scholarly journals The Potential Use of Intrauterine Insemination as a Basic Option for Infertility: A Review for Technology-Limited Medical Settings

2009 ◽  
Vol 2009 ◽  
pp. 1-11 ◽  
Author(s):  
Abdelrahman M. Abdelkader ◽  
John Yeh
Keyword(s):  
Intrauterine Insemination ◽  
Uterine Cavity ◽  
Infertility Treatment ◽  
Semen Parameters ◽  
Male Factor Infertility ◽  
Review Of Literature ◽  
First Line ◽  
Male Factor ◽  
Medical Settings ◽  
Potential Use

Objective. There is an asymmetric allocation of technology and other resources for infertility services. Intrauterine insemination (IUI) is a process of placing washed spermatozoa transcervically into the uterine cavity for treatment of infertility. This is a review of literature for the potential use of IUI as a basic infertility treatment in technology-limited settings.Study design. Review of articles on treatment of infertility using IUI.Results. Aspects regarding the use of IUI are reviewed, including ovarian stimulation, semen parameters associated with good outcomes, methods of sperm preparation, timing of IUI, and number of inseminations. Implications of the finding in light of the needs of low-technology medical settings are summarized.Conclusion. The reviewed evidence suggests that IUI is less expensive, less invasive, and comparably effective for selected patients as a first-line treatment for couples with unexplained or male factor infertility. Those couples may be offered three to six IUI cycles in technology-limited settings.

Comparison of semen parameters in pregnancy and nonpregnancy couples with male factor infertility during intrauterine insemination

2007 ◽  
Vol 88 ◽  
pp. S378
Author(s):  
C. Iltemir Duvan ◽  
B. Berker ◽  
O. Bayrak ◽  
K. Aydos ◽  
N. Ozturk Turhan ◽  
...  
Keyword(s):  
Intrauterine Insemination ◽  
Semen Parameters ◽  
Male Factor Infertility ◽  
Male Factor ◽  
In Pregnancy

scholarly journals Controlled ovarian stimulation should not be preferred for male infertility treated with intrauterine insemination: a retrospective study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yan Tang ◽  
Qian-Dong He ◽  
Ting-Ting Zhang ◽  
Jing-Jing Wang ◽  
Si-Chong Huang ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Intrauterine Insemination ◽  
Multiple Pregnancy ◽  
Clinical Pregnancy ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Ovulatory Follicles ◽  
Multiple Pregnancy Rate

Abstract Background Some studies have stated that intrauterine insemination (IUI) with controlled ovarian stimulation (COS) might increase the pregnancy rate, while others suggest that IUI in the natural cycle (NC) should be the first line of treatment. It remains unclear whether it is necessary to use COS at the same time when IUI is applied to treat isolated male factor infertility. Thus, we aimed to investigate efficacy of IUI with COS for isolated male factor infertility. Methods A total of 601 IUI cycles from 307 couples who sought medical care for isolated male factor infertility between January 2010 and February 2020 were divided into two groups: NC-IUI and COS-IUI. The COS-IUI group was further divided into two subgroups according to the number of pre-ovulatory follicles on the day of HCG: cycles with monofollicular development (one follicle group) and cycles with at least two pre-ovulatory follicles (≥ 2 follicles group). The IUI outcomes, including clinical pregnancy, live birth, spontaneous abortion, ectopic pregnancy, and multiple pregnancy rates were compared. Results The clinical pregnancy, live birth, spontaneous abortion, and ectopic pregnancy rates were comparable between the NC-IUI and COS-IUI group. Similar results were also observed among the NC-IUI, one follicle, and ≥ 2 follicles groups. However, with respect to the multiple pregnancy rate, a trend toward higher multiple pregnancy rate was observed in the COS-IUI group compared to the NC-IUI group (8.7% vs. 0, P = 0.091), and a significant difference was found between the NC-IUI and ≥ 2 follicles group (0 vs. 16.7%, P = 0.033). Conclusion In COS cycles, especially in those with at least two pre-ovulatory follicles, the multiple pregnancy rate increased without a substantial gain in overall pregnancy rate; thus, COS should not be preferred in IUI for isolated male factor infertility. If COS is required, one stimulated follicle and one healthy baby should be the goal considering the safety of both mothers and foetuses.

Male Infertility: Surgical Treatment (Varicocele, Microsurgical Reconstruction, TUR Ejaculatory Ducts)

2019 ◽  
Author(s):  
Vanessa L. Dudley ◽  
Marc Goldstein
Keyword(s):  
Intrauterine Insemination ◽  
Ejaculatory Duct ◽  
Obstructive Azoospermia ◽  
Male Factor Infertility ◽  
Nonobstructive Azoospermia ◽  
Male Factor ◽  
Sperm Retrieval ◽  
Donor Sperm ◽  
Vitro Fertilization

Male factor infertility contributes to at least half of all cases of infertility in couples. The most common causes of male factor infertility are impaired sperm production due to varicoceles, obstruction of the ductal system, and genetic defects causing nonobstructive azoospermia. A majority of these underlying conditions are treatable. Even when in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) is necessary, treatment of men has been shown to improve the outcomes of IVF-ICSI and potentially increase the chances of finding sperm with microdissection sperm extraction in some cases of nonobstructive azoospermia. Important advances in the field include abundant evidence now supporting microsurgical repair of varicocele in varicocele-associated nonobstructive azoospermia prior to IVF-ICSI or attempted surgical sperm retrieval. Advances in techniques for reconstruction of obstruction is dependent on the surgeon’s skill in creating a tension-free and leak-proof mucosa-to-mucosa accurate approximation with a good blood supply and healthy mucosa and muscularis and can result in higher patency rates. Treating the men often allows upgrading men from being solely candidates for donor sperm or adoption to candidates for ICF-ICSI with surgically retrieved testicular sperm to allowing IVF-ICSI with ejaculated sperm and from IVF-ICSI with ejaculated sperm to allowing the simpler intrauterine insemination and, finally, the possibility of a naturally conceived pregnancy. This review contains 27 figures, 1 table, and 69 references. Key Words: microsurgery, obstructive azoospermia, transurethral resection of the ejaculatory duct, varicocele, vasectomy reversal, vasoepididymostomy, vasography, vasovasostomy

scholarly journals Randomized Clinical Trial: Effect of Walnuts on Semen Parameters and Male Fertility (P18-042-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Wendie Robbins ◽  
Howard Kim ◽  
Justin Houman ◽  
Geng-Wei Lee
Keyword(s):  
Clinical Trial ◽  
Los Angeles ◽  
Randomized Clinical Trial ◽  
Sperm Motility ◽  
Clinical Care ◽  
Sperm Concentration ◽  
Nutritional Supplement ◽  
Semen Parameters ◽  
Male Factor Infertility ◽  
Male Factor

Abstract Objectives Infertility affects ∼8–12% of couples worldwide with ∼40% attributed to male factors. Recent studies suggest a role for paternal diet in fertility. Walnuts contain a variety of nutrients essential in the development of spermatozoa. We conducted a randomized clinical trial (RCT) to determine if consumption of walnuts improves semen parameters and fertility in men seeking clinical care for male factor infertility. Methods This was a two arm, single blind, RCT. The comparison groups both received usual care for male factor infertility. One group added 42 gm/d walnuts to their diet, and the other group added a daily nutritional supplement recommended for male reproductive health. Participants (n = 75) were enrolled at an infertility clinic located in a large metropolitan medical center. Eligibility was determined by history, physical exam, and lab tests collected as part of clinical care. Research measures included semen analysis and blood sample at baseline and 3 months; ASA24 dietary recall at baseline, 2 and 3 months; and fertility report at 3 months and 1 year. Results Age range was 27 to 61 years (39.7 ± 7.0); BMI range 19.6 to 46.9 (26.8 ± 4.5); participant race was Asian 26.2%, White 44.3%, Hispanic White 16.4%, Black 8.2%, other 4.9%. Baseline sperm concentration was 39.4 ± 30 million per ml; sperm motility 31.1 ± 23.4%; and progressive motility 21.2 ± 15.8%. At 3 months, the walnut group demonstrated increased sperm motility and concentration, P = .04 and P = .07, respectively, whereas no significant changes from baseline were found in the nutritional supplement group. Both groups showed improved sperm morphology, P < .03. Preliminary data from the subset of men with 1-year follow-up data shows higher frequency of pregnancy in the walnut group compared to nutritional supplement, although not statistically significant, P = .09. We continue to follow the remaining participants until their 1-year fertility report. Conclusions This RCT demonstrated a beneficial effect of adding walnuts to the diet on sperm motility and morphology in men seeking care for infertility. Preliminary fertility data suggests walnuts may enhance the probability of pregnancy for men with male factor infertility. Funding Sources Center for Occupational and Environmental Health, University of California, Los Angeles; California Walnut Commission.

scholarly journals The pioneering of intracytoplasmic sperm injection: historical perspectives

Reproduction ◽  
2017 ◽  
Vol 154 (6) ◽  
pp. F71-F77 ◽  
Author(s):  
Zev Rosenwaks ◽  
Nigel Pereira
Keyword(s):  
Intracytoplasmic Sperm Injection ◽  
Scientific Work ◽  
Semen Parameters ◽  
Male Factor Infertility ◽  
Fertilization Failure ◽  
Male Factor ◽  
Live Births ◽  
Historical Perspectives ◽  
Mammalian Fertilization

Intracytoplasmic sperm injection (ICSI) has often been heralded as a ground-breaking technique that has transformed the treatment of couples with infertility. By injecting a single spermatozoon into the cytoplasm of the oocyte, ICSI bypasses the zona pellucida and increases the chances of fertilization and subsequent embryo development, independent of semen parameters. Ever since the first live births using ICSI were reported in 1992, ICSI has become the mainstay of treating male factor infertility as well as overcoming fertilization failure associated with conventional in vitro insemination. Today, ICSI is utilized in nearly 66% of all assisted reproductive treatments worldwide and has resulted in the birth of millions of babies. The primary goal of this review is to provide historical perspectives about the pioneering of ICSI. We begin by highlighting the scientific work of early investigators who elucidated the mechanisms central to mammalian fertilization. Furthermore, we briefly discuss how these findings contributed to the development of IVF for the treatment of infertility. We then emphasize the shortcomings of IVF in treating severe forms of male factor infertility and enumerate the micromanipulation techniques that were developed to circumvent these shortcomings. Finally, we indicate how the inadequacies of these micromanipulation techniques lead to the inception, application and popularity of ICSI.

Sign in / Sign up

Export Citation Format

Share Document