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PubMed1995

Comparison of sperm parameters, in vitro fertilization results, and subsequent pregnancy rates using sequential ejaculates, collected two hours apart, from oligoasthenozoospermic men.

OBJECTIVE: To evaluate the effect of second consecutive ejaculate collected 2 hours after the first one from infertile men on sperm quality and fertilization and pregnancy rates (PRs) in IVF. DESIGN: A prospective case-control study. SETTING: In vitro fertilization unit of a university hospital. PATIENTS: Thirty-nine consecutive infertile patients with oligoasthenozoospermia scheduled for IVF-ET. MAIN OUTCOME MEASURES: Two consecutive ejaculates were obtained 2 hours apart and were assessed for volume, sperm count, motility, morphology, and quality of swim-up fraction. The subsequent fertilization, cleavage, and PRs (as defined by the appearance of intrauterine gestational sac) were compared between the two ejaculates. RESULTS: In 28.2% of the individuals the semen analysis of the first ejaculate precluded proceeding with IVF. A statistically significant improvement was shown in sperm cell motility (31.9% +/- 20.7% versus 15.6% +/- 15.3%) and in motile count after swim-up (4.9 +/- 4.5 versus 2.6 +/- 3.1 x 10(6) sperm). No improvement could be demonstrated in sperm density or morphology. The volume of the second ejaculate was decreased significantly as compared with the first one. The fertilization rate, the cleavage rate, and PR were all increased when oocytes were exposed to sperm from the second ejaculate compared with oocytes exposed to sperm from the first ejaculate. The overall PR in our series was 25.6%. CONCLUSIONS: We suggest that in the group of infertile men with oligoasthenozoospermia, whose partners are scheduled for IVF-ET, if on the day of retrieved oocytes insemination, the ejaculate is of unacceptable quality, a second ejaculate collected 2 hours after collection of the initial ejaculate may produce a sample that exhibits improvements in both semen parameters and reproductive potential.

Adult↗
PubMed1995

Intracytoplasmic sperm injection in the mouse.

Intracytoplasmic sperm injection (ICSI) into mouse oocytes involves a very low survival rate. This study was designed to determine why ICSI frequently fails in mice. Metaphase II oocytes were obtained from superovulated 4-6 week old F1 hybrid mice. Spermatozoa were retrieved from the epididymis of 12-14 week old F1 hybrid mice. The spiked microinjection pipette used to inject a spermatozoon into the ooplasm had outer and inner diameters of 10 and 8 microns respectively. The oocytes used in the first part of the study were not activated (group 1). Some oocytes were incubated with calcium ionophore for 5 min (group 2). The injected oocytes were evaluated 6, 20, 48 and 72 h after injection. A total of 143 eggs in each group underwent ICSI. In group 1, sperm heads escaped into the perivitelline space. In all, 63 (47%) of the remaining oocytes were damaged during the injection or had degenerated by the first evaluation. The survival rate was 53%, but fertilization did not occur. In group 2, 31 oocytes (22%) were damaged during microinjection or soon degenerated. Two oocytes underwent accidental subzonal insemination. Six oocytes were fertilized (4.2%) among the 78% of survivors. After injection, the sperm tail was found in the cytoplasm (27 and 31% in groups 1 and 2 respectively), the perivitelline space (45% in both groups) or protruding through the zona pellucida (28 and 23% respectively). More oocytes degenerated when the tail remained in the cytoplasm, i.e. 78% in group 1 and 36% in group 2.

Animals↗
PubMed2002

Effect of repeated assisted reproductive technology cycles on ovarian response.

OBJECTIVE: To assess the effect of repeated assisted reproductive technology (ART) cycles on the ovarian response in patients treated with human menopausal gonadotropins and GnRH agonists. DESIGN: Retrospective analysis. SETTING: Tertiary referral center. PATIENT(S): Three thousand two hundred forty-nine patients who had completed at least two in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles (minimum two, maximum six cycles per patient). INTERVENTION(S): Nine thousand three hundred seventy-nine repeated IVF/ICSI cycles. MAIN OUTCOME MEASURE(S): Mean number of cumulus oocyte complexes (COC) retrieved per cycle, mean number of ampules used per attempt. RESULT(S): Repeated ART cycles did not exert a significant effect on the mean number of COC retrieved per attempt in contrast to maternal age, which was inversely related to the mean number of COC retrieved in all cycles performed. Across repeated ART attempts, an increase in the mean number of ampules used per cycle was observed. This was due to an effect of maternal age, which increased in line with the mean number of ampules used per cycle, as well as to an age-independent effect of repeated cycles. CONCLUSION(S): An age-independent deterioration of the ovarian response appears to occur across repeated ART cycles.

Adult↗
PubMed1996

Effect of incremental time experience on the results of in vitro fertilization with intracytoplasmic sperm injection (ICSI).

PURPOSE: Our objective was to determine the effect of experience on the results with intracytoplasmic sperm injection. METHODS: The quarterly outcome with both ICSI and traditional in vitro fertilization (IVF) in 1994 was analyzed in 475 patients under age 40 undergoing 595 oocyte retrievals. The data represent 307 patients undergoing 379 retrievals for IVF and 165 patients undergoing 216 retrievals for ICSI. RESULTS: Fertilization rates with ICSI improved significantly each quarter (52.96, 62.17, 70.17, and 74.87% in Q-I, Q-II, Q-III, and Q-IV, respectively), while the rate with IVF improved significantly between Q-I (69.9%) and Q-II (80.10%) and slightly but significantly between Q-II and Q-IV (82.88%). The implantation rate per embryo after ICSI improved significantly after Q-I (6.17%) compared to Q-II (10.70%) and Q-IV (12.14%). The pregnancy rate per transfer with ICSI increased steadily after Q-I (13.79, 21.88, 23.53, and 25.00% in Q-I through Q-IV), reaching statistical significance between Q-I and Q-III and between Q-I and Q-IV. CONCLUSIONS: Although acceptable results can be obtained with ICSI after a relatively short period of time, optimum results require substantial experience.

Embryo Transfer↗
PubMed1998

Zygote intrafallopian transfer may improve pregnancy rate in patients with repeated failure of implantation.

OBJECTIVE: To evaluate the efficacy of zygote intrafallopian transfer (ZIFT) on implantation rates and pregnancy rates (PRs) in patients with repeated failure of implantation in IVF-ET cycles. DESIGN: A case-control study. PATIENT(S): Criteria for patient selection included male factor or unexplained infertility, normal uterine cavity, and at least three failures of implantation in IVF-ET cycles in which at least three embryos were placed per transfer. Data on 70 patients who underwent 92 ZIFT cycles are presented. A control group consisted of patients with the same selection criteria who underwent an additional standard IVF-ET cycle during the same time period. INTERVENTION(S): Ovulation induction consisted of down-regulation with GnRH analogue followed by ovarian stimulation with FSH and hMG. Intracytoplasmic sperm injection was performed on the oocytes of all patients with male factor infertility. Zygotes were transferred by laparoscopy into the fallopian tube 24-26 hours after oocyte retrieval. MAIN OUTCOME MEASURE(S): Implantation rates and PRs in the ZIFT and control groups were compared. RESULT(S): The PRs and implantation rates were significantly higher in the ZIFT group than in the control group: 34.2% (24/70) and 8.7% (29/333) versus 17.1% (12/70) and 4.4% (13/289), respectively (P = 0.002 and P = 0.04). The cumulative conception rate for two ZIFT cycles was 59.3%. CONCLUSION(S): Zygote intrafallopian transfer should be considered a beneficial mode of treatment for patients with repeated failure of implantation in IVF and transcervical ET. More prospective randomized studies are needed to support this observation.

Adult↗
PubMed1998

A prospective randomized clinical trial comparing recombinant follicle stimulating hormone (Puregon) and human menopausal gonadotrophins (Humegon) in non-down-regulated in-vitro fertilization patients.

A randomized clinical trial was performed comparing recombinant follicle stimulating hormone (rFSH, Puregon, n = 54) and human menopausal gonadotrophin (HMG, Humegon, n = 35) in infertile women undergoing in-vitro fertilization without the use of a gonadotrophin-releasing hormone (GnRH) agonist. Most patients had a tubal or idiopathic infertility, the latter always longer than 4 years' duration. Patients with sperm abnormalities were excluded. None of the between-group differences in treatment outcome was statistically significant. In the rFSH group, a mean number of 11.2 oocytes was retrieved compared with 8.3 in the HMG group. Ongoing pregnancy rates per started cycle were higher in the rFSH group (22.2%) than in the HMG group (17.1%). Implantation rates were 27.5% in the rFSH group in comparison with 16.7% in the HMG group. In the rFSH group, a mean total dose of 1410 IU during 6.2 days was administered compared with 1365 IU in 6.0 days in the HMG group. Oestradiol concentrations on the day of human chorionic gonadotrophin administration were 3889 pmol/l in the rFSH group and 3145 pmol/l in the HMG group. In 15 subjects (rFSH: n = 9, 16.7%; HMG: n = 6, 17.1%) luteinizing hormone concentrations higher than 10 IU/l were seen during stimulation. In two of them, both from the rFSH group, ongoing pregnancies were achieved. The results indicate that rFSH (Puregon) is at least as efficacious as HMG and that acceptable pregnancy rates can be achieved without the use of a GnRH agonist.

Adult↗
PubMed2005

Favourable pregnancy results with insemination of in vitro matured oocytes from unstimulated patients.

BACKGROUND: The purpose has been to develop an in vitro oocyte maturation (IVM) method for a wide range of patients. METHODS: A total of 239 cycles with immature oocyte retrieval (IOC) were carried out without hormonal priming. Patients with regular cycles and normal or polycystic ovaries (PCO) and anovulatory cycles with PCOS were included. Insemination or intracytoplasmic sperm injection (ICSI) according to sperm quality was alternatively used in fertilization of the matured oocytes. RESULTS: A total of 971 immature oocytes (mean 8.0 +/- 5.2) were collected in 122 IVM-IVF cycles and 851 oocytes (mean 7.3 +/- 4.4) in 117 IVM-ICSI cycles. The oocyte maturation and fertilization rate was 62.6% and 37.7% after insemination, and 53.9% and 69.3% after ICSI, respectively. The mean number of embryos transferred was 1.6. Clinical pregnancy rate per IOC was 23.8% in IVM-IVF and 17.1% in IVM-ICSI (ns). Implantation rate was higher in IVM-IVF (24.2%) than in IVM-ICSI (14.8%) (P < 0.05). CONCLUSIONS: Insemination of IVM oocytes functions well, resulting in comparable pregnancy rates per IOC between IVM-IVF and IVM-ICSI. Good pregnancy results can be achieved both in patients with regular cycles and with PCO(S) by transferring only one or two embryos at a time.

Cells, Cultured↗
PubMed2002

Conventional versus microdissection testicular sperm extraction for nonobstructive azoospermia.

PURPOSE: We established a practical and safe strategy for testicular sperm extraction (TESE) in patients with nonobstructive azoospermia and compared conventional with microdissection TESE. MATERIALS AND METHODS: In a retrospective comparative study 46 patients, including 22 with obstructive and 24 with nonobstructive azoospermia, underwent conventional TESE. Another 100 patients, including 26 with obstructive and 74 with nonobstructive azoospermia, underwent microdissection TESE. Conventional TESE was performed via 3 small 5 mm. incisions in the tunica albuginea. Microdissection TESE was performed by making a 3 to 4 cm. incision in the tunica albuginea under operating microscopy, avoiding the underlying testicular artery. Seminiferous tubules that appeared dilated and opaque were harvested. Sperm recovery rates were compared, as were complication rates assessed by ultrasonographic and endocrinological evaluations. RESULTS: In obstructive azoospermia cases the sperm recovery rate was 100% for each procedure. In nonobstructive azoospermia cases sperm were recovered in 16.7% and 44.6% by conventional and microdissection TESE, respectively (p = 0.0271). In cases of histologically diagnosed maturation arrest the sperm recovery rate was 37.5% and 75%, respectively (p = 0.22585). In cases of the Sertoli-cell-only syndrome the sperm recovery rate was 6.3% and 33.9%, respectively (p = 0.0494). We identified dilated and opaque seminiferous tubules containing spermatozoa under operating microscopy in 22.2% of patients with maturation arrest and in 63.2% with the Sertoli-cell-only syndrome. The complication rate was significantly lower for microdissection than for conventional TESE. CONCLUSIONS: In nonobstructive cases, especially those of the Sertoli-cell-only syndrome, microdissection TESE can effectively retrieve spermatozoa and minimize the risk of complications.

Humans↗
PubMed1999

Quality of embryo does not affect the implantation rate of IVF-ET in infertile women with antisperm antibody.

OBJECTIVE: To determine whether low quality score of embryos and advanced maternal age affect the implantation rate in infertile women with sperm-immobilizing antibody. DESIGN: A retrospective study. SETTING: The IVF Unit of the Department of Obstetrics and Gynecology at Tokushima University Hospital. PATIENT(S): Four infertile groups were studied: 20 women with sperm-immobilizing antibodies; 169 with tubal; 129 with male factor; and 72 with unexplained etiology. INTERVENTION(S): All women were hyperstimulated with GnRH analogue and scheduled ovarian stimulation with FSH and hMG for oocyte retrieval. MAIN OUTCOME MEASURE(S): Relationship of quality of transferred embryos, implantation rate and maternal age among four groups of infertile couples. RESULT(S): In the antisperm group, the fertilization rate (57.6%) and mean (+/- SD) score of transferred embryos (5.4+/-1.9) were significantly lower than those in the tubal group (72.4% and 6.2+/-1.9, respectively). However, the implantation rate in the antisperm group (23.6%) was significantly higher than those in other three groups (tubal, 8.6%; male factor, 9.5%; unexplained, 7.6%). With advancing maternal age, the implantation rate decreased in the three comparative groups. In contrast, the implantation rate in the antisperm group did not decrease with advancing maternal age. CONCLUSION(S): Women with antisperm antibodies have several disadvantages to overcome in order to achieve successful IVF-ET, such as a low fertilization rate and poor quality of transferred embryos. However, a high implantation rate was observed in this group, even in women at advanced age. The occurrence of a cellular or humoral immune reaction against sperm may augment the uterine receptivity for the implantation of fertilized ova or blastocyst.

Adult↗
PubMed2000

Successful birth after intracytoplasmic sperm injection for severe male factor infertility in a woman with poor response to controlled ovarian hyperstimulation.

Poor responders to controlled ovarian hyperstimulation (COH) present a clinical challenge for in vitro fertilization (IVF) and embryo transfer. The failure of IVF for the treatment of severe male-factor infertility can now be overcome by intracytoplasmic sperm injection (ICSI). The infertile couple documented in this case report came to our hospital because of bilateral tubal occlusion and severe oligoasthenospermia. After three poor-response cycles to COH, one mature oocyte was retrieved and was fertilized using ICSI. Normal fertilization ensued and one good-quality, eight-celled embryo was transferred into the woman's uterus. A single gestation was confirmed by ultrasound seven weeks after transfer. Amniocentesis was performed at 16 weeks and demonstrated a normal male fetus with a karyotype of 46,XY. The patient had a spontaneous, normal, vaginal delivery of a 2,650 g healthy male infant.

Adult↗
PubMed1999

Conventional in-vitro fertilization versus intracytoplasmic sperm injection in sibling oocytes from couples with tubal infertility and normozoospermic semen.

An auto-controlled study was conducted in couples with tubal infertility and normozoospermic semen. The fertilization rates and embryonic development in sibling oocytes treated, using the same semen sample, either by conventional in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) at the same time were compared. Sibling oocyte-cumulus complexes (OCC) of 56 different couples with tubal infertility and normozoospermic semen were randomly divided in order of retrieval into two groups inseminated either by conventional IVF or by ICSI. Of the retrieved OCC in the same cohort, 53.0 +/- 31.2 and 62.0 +/- 26.6% showed two distinct pronuclei after conventional IVF and ICSI respectively (not significant). Complete fertilization failure occurred after conventional IVF in 12.5% (7/56 couples). After ICSI, the comparable figure was 3.6% (2/56). The number of cases was too small to apply a statistical test to this difference. Total cleavage rates were quite similar: 86.7 +/- 28.0 and 90.1 +/- 21% of the zygotes developed into transferable embryos after IVF and ICSI respectively (not significant). Similarly, no difference in embryo quality was observed. Although injection and insemination of the oocytes were performed at the same time in the two groups, at 42 h post-insemination more embryos were at the four-cell stage after ICSI (P < 0.001) than after conventional IVF, where more embryos were still at the two-cell stage (P < 0.02). Embryo transfer was possible in all 56 couples, resulting in 16 positive serum human chorionic gonadotrophin tests (28.6% per embryo transfer), from which a clinical pregnancy resulted in 15 couples. The best embryos were selected for transfer independently of the insemination procedure, but preferably from the same origin. There appeared to be no difference in implantation potency of the embryos obtained with either technique after the non-randomized transfers.

Adult↗
PubMed2006

Cumulative live birth rate following in vitro fertilization: study of 5,310 cycles.

Most previous studies that calculated cumulative delivery rates following in vitro fertilization (IVF) treatments were limited in the number of cycles and the implementation of intracytoplasmic sperm injection (ICSI). Therefore, we assessed the yield of high-order consecutive IVF treatments (up to 14 consecutive cycles) with and without ICSI. Data from IVF cycles performed in a single center were retrieved from a computerized database. A total of 5,310 cycles among 1,928 patients were evaluated and cumulative delivery rates until the first delivery were calculated using life-table analyses. There were 1,126 pregnancies resulting in 689 live births. Cumulative delivery rates reached 87% following 14 consecutive cycles. Cumulative delivery rates were higher following ICSI compared with cycles without (92.7% vs. 85.4%). In conclusion, each treatment cycle increased the cumulative delivery rate, resulting in a rate of 87% after 14 consecutive cycles. The introduction of ICSI resulted in the highest cumulative rates.

Adolescent↗
PubMed1998

Blastocyst transfer in day-5 embryo transfer depends primarily on the number of oocytes retrieved and not on age.

OBJECTIVE: To analyze the effects of patient age and treatment cycle number on the occurrence of blastocyst transfer and subsequent implantation. DESIGN: Prospective study. SETTING: Department of endocrinology and reproduction. PATIENT(S): All 1,099 women had day-5 transfers after IVF or intracytoplasmic sperm injection treatment. INTERVENTION(S): All patients were checked for embryo development in vitro in consecutive day-5 transfer cycles. Two blastocysts or three lesser-developed embryos were transferred. MAIN OUTCOME MEASURE(S): Blastocyst formation rate or clinical pregnancy/implantation rate. RESULT(S): Of 929 patients in the first cycle, 545 (59%) had at least one blastocyst available for ET. Among 151 patients with a blastocyst in cycle 1, 77 developed one or more blastocysts in cycle 2 (51%). Fifty of 143 patients without a blastocyst in cycle 1 had at least one blastocyst in cycle 2 (35%). After subdivision of all day-5 ETs according to the first four cycles, the following implantation rates per embryo were found for ET with one or more blastocysts: cycle 1 (n = 545), 23%; cycle 2 (n = 264), 23%; cycle 3 (n = 110), 14%; and cycle 4 (n = 27), 12%, and with noncavitating embryos, respectively: (n = 384) 6%, (n = 193) 6%, (n = 94) 2%, and (n = 35) 3%. The negative correlation of the age of the woman on blastulation depended primarily on the number of oocytes retrieved. CONCLUSION(S): The blastocyst implantation rate decreased after cycle 2. Biologic ovarian age, rather than chronologic age, determines the frequency of blastocyst transfer or pregnancy rate.

Adult↗
PubMed2002

Comparison of poor responders with good responders using intentionally frozen-thawed epididymal spermatozoa in subsequent ICSI cycles.

PURPOSE: To compare the outcome of intracytoplasmic sperm injection (ICSI) cycles performed with frozen-thawed epididymal spermatozoa between patients who respond poorly and patients who respond well to ovarian stimulation. METHODS: 17 patients suffering from obstructive azoospermia underwent microsurgical retrieval of epididymal spermatozoa (MESA) and the spermatozoa were frozen. The frozen-thawed spermatozoa were used in subsequent ICSI cycles. In six patients, the female partners responded poorly to ovarian stimulation. They accomplished nine ICSI cycles. In 11 patients, the female partners responded well to ovarian stimulation and they accomplished 16 cycles. RESULTS: Poor responders were older than those who reponded well. The mean number of metaphase II oocytes collected was lower in the poor responder group. In the poor responders, two couples failed to fertilise the oocytes in two ICSI cycles. In the good responders, one couple failed to fertilise the oocytes in an ICSI cycle. There were no significant differences in fertilization rates between the two groups. The estradiol concentrations on the day of hCG administration were significantly higher in the good responders. There was no pregnancy in the poor responder group, while three patients who responded well conceived. Eight good responders had 34 supernumerary 2PN oocytes which were cryopreserved. CONCLUSION: Frozen-thawed epididymal spermatozoa from men with obstructive azoospermia are potent to achieve satisfactory fertilization rates. Poor ovarian response to stimulation induction appears to be the main limiting factor in reaching the stage of embryo transfer. It is preferable in older women to cancel cycles with poor response in the hope that a better response might be obtained in a subsequent cycle. Thus, the frozen-thawed epididymal sperm can be preserved and the most stressful and expensive phase of IVF-ICSI treatment can be avoided.

Adult↗
PubMed2005

Birth of a healthy baby after transfer of blastocysts derived from cryopreserved human oocytes fertilized with frozen spermatozoa.

OBJECTIVE: To report the birth of a healthy baby after transfer of blastocysts derived from frozen eggs and frozen spermatozoa. DESIGN: Case report. SETTING: University-based assisted reproduction center. PATIENT(S): A 37-year-old woman with secondary infertility of 4 years' duration. INTERVENTION(S): Retrieved oocytes were cryopreserved in 1.5 M 1,2-propanediol (PROH) and 0.3 M sucrose by a slow freezing-rapid thawing protocol, semen cryopreservation, and insemination by intracytoplasmic sperm injection (ICSI) at 4 hours after thawing. MAIN OUTCOME MEASURE(S): Fertilization and embryo development to blastocyst stage, pregnancy, and outcome. RESULT(S): Ten of 14 frozen oocytes survived after thawing. Eight of them were fertilized by performing ICSI and three developed into 7- to 8-cell embryos on day 3. Two of these embryos developed into blastocysts on day 5 and were transferred. This resulted in a successful pregnancy and the delivery of a healthy baby boy. CONCLUSION(S): This case demonstrates the feasibility of inseminating the frozen-thawed human oocytes after 4 hours of in vitro culture and the zygotes derived from frozen oocytes and frozen spermatozoa can be cultured to blastocysts resulting in the live birth of a healthy baby boy.

Adult↗
PubMed2006

Successful dizygotic twin pregnancy after recryopreservation by vitrification of human expanded blastocysts developed from frozen cleaved embryos on day 6: a case report.

BACKGROUND: Vitrification has evolved into an established technique for cryopreservation of human blastocysts. However, it is still unclear whether the blastocysts developed from frozen embryos can be cryopreserved a second time by vitrification for further embryo transfer. CASE: A 31-year-old woman underwent a long-treatment protocol for ovarian stimulation. Twenty-seven mature oocytes were obtained, and 21 were fertilized with intracytoplasmic sperm injection. On day 3, 2 cleaved embryos were transferred, but no implantation occurred. The remaining 19 embryos were cryopreserved with the slow freezing method. Three months after oocyte retrieval, 5 frozen day 3 embryos were thawed, the surviving 2 were transferred, but no implantation occurred. Six months after oocyte retrieval, the remaining 14 frozen day 3 embryos were thawed and the surviving 12 cultured. On day 5, 2 embryos reached the expanded blastocyst stage and were transferred, but no implantation occurred. On day 6, 5 of the nontransferred embryos became expanded blastocysts and were cryopreserved again by vitrification. Eight months after oocyte retrieval, 2 recryopreserved day 6 blastocysts were warmed and transferred. Implantation resulted in a dizygotic twin pregnancy. The pregnancy resulted in delivery of normal, healthy male and female infants weighing 2,155 and 2,590 g at birth, at 36 weeks of gestation. CONCLUSION: The blastocysts developed from frozen embryos on day 6 can be recryopreserved by vitrification and have pregnancy potential after warming.

Adult↗
PubMed2004

Electronic data base systems support the evaluation of male infertility factors, example cryptorchidism.

BACKGROUND: A new data base system was applied to analyse our patient group with two aims: (a) to analyze the effects of former cryptorchidism on the fertility of OUR infertility patients in comparison with the data of the literature and (b) to evaluate this system in a clinical study. MATERIALS AND METHODS: Using the electronic data base Winsperm 2000, 1,648 infertility patients, 79 patients with testicular cancer and 201 healthy semen donors were examined. RESULTS: A history of cryptorchidism, treated at 6.8 +/- 3.3 years of life, was found in 10.1% of our infertility patient group. The routine spermiogram parameters, as well as basal hormone concentration of FSH, LH and testosterone, differed significantly from those of the healthy semen donor group. Comparison between patients with former unilateral and bilateral cryptorchidism differed significantly only in total sperm count. 27.7% of patients with a history of unilateral and 5.4% of patients with a history of bilateral cryptorchidism showed a sperm concentration within the normal range (p < 0.01). Azoospermia was detected in 13.1% of patients with unilateral cryptorchidism and in 29.7% of patients with former bilateral cryptorchidism (p < 0.05). The patients responding to our conception questionnaire realised a total conception rate of 46.1% in the 'non-cryptorchidism group' and of 20.6% in the 'cryptorchidism-group' (p < 0.05), whereas the conception rates did not differ between former unilateral and bilateral cryptorchidism (p > 0.05). Sixteen (20.3%) of the 79 patients with testicular neoplasm were previously treated for cryptorchidism. CONCLUSION: The results of our patient group underline the significance of former cryptorchidism for infertility and testicular neoplasm. The new data base system facilitates rapid data retrieval and examination.

Adult↗
PubMed2006

Correlation of sperm DNA damage with IVF and ICSI outcomes: a systematic review and meta-analysis.

PURPOSE: To assess the effects of sperm DNA damage, as determined by the TUNEL assay and the SCSA respectively, on the outcomes of IVF/ICSI treatment. METHODS: A Medline search (from Jan 1978 to Apr 2006) was performed, together with a manual search of the bibliographies of retrieved original papers and review articles. 8 articles met all inclusion/exclusion criteria, of which, 5 used the TUNEL assay and the other 3 used the SCSA. All these articles were included in separate meta-analysis. The meta-analysis was conducted using the RevMan software with fixed-effect model or random-effects model. RESULTS: As for articles using the TUNEL assay, the pooled results of IVF outcomes indicated that the clinical pregnancy rate (RR 0.68, 95% CI 0.54 to 0.85, P = 0.006), but not the fertilization rate (RR 0.79, 95% CI 0.54 to 1.16, P = 0.23) decreased significantly for patients with high degree of sperm DNA damage compared with those with low degree of sperm DNA damage. RRs of the ICSI outcomes indicated that there was no significant difference in either fertilization rate (RR 1.03, 95% CI 0.89 to1.18, P = 0.70) or clinical pregnancy rate (RR 0.76, 95% CI 0.55 to 1.04, P = 0.09) between these two groups. As for the SCSA papers, the pooled results showed no significant effects of sperm DNA damage on the clinical pregnancy rate after IVF (RR 0.58, 95% CI 0.25 to 1.31, P = 0.19) or ICSI (RR 1.18, 95% CI 0.81 to 1.74, P = 0.38). CONCLUSION(S): Our meta-analysis indicates that sperm DNA damage, as assessed by the TUNEL assay, significantly decreases only the chance of IVF clinical pregnancy, but not that of either IVF fertilization or ICSI fertilization or ICSI clinical pregnancy. Besides, our results also reveal that sperm DNA damage, when assessed by the SCSA, has no significant effect on the chance of clinical pregnancy after IVF or ICSI treatment.

DNA Damage↗