-Department of Urology- College of Medicine- Al-Nahrain University-
More informationWhat You Need to Know
UW MEDICINE PATIENT EDUCATION What You Need to Know Facts about male infertility This handout explains what causes male infertility, how it is diagnosed, and possible treatments. Infertility is defined
More informationIndex. B Bcl 2 family, abortive apoptosis, 299
Index A Abortive apoptosis DNA damage, 301 germ cell apoptosis, genes regulation Bcl 2 family, 299 caspases, 300 c-kit, 300 CREM, 300 p53, 300 hormonal regulation, 301 vs. necrosis, 296 programmed cell
More informationSelection of sperm for ICSI: hyaluronan binding
Selection of sperm for ICSI: hyaluronan binding Dave Morroll Director of Embryology Reference Values Volume: 2.0 2.0 1.5 (1.4-1.7) ph: 7.2-7.8 7.2 >7.2 Concn (x10 6 ml): 20 20 15 (12-16) Total count(x10
More informationFood for special medical purposes for the dietary management of male fertility issues related to limited semen quality.
A-Bregenz, 27.04.2016 To Romanian authorities / to whom it may concern, Römerstrasse 2,, Austria, hereby informs. Fertilovit M plus Food for special medical purposes for the dietary management of male
More informationNICE fertility guidelines. Hemlata Thackare MPhil MSc MRCOG Deputy Medical Director London Women s Clinic
NICE fertility guidelines Hemlata Thackare MPhil MSc MRCOG Deputy Medical Director London Women s Clinic About the LWC 4 centres around the UK London Cardiff Swansea Darlington The largest sperm bank in
More informationUsefulness of Sperm Chromatin Tests in the Context of Infertility Treatment: IUI, IVF, ICSI
Usefulness of Sperm Chromatin Tests in the Context of Infertility Treatment: IUI, IVF, ICSI Armand Zini, MD McGill University Clinical Value of Sperm DNA Tests Overview Etiology of sperm DNA damage Influence
More informationMale fertility disorders
Male fertility disorders Etiology diagnosis therapeutic approaches Dr. Cornelia Roggenbuck September 29, 2009 Orthomol pharmazeutische Vertriebs GmbH Content Fertility Facts and figures Factors of influence
More informationHuman Sperm Nuclear DNA Fragmentation Assays and Their Values in Assisted Conception
Human Sperm Nuclear DNA Fragmentation Assays and Their Values in Assisted Conception (Values of Sperm Nuclear DNA Testing in Assisted Reproduction) Mahmood Morshedi, Ph.D., HCLD(ABB) Eastern Virginia Medical
More information24-Feb-15. Learning objectives. Family genetics: The future??? The traditional genetics. Genetics and reproduction in early 2015.
Learning objectives Family genetics: The future??? Peter Illingworth Medical Director IVFAustralia Understand how genetic problems may affect successful conception Consider the possible conditions and
More informationThe study of relationship between chromosomal abnormality in lymphocyte cells of infertile men with intra-cytoplasmic sperm injection outcomes
The study of relationship between chromosomal abnormality in lymphocyte cells of infertile men with intra-cytoplasmic sperm injection outcomes Fallahi P, Rezaeian Z, *Moghbelinejad S Fertility and infertility
More informationOUTCOME OF TREATMENT FOR OAT SYNDROME BY INTRACYTOPLASMIC SPERM INJECTION AT THE ART CENTER
OUTCOME OF TREATMENT FOR OAT SYNDROME BY INTRACYTOPLASMIC SPERM INJECTION AT THE ART CENTER Ho Sy Hung, Trinh Thi Thuy Hanoi Medical University, Thaibinh Medical University INTRODUCTION Infertility rate
More informationInfertility Pregnancy After Varicocelectomy: Impact of Postoperative Motility and DFI
Infertility Pregnancy After Varicocelectomy: Impact of Postoperative Motility and DFI Karen Baker, John McGill, Rakesh Sharma, Ashok Agarwal, and Edmund Sabanegh, Jr. OBJECTIVE METHODS RESULTS CONCLUSION
More informationChris Davies & Greg Handley
Chris Davies & Greg Handley Contents Definition Epidemiology Aetiology Conditions for pregnancy Female Infertility Male Infertility Shared infertility Treatment Definition Failure of a couple to conceive
More informationRelation between Level of Total Antioxidant Capacity and Semen Quality in Male Infertility
Relation between Level of Total Antioxidant Capacity and Semen Quality in Male Infertility Ahmed M. A. Tahoun, Tarek M. Emran, Amr M. Al-Kharasawy and Ahmed A. Abo Nar Department of Clinical Pathology,
More informationBiology of fertility control. Higher Human Biology
Biology of fertility control Higher Human Biology Learning Intention Compare fertile periods in females and males What is infertility? Infertility is the inability of a sexually active, non-contracepting
More informationCOMMISSIONING POLICY. Tertiary treatment for assisted conception services
Final Version COMMISSIONING POLICY Tertiary treatment for assisted conception services Designated providers for patients registered with a Worcestershire GP BMI The Priory Hospital, Birmingham - 1 - Commissioning
More informationDirector of Commissioning, Telford and Wrekin CCG and Shropshire CCG. Version No. Approval Date August 2015 Review Date August 2017
Commissioning Policy for In Vitro Fertilisation (IVF)/ Intracytoplasmic Sperm Injection (ICSI) within tertiary Infertility Services, in Shropshire and Telford and Wrekin Owner(s) Version No. Director of
More informationGonadosan Distribution GmbH Römerstr Bregenz Österreich Telefon: Fax:
A-Bregenz, 27.04.2016 To Romanian authorities / to whom it may concern, Römerstrasse 2,, Austria, hereby informs. Fertilovit MT Dietary supplement with zinc and selenium. Zinc contributes to normal fertility
More informationMale Factor Infertility
Male Factor Infertility Simplified Evaluaon and Treatment* ^ * In 20 minutes or less In 20 slides ^ 5 minute office visit ALWAYS EVALUATE THE MALE & THE FEMALE Why 1. To help the coupleachieve a pregnancy
More informationASSISTED REPRODUCTIVE TECHNOLOGIES (ART)
ASSISTED REPRODUCTIVE TECHNOLOGIES (ART) Dr. Herve Lucas, MD, PhD, Biologist, Andrologist Dr. Taher Elbarbary, MD Gynecologist-Obstetrician Geneva Foundation for Medical Education and research Definitions
More informationICSI FROM FRESH TESE IN ABSOLUTE ASTHENOZOOSPERMIA: AN OPTION OR SOLUTION?
ICSI FROM FRESH TESE IN ABSOLUTE ASTHENOZOOSPERMIA: AN OPTION OR SOLUTION? Mirco Castiglioni 1 Benedetta Scarselli 2 Valentina Zambelli 2 Giovanni M. Colpi 1 1) Andrological Urology & IVF Unit (Director:
More informationHuman Sperm Nuclear DNA Fragmentation Assays and Their Values in Assisted Conception. Mahmood Morshedi, Ph.D., HCLD(ABB)
Human Sperm Nuclear DNA Fragmentation Assays and Their Values in Assisted Conception Mahmood Morshedi, Ph.D., HCLD(ABB) Outline Of The Talk Structure of DNA Changes in DNA to facilitate the nuclear matrix
More informationThe new 5 th WHO manual semen parameter reference values do they help or hinder?
The new 5 th WHO manual semen parameter reference values do they help or hinder? Roelof Menkveld, PhD Andrology Laboratory, Department of Obstetrics and Gynaecology, Tygerberg Academic Hospital and University
More informationClinical evaluation of infertility
Clinical evaluation of infertility DR. FARIBA KHANIPOUYANI OBSTETRICIAN & GYNECOLOGIST PRENATOLOGIST Definition: inability to achieve conception despite one year of frequent unprotected intercourse. Male
More informationReproductive Technology, Genetic Testing, and Gene Therapy
Michael Cummings Chapter 16 Reproductive Technology, Genetic Testing, and Gene Therapy David Reisman University of South Carolina 16.1 Infertility Is a Common Problem In the US, about 13% of all couples
More informationEast and North Hertfordshire CCG. Fertility treatment and referral criteria for tertiary level assisted conception
East and North Hertfordshire CCG Fertility treatment and referral criteria for tertiary level assisted conception December 2015 1 1. Introduction This policy sets out the entitlement and service that will
More informationCase Report Successful Pregnancy in a Couple with Severe Male Factor Infertility after Selection of Sperm with Cytoplasmic Droplets
Case Reports in Obstetrics and Gynecology Volume 2015, Article ID 276931, 4 pages http://dx.doi.org/10.1155/2015/276931 Case Report Successful Pregnancy in a Couple with Severe Male Factor Infertility
More informationSupport for Fertility and Infertility Treatment
Support for Fertility and Infertility Treatment Obesity causes an alteration to the hormones associated with women fertility Many different studies have concluded that obesity is related to impaired fertility.
More informationDr Guy Gudex. Gynaecologist and Fertility Specialist Repromed. 9:05-9:30 Advances in Assisted Reproduction What s New?
Dr Guy Gudex Gynaecologist and Fertility Specialist Repromed 9:05-9:30 Advances in Assisted Reproduction What s New? Rotorua GP CME June 2016 Advances in Assisted Reproduction-What s new? Dr Guy Gudex
More informationMale Fertility: Your Questions Answered
Male Fertility: Your Questions Answered Michael S. Neal Scientific Director, ONE Fertility, 3210 Harvester Rd. Burlington, Ontario www.onefertility.com mneal@onefertility.com Outline Assisted Conception
More informationINSIDE IVF: HOW SCIENCE CARES FOR PATIENTS DR DEIRDRE ZANDER-FOX MONASH IVF GROUP HDA GRAND ROUND OCTOBER 31 ST 2018
INSIDE IVF: HOW SCIENCE CARES FOR PATIENTS DR DEIRDRE ZANDER-FOX MONASH IVF GROUP HDA GRAND ROUND OCTOBER 31 ST 2018 IVF-THE ULTIMATE GOAL FERTILISATION EMBRYO CLEAVAGE AND DEVELOPMENT POSITIVE HCG POSITIVE
More informationUnexplained Male infertility: Diagnosis and Management
REVIEW Article Vol. 38 (5): 576-594, September - October, 2012 Unexplained Male infertility: Diagnosis and Management Alaa Hamada, Sandro C. Esteves, Mark Nizza, Ashok Agarwal Center for Reproductive Medicine,
More informationReversible Conditions Organising More Information semen analysis Male Infertility at Melbourne IVF Fertility Preservation
Male Infertility Understanding fertility in men Conceiving a baby depends on a number of factors, including healthy sperm. After a woman s age, this can be the biggest issue. Reproduction, although simple
More informationInfertility TUNEL as a Test for Sperm DNA Damage in the Evaluation of Male Infertility
Infertility TUNEL as a Test for Sperm DNA Damage in the Evaluation of Male Infertility Rakesh K. Sharma, Edmund Sabanegh, Reda Mahfouz, Sajal Gupta, Aparna Thiyagarajan, and Ashok Agarwal OBJECTIVES METHODS
More informationFertility 101. About SCRC. A Primary Care Approach to Diagnosing and Treating Infertility. Definition of Infertility. Dr.
Dr. Shahin Ghadir A Primary Care Approach to Diagnosing and Treating Infertility St. Charles Bend Grand Rounds November 30, 2018 I have no conflicts of interest to disclose. + About SCRC State-of-the-art
More informationINVESTIGATIONS ON THE QUANTITY OF DEZOXYRIBONUCLEIC ACID (DNA) FRAGMENTED FROM NUCLEUS OF HUMAN SPERM CELL
INVESTIGATIONS ON THE QUANTITY OF DEZOXYRIBONUCLEIC ACID (DNA) FRAGMENTED FROM NUCLEUS OF HUMAN SPERM CELL Mihaela OSTAN 1, Anca-Laura STĂNIA 2,3, Olga-Alina RADA 1, Raluca POPESCU 3, Delia HUŢANU 2,3
More informationIMPACT OF NUTRITION ON MALE GAMETE
IMPACT OF NUTRITION ON MALE GAMETE Pr R. LEVY and C. FAURE, N. SERMONDADE, C. DUPONT, P. LEVEILLE, I. CEDRIN, S. HERCBERG and S. CZERNICHOW Histologie Embryologie Cytogénétique CECOS, CHU Jean Verdier,
More informationResults and Discussion
The AMH and Inhibin B in serum and follicular fluid was a very good predictive marker for assessment of oocyte quantity but did not correlate with the maturity of the oocyte or fertilization or reproductive
More informationJournal of Paramedical Sciences (JPS) Spring 2011 Vol.2, No.2 ISSN
Rare association of multiple etiologies in a severe oligoasthenospermic male Vineeth V.S. 1, Mohsen Najafi 1, Sreenivasa G. 1, Sharath Kumar C. 2, Suttur S. Malini 1,* 1 Department of Studies in Zoology,
More informationPrepare your first visit to Sakthi Fertility
Prepare your first visit to Sakthi Fertility Infertility History Form CONTACT INFORMATION FEMALE: First Name Middle Initial Last Name Date of birth (MM/DD/YY) / / Occupation Health card number Version
More informationWhat to do about infertility?
What to do about infertility? Dr. M.A. Fischer Section Head, Division of Urology, Department of Surgery Assistant Clinical Professor, Department of Obstetrics and Gynecology Hamilton Health Sciences, Hamilton,
More informationTHE INFLUENCE OF EJACULATORY ABSTINENCE INTERVALS ON SEMEN QUALITY - OLD CONCEPT, NEW EVIDENCES
THE INFLUENCE OF EJACULATORY ABSTINENCE INTERVALS ON SEMEN QUALITY - OLD CONCEPT, NEW EVIDENCES Edson Borges Jr 1,2, Amanda Setti Raize 1,2 ; Daniela Paes de Almeida Ferreira Braga 1,2 Rodrigo R. Provenza
More informationFertility treatment and referral criteria for tertiary level assisted conception
Fertility treatment and referral criteria for tertiary level assisted conception Version Number Name of Originator/Author Cross Reference V2 East of England Consortium Commissioning Policy for Fertility
More informationReda Mahfouz, MD Jeffrey Goldberg MD Tommaso Falcone, MD
CENTER for REPRODUCTIVE MEDICINE Glickman Urological and Kidney Institute and Obstetrics Gynecology and Women s Health Institute Duration: August 1 30, 2008 Locations: TT3 (Cleveland Clinic), A81 Gynecology
More informationRejuvenation of Gamete Cells; Past, Present and Future
Rejuvenation of Gamete Cells; Past, Present and Future Denny Sakkas PhD Scientific Director, Boston IVF Waltham, MA, USA Conflict of Interest I have no conflict of interest related to this presentation.
More informationInternational Journal of Advanced Research in Biological Sciences
International Journal of Advanced Research in Biological Sciences www.ijarbs.com Research Article Sperm chromatin and ICSI Outcome Mahmoud Edessy, Abdel-naser M. Ali, Ahmed A. M. Nasr, Manal Gaber Abd
More informationRole of Antioxidants in Assisted Reproductive Techniques
pissn: 2287-4208 / eissn: 2287-4690 World J Mens Health 2017 August 35(2): 77-93 https://doi.org/10.5534/wjmh.2017.35.2.77 Review Article Role of Antioxidants in Assisted Reproductive Techniques Ashok
More informationWiltshire CCG Fertility Policy
Wiltshire CCG Fertility Policy Introduction This policy sets out the limits within which WCCG will fund treatment with either Intrauterine Insemination [IUI], ovulation induction medication or donor insemination
More informationMale fertility and infertility
Male fertility and infertility Allan A Pacey Abstract In 30 50% of sub-fertile couples the male partner has poor semen quality, either because of low sperm count, poorly motile sperm or sperm with abnormal
More informationMedical Affairs Policy
Medical Affairs Policy Service: Infertility and Recurrent Pregnancy Loss Testing and Treatment PUM 250-0018-1706 Medical Policy Committee Approval 06/16/17 Effective Date 10/01/17 Prior Authorization Needed
More informationSperm Surface Antibodies: IUI vs. IVF Treatment
Research Article Sperm Surface Antibodies: IUI vs. IVF Treatment Afaf Felemban MD*, Seham M. Hassonah MD, Najla Felimban KD, Hadeel Alkhelb MD, Samar Hassan MD, Fahad Alsalman MD Department of Obstetrics
More informationFertility treatment and referral criteria for tertiary level assisted conception
Fertility treatment and referral criteria for tertiary level assisted conception Version Number 2.0 Ratified by HVCCG Exec Team Date Ratified 9 th November 2017 Name of Originator/Author Dr Raj Nagaraj
More informationFertility Preservation By Dr Mary Birdsall Chair, Fertility Associates
Fertility Preservation By Dr Mary Birdsall Chair, Fertility Associates What can you put in the Freezer and why would you? Sperm Embryos Eggs Ovarian Tissue Freezing Sperm 60 years ago first human pregnancy
More informationEffect of chemo- or radiotherapeutic agents on human sperm: the reproductive needs of young male cancer survivors. Ghamartaj-Hosseini
Effect of chemo- or radiotherapeutic agents on human sperm: the reproductive needs of young male cancer survivors Effect of chemo- or radiotherapeutic agents on human sperm: the reproductive needs of young
More informationInfertility Age-Related Increase of Reactive Oxygen Species in Neat Semen in Healthy Fertile Men
Infertility Age-Related Increase of Reactive Oxygen Species in Neat Semen in Healthy Fertile Men Marcello Cocuzza, Kelly S. Athayde, Ashok Agarwal, Rakesh Sharma, Rodrigo Pagani, Antonio M. Lucon, Miguel
More informationTherapeutic Sperm Banking
Therapeutic Sperm Banking An Option for Preserving Male Fertility Andrology Laboratory and Reproductive Tissue Bank Information For Patients Men undergoing cancer treatment, including certain types of
More informationSperm DNA Damage In Smokers
Sperm DNA Damage In Smokers Original Article Elsayed S. Hewedy 1, Ghada F. Hassan 1, Rana M. Abo El Enein 1, Mohammad A. Saad 2 1 Departments of Dermatology and Venereology and 2 Clinical Pathology, Faculty
More informationIMPACT OF SPERM QUALITY ON
IMPACT OF SPERM QUALITY ON EMBRYO VIABILITY M.C. Magli, L. Gianaroli, A.P. Ferraretti SISMER, Reproductive Medicine Unit, Bologna, Italy www.iiarg.com www.sismer.it LEARNING OBJECTIVES To define the sperm
More informationFertility Assisted Conception Criteria Based Access Protocol Supporting people in Dorset to lead healthier lives
NHS Dorset Clinical Commissioning Group Fertility Assisted Conception Criteria Based Access Protocol Supporting people in Dorset to lead healthier lives POLICY TRAIL AND VERSION CONTROL SHEET: Policy Reference:
More information2. If it is true, do you think there is apt number of clinical experts and expertise to tackle this issue?
1. What is your opinion about the rising male infertility globally? Response: It is tempting to suggest that the male infertility is rising globally. Worldwide, an estimated 9% of couples meet the definition
More informationSperm Health Optimizer. Literature Report. Dietary effects of micronutrients on male fertility
Sperm Health Optimizer Literature Report Dietary effects of micronutrients on male fertility Summary 1. Micronutrient combinations Wong WY, Merkus HMWM, Thomas CMG, et al. Effects of folic acid and zinc
More informationBringing Life to the Living
Bringing Life to the Living ReGenesis Where Life Begins Centre for Assisted Reproduction, Endoscopy and Fetal Medicine Traditionally, infertility is defined as the inability to conceive for more than two
More informationDRAFT Policy for the Provision of NHS funded Gamete Retrieval and Cryopreservation for the Preservation of Fertility
NHS Birmingham and Solihull Clinical Commissioning Group NHS Sandwell and West Birmingham Clinical Commissioning Group DRAFT Policy for the Provision of NHS funded Gamete Retrieval and Cryopreservation
More informationREPRODUCTIVE RESEARCH CENTER Glickman Urological and Kidney Institute and Department of Obstetrics & Gynecology. ART Training and Teaching Schedule
REPRODUCTIVE RESEARCH CENTER Glickman Urological and Kidney Institute and Department of Obstetrics & Gynecology ART Training and Teaching Schedule Hullamani Malleshappa Puttappa, ; Nirmala Agarwal, ; Preethi
More informationTECNICHE E SIGNIFICATO DELLA SELEZIONE SPERMATICA PER ICSI
TECNICHE E SIGNIFICATO DELLA SELEZIONE SPERMATICA PER ICSI Enzo Troilo Lodovico Parmegiani GynePro Medical Centers Bologna - Italy www.gynepro.it Intracytoplasmic Sperm Injection (ICSI) The selection of
More informationUnderstanding eggs, sperm and embryos. Marta Jansa Perez Wolfson Fertility Centre
Understanding eggs, sperm and embryos Marta Jansa Perez Wolfson Fertility Centre What does embryology involve? Aims of the embryology laboratory Creation of a large number of embryos and supporting their
More informationLaura Rienzi Senior Clinical Embryologist
www.generaroma.it CLINICA VALLE GIULIA, Rome SALUS, Marostica UMBERTIDE, Perugia Laura Rienzi Senior Clinical Embryologist Salzburg, Austria 1,2 April 2011 No commercial activities are related to this
More informationFACT SHEET. Failure of Ovulation Blocked or Damaged Fallopian TubesHostile Cervical Mucus Endometriosis Fibroids
FACT SHEET Overview of infertility If getting pregnant has been a challenge for you and your partner, you're not alone. Ten to 15 percent of couples in the Lithuania are infertile. Infertility is defined
More informationIVF AND PREIMPLANTATION GENETIC TESTING FOR ANEUPLOIDY (PGT-A) WHAT THE COMMUNITY PHYSICIAN NEEDS TO KNOW
IVF AND PREIMPLANTATION GENETIC TESTING FOR ANEUPLOIDY (PGT-A) WHAT THE COMMUNITY PHYSICIAN NEEDS TO KNOW Jon Havelock, MD, FRCSC, FACOG Co-Director - PCRM Disclosure No conflict of interest in relation
More informationSperm DNA fragmentation testing: a cross sectional survey on current practices of fertility specialists
Original Article Sperm DNA fragmentation testing: a cross sectional survey on current practices of fertility specialists Ahmad Majzoub 1, Ashok Agarwal 2, Chak-Lam Cho 3, Sandro C. Esteves 4,5 1 Department
More informationFertility Services Commissioning Policy
Fertility Services Commissioning Policy Author: Commissioning Team Version No: Two Policy Effective From: 29 September 2016 Review Date: September 2017 Policy Amendment: 02 August 2017 Document Reader
More informationClinical Policy Committee
Northern, Eastern and Western Devon Clinical Commissioning Group South Devon and Torbay Clinical Commissioning Group Clinical Policy Committee Commissioning policy: Assisted Conception Fertility treatments
More informationDr Devashana Gupta. Dr Karen Buckingham. Obstetrician and Gynaecologist Repromed. Repromed Auckland
Dr Karen Buckingham Obstetrician and Gynaecologist Repromed Dr Devashana Gupta Repromed Auckland 8:30-9:25 WS #93: Optimising Fertility - Periconception Management 9:35-10:30 WS #105: Optimising Fertility
More informationMALE INFERTILITY & SEMEN ANALYSIS
MALE INFERTILITY & SEMEN ANALYSIS DISCLOSURE Relevant relationships with commercial entities none Potential for conflicts of interest within this presentation none Steps taken to review and mitigate potential
More informationIntrauterine (IUI) and Donor Insemination (DI) Policy (excluding In vitro fertilisation (IVF) & Intracytoplasmic sperm injection (ICSI) treatment)
Leicester City Clinical Commissioning Group West Leicestershire Clinical Commissioning Group East Leicestershire and Rutland Clinical Commissioning Group POLICY DOCUMENT Intrauterine (IUI) and Donor Insemination
More informationInfluence of Oxidative Stress on Functional Integrity of Human Spermatozoal Membrane.
The Journal of Obstetrics and Gynecology of India, March / April 2011 pg 195-199 Original Article Influence of Oxidative Stress on Functional Integrity of Human Spermatozoal Membrane. Chaudhari Ajay 1,
More informationFertility in the 21 st Century Dr Leigh Searle
Fertility in the 21 st Century Dr Leigh Searle Fertility Specialist, Obstetrician, Gynaecologist FRANZCOG, PGDipOMG, MBChB Dr Kate Van Harselaar Fertility Specialist, Obstetrician and Gynaecologist Overview
More informationUse of donor semen in the treatment of
Use of donor semen in the treatment of male infertility Where is the evidence? Max H.J.M. Curfs Isala clinics Zwolle, The Netherlands Strength of evidence Systematic review Meta-analysis RCT 1A 1A 1B
More informationDr Guy Gudex. Director Repromed. 17:00-17:30 Recent Advances in Fertility Management
Dr Guy Gudex Director Repromed 17:00-17:30 Recent Advances in Fertility Management Recent Advances in Fertility Management Practice Nurses Programme NZMA GP CME June 2018 Dr Guy Gudex ART in NZ -2014 ACART
More informationIs defined as the altruistic gift of the male gametes from an anonymous man to help single women and couples to procreate.
Dr. Marcos Meseguer (marcos.meseguer@ivi.es) Dr. Nicolás Garrido (nicolas.garrido@ivi.es) Help Wanted; Sperm donation in the era of ICSI Sperm Donation Is defined as the altruistic gift of the male gametes
More information