Postchemotherapy Ejaculatory Azoospermia: Fatherhood With Sperm From Testis Tissue With Intracytoplasmic Sperm Injection

2002 ◽  
Vol 20 (4) ◽  
pp. 930-936 ◽  
Author(s):  
M. N. Damani ◽  
V. Masters ◽  
M. V. Meng ◽  
C. Burgess ◽  
P. Turek ◽  
...  
Keyword(s):  
Intracytoplasmic Sperm Injection ◽  
Fertilization Rate ◽  
Nonobstructive Azoospermia ◽  
Fresh Tissue ◽  
Icsi Cycle ◽  
Small Subgroup ◽  
History Of ◽  
Fertility Potential ◽  
Late Maturation ◽  
Testis Tissue

PURPOSE: To define the success of testis sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) in azoospermic men with a history of chemotherapy. PATIENTS AND METHODS: In a retrospective study, 23 men with ejaculatory azoospermia and a history of chemotherapy underwent TESE in a search for usable spermatozoa. In six patients cryopreserved tissue and in nine patients fresh tissue provided sperm for an ICSI cycle. Histologic analysis of the testis was performed in all patients. The presence or absence of sperm, fertilization rates with ICSI, and final outcomes of pregnancy were recorded. RESULTS: Spermatozoa were found on TESE in 15 (65.2%) of 23 men. On histopathology, the predominant pattern observed was Sertoli cell only (47.8%), followed by hypospermatogenesis (30.4%), mixed (17.4%), and late maturation arrest (4.3%). The fertilization rate was 65.2%, and ongoing/delivered pregnancies occurred in 30.8% of cycles. Six healthy boys and four healthy girls have been born to date. CONCLUSION: Men who are azoospermic and have had prior cytotoxic therapy make up a small subgroup of males with nonobstructive azoospermia. It is important to define and characterize this subgroup and better define their true fertility potential. Approximately two thirds of these men have retrievable testis sperm, which may be used with ICSI to have healthy offspring. This exciting avenue for paternity has heretofore not been available to such patients.

P–143 Improved embryonic development and utilization rates with EmbryoScope: A within-subject comparison versus a benchtop incubator

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
P Guilherme ◽  
A Setti ◽  
D Braga ◽  
K Precipito ◽  
A Iaconell ◽  
...  
Keyword(s):  
Embryonic Development ◽  
Clinical Outcomes ◽  
Study Design ◽  
Intracytoplasmic Sperm Injection ◽  
Fertilization Rate ◽  
Development Rate ◽  
Blastocyst Development ◽  
Icsi Cycle ◽  
Frozen Embryos ◽  
Post Hoc

Abstract Study question In consecutive intracytoplasmic sperm injection (ICSI) cycles, is embryonic development in EmbryoScope better than the previous one obtained in a benchtop (G–185) incubator? Summary answer Embryonic development, and oocyte and embryo utilization rates (OUR and EUR) are significantly improved in the EmbryoScope, as compared to G–185. What is known already The time-lapse imaging (TLI) system, which allows a non-invasive continuous assessment of embryo morphokinetics parameters in a closed culture system has been developed, promising improved embryo development by reducing oscillations in pH, humidity and temperature. To investigate this hypothesis, one study has already compared embryonic development in a TLI versus a benchtop incubator. However, It has never been investigated whether embryonic development can be improved within-subject, by changing from benchtop incubator in the first intracytoplasmic sperm injection (ICSI) cycle to the EmbryoScope, a TLI incubator, in the following ICSI cycle, and that was the objective of the present study. Study design, size, duration This study had a retrospective within-subject design, in which each cycle served as its own control. Data were obtained via chart review of patients undergoing ICSI in a private university–affiliated IVF center that fulfilled the following criteria: second ICSI attempt in which embryos had been cultured in a TLI incubator system (TLI group, n = 71), preceded by a first ICSI attempt in which embryos had been cultured in a conventional incubator (Control group, n = 71). Participants/materials, setting, methods Embryonic development up to the fifth day of development, OUR (transferred embryos plus frozen embryos per retrieved oocytes) and EUR (transferred embryos plus frozen embryos per fertilized oocytes) were compared between the groups using generalized linear models followed by Bonferroni post hoc. The post hoc achieved power was 82.6%, considering the sample size, the effect size obtained for blastocyst development rate and 5% significance level. Main results and the role of chance There were significant differences in fertilization rate (76.0% ± 1.3 vs. 80.0% ± 1.4, p = 0.044, OR: 1.051, CI: 1.001 – 1.103), non-fertilization rate (14.8% ± 0.6 vs. 6.3% ± 0.4, p < 0.001, OR: 0.424, CI: 0.370 – 0.486), day–2 non-cleavage rate (3.8% ± 0.2 vs. 1.1% ± 0.1, p < 0.001, OR: 0.285, CI: 0.234 – 0.347), blastocyst development rate (40.9% ± 1.1 vs. 55.6% ± 1.3, p < 0.001, OR: 1.358, CI: 1.267 – 1.456), frozen blastocyst rate (31.8% ± 0.8 vs. 37.0% ± 0.9, p < 0.001, OR: 1.163, CI: 1. 085 – 1.248), OUR (40.7% ± 1.0 vs. 50.2% ± 1.1, p < 0.001, OR: 1.232, CI: 1.155 – 1.314), and EUR (52.4% ± 1.1 vs. 66.6% ± 1.2, p < 0.001, OR: 1.269, CI: 1.202 - 1.341), all in favor of TLI group. Pregnancy rate (30.2% vs. 30.8%, p = 0.940), implantation rate (24.6% ± 40.0 vs. 26.1% ± 41.6, p = 0.830), and miscarriage rate (21.1% vs. 15.0%, p = 0.622) were similar between Control and TLI groups, respectively. Limitations, reasons for caution (i) Different culture dishes were used in each system; (ii) it is not possible to confirm how much of the embryonic improvement was due to the culture conditions; (iii) the study design is not ideal for the comparison of clinical outcomes and, also, underpowered to do so. Wider implications of the findings: Even though the clinical outcomes were similar between the groups, the results may also lead to higher cumulative pregnancy outcomes following embryo thawing and transfer. Trial registration number Not applicable

How Valid are Patient Reports of Family History of Illness?

1980 ◽  
Vol 19 (03) ◽  
pp. 162-164 ◽  
Author(s):  
Rachel Harris ◽  
W. Margaret ◽  
Kathleen Hunter
Keyword(s):  
Family History ◽  
Medical History ◽  
Cancer Patients ◽  
Cause Of Death ◽  
Death Certificate ◽  
Recall Rate ◽  
Patient Reports ◽  
Small Subgroup ◽  
History Of ◽  
Medical Histories

The recall rate of patients’ family medical histories was studied in 200 cancer and non-cancer patients. Data on age and cause of death for parents and grandparents were collected. Although most patients knew the age and cause of death of parents, less than half knew for grandparents. Cancer patients had significantly greater recall for maternally related relatives. A subsample of patients’ family medical histories was compared to death certificate data. Patients’ reports were found to be highly inaccurate. Since only a small subgroup could provide medical history data for grandparents, the generaliz-ability for history of family illness is questioned.

Effects of oocyte age, cumulus cells and injection methods on in vitro development of intracytoplasmic sperm injection rabbit embryos

Zygote ◽  
2004 ◽  
Vol 12 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Yue-Liang Zheng ◽  
Man-Xi Jiang ◽  
Yan-Ling Zhang ◽  
Qing-Yuan Sun ◽  
Da-Yuan Chen
Keyword(s):  
Intracytoplasmic Sperm Injection ◽  
Polar Body ◽  
Cumulus Cells ◽  
Fertilization Rate ◽  
First Polar Body ◽  
Injection Methods ◽  
Blastocyst Rate ◽  
Repeated Aspiration ◽  
Rabbit Embryos

This study assessed the effects of oocyte age, cumulus cells and injection methods on in vitro development of intracytoplasmic sperm injection (ICSI) rabbit embryos. Oocytes were recovered from female rabbits superovulated with PMSG and hCG, and epididymal sperm were collected from a fertile male rabbit. The oocyte was positioned with the first polar body at 12 o'clock position, and a microinjection needle containing a sperm was inserted into the oocyte at 3 o'clock. Oolemma breakage was achieved by aspirating ooplasm, and the aspirated ooplasm and sperm were re-injected into the oocyte. The injected oocytes were cultured in M199 medium containing 10% fetal calf serum at 38 °C with 5% CO2 in air. The results showed that oocytes injected at 1 h post-collection produced a higher (p<0.05) fertilization rate than those injected at 4 or 7 h post-collection. Blastocyst rate in the 1 h group was higher (p<0.05) than in the 7 h group. Denuded oocytes (group A) and oocytes with cumulus cells (group B) were injected, respectively. Rates of fertilization and development of ICSI embryos were not significantly different (p<0.05) between the two groups. Four ICSI methods were applied in this experiment. In methods 1 and 2, the needle tip was pushed across half the diameter of the oocyte, and oolemma breakage was achieved by either a single aspiration (method 1) or repeated aspiration and expulsion (method 2) of ooplasm. In methods 3 and 4, the needle tip was pushed to the oocyte periphery opposite the puncture site, and oolemma breakage was achieved by either a single aspiration (method 3) or repeated aspiration and expulsion (method 4) of ooplasm. Fertilization rate in method 2 was significantly higher (p<0.05) than in methods 1 and 3. Blastocyst rates were not significantly different (p<0.05) among methods 1, 3 and 4, but method 2 produced a higher (p<0.05) blastocyst rate than method 3.

Development and implementation of intracytoplasmic sperm injection (ICSI)

1995 ◽  
Vol 7 (2) ◽  
pp. 211 ◽  
Author(s):  
GD Palermo ◽  
J Cohen ◽  
M Alikani ◽  
A Adler ◽  
Z Rosenwaks
Keyword(s):  
Intracytoplasmic Sperm Injection ◽  
Human Sperm ◽  
Fertilization Rate ◽  
Semen Parameters ◽  
Ongoing Pregnancy Rate ◽  
Vitro Fertilization ◽  
Human Oocytes ◽  
Intracytoplasmic Injection ◽  
Previously Treated

The purpose of this paper is to elucidate the experimental steps that led to the development of intracytoplasmic sperm injection (ICSI) and its application in the human. ICSI has become the most successful micromanipulation procedure for treating male infertility. A total of 355 in vitro fertilization (IVF) cycles utilizing ICSI are described; 180 couples were previously treated in 509 IVF cycles but achieved no fertilization and 175 couples could not be treated by IVF because of extremely poor semen parameters. Of the 3063 metaphase II (M II) oocytes retrieved, 2970 were injected with a survival rate of 93.6%, yielding 1917 bipronuclear zygotes (64.5%). In 148 patients, a foetal heart was evidenced by ultrasound; 11 of these patients miscarried between 7 and 13 weeks of gestation. The ongoing pregnancy rate was 38.6% (137/355) per retrieval and 40.5% (137/338) per embryo replacement. At the time of writing, there were 22 deliveries and one therapeutic abortion for a trisomy 21 chromosomal abnormality. In addition, 66 singleton, 37 twin, 10 triplet and 1 quadruplet pregnancies were ongoing. The concentration of motile spermatozoa in the ejaculate only slightly influenced the fertilization rate (P < 0.001) and the pregnancy outcome (P < 0.01). A preliminary injection procedure utilizing intracytoplasmic injection of isolated sperm heads was performed in 35 M II human oocytes with resultant fertilization and cleavage rates of 74% and 73% respectively. Skills in ICSI were acquired by injecting hamster and unfertilized human oocytes with human sperm. ICSI can be used to successfully treat couples who have failed IVF or who have too few spermatozoa for conventional in vitro insemination.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals 16-Unsaturated C19 3-oxo steroids as metabolic intermediates in boar testis

1972 ◽  
Vol 128 (4) ◽  
pp. 945-952 ◽  
Author(s):  
P. J. Brophy ◽  
D. B. Gower
Keyword(s):  
Prolonged Storage ◽  
Fresh Tissue ◽  
Optimum Yield ◽  
Metabolic Intermediates ◽  
Unsaturated Alcohols ◽  
Testis Tissue

1. The formation of the two 16-unsaturated alcohols 5α-androst-16-en-3α-ol and 5α-androst-16-en-3β-ol from [5α-3H]5α-androst-16-en-3-one has been demonstrated in boar testis homogenates. 2. The optimum yield (23%) of the 3α-alcohol was obtained in the presence of NADPH, whereas that for the 3β-alcohol (74%) was obtained when NADH was the added cofactor. 3. The two alcohols were not interconvertible. 4. Prolonged storage of boar testis tissue at −20°C abolished the ability to form all androst-16-enes except androsta-4,16-dien-3-one from [4-14C]progesterone. 5. The production of 5α-androst-16-en-3-one and the two alcohols from [7α-3H]androsta-4,16-dien-3-one only occurred when fresh tissue was used, whereas reduction of [5α-3H]5α-androst-16-en-3-one was unaffected by storage of testis at −20°C. 6. NADPH was the preferred cofactor for the reduction of androsta-4,16-dien-3-one. 7. The previously established conversion of androsta-5,16-dien-3β-ol into androsta-4,16-dien-3-one was shown to be reversible, NADH and NADPH being equally effective cofactors. 8. Pathways of biosynthesis of 5α-androst-16-en-3α- and 3β-ols, with the C19 3-oxo steroids as intermediates, are presented.

scholarly journals Varicocele Repair Improves Testicular Histology in Men with Nonobstructive Azoospermia

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Murat Ustuner ◽  
Hasan Yilmaz ◽  
Ufuk Yavuz ◽  
Seyfettin Ciftci ◽  
Ali Saribacak ◽  
...  
Keyword(s):  
Extraction Procedure ◽  
Testicular Biopsy ◽  
Testicular Tissue ◽  
High Serum ◽  
Histopathological Analysis ◽  
Nonobstructive Azoospermia ◽  
Biopsy Specimens ◽  
Testicular Histology ◽  
Late Maturation ◽  
Varicocele Repair

Objective. To determine the histopathological differences after varicocele repair in testicular tissue in males with nonobstructive azoospermia.Methods. Between 2009 and 2014, 45 men with complete azoospermia and palpable varicocele, presenting with primary infertility of at least 1 year, undergoing varicocele repair at our institution were selected for the study. A standard systematic testicular 6-core Tru-Cut biopsy was performed during varicocele repair. Other biopsies were obtained from each testicle of all patients at the time of microscopic sperm extraction procedure.Results. Nineteen patients were selected for the study. Testicular biopsy specimens were classified as Sertoli cell only on preoperative histopathological analysis in 14 patients. After varicocele repair, focal spermatogenesisn=3and late maturation arrestn=2were found in these patients. Average Johnsen score was significantly increased after varicocelectomyP=0.003. Motile sperm was found in one patient on postoperative semen analyses and in 10 more patients in the microscopic sperm extraction procedure. Preoperative high serum follicle stimulating hormone level and venous reflux were significantly and negatively correlated with the increase in average Johnsen scoreP<0.05.Conclusions. Our findings suggest significant improvement in testicular histology after varicocele repair.

320 EFFECTS OF DIFFERENT ACTIVATION REGIMENS ON PRONUCLEAR FORMATION AND PRE-IMPLANTATION DEVELOPMENTAL COMPETENCE OF IN VITRO-MATURED BOVINE OOCYTES AFTER INTRACYTOPLASMIC SPERM INJECTION

2015 ◽  
Vol 27 (1) ◽  
pp. 249
Author(s):  
M. E. Arias ◽  
R. Sanchez ◽  
R. Felmer
Keyword(s):  
Intracytoplasmic Sperm Injection ◽  
Standard Procedure ◽  
Chemical Activation ◽  
Developmental Rate ◽  
Fertilization Rate ◽  
Developmental Competence ◽  
Assisted Reproductive Technique ◽  
Pronuclear Formation ◽  
Bovine Oocytes

Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technique that has been used with considerable success in humans; however, in the bovine species the efficiency of this technique is far from optimal. The objective of the present study was to evaluate the effect of 4 chemical activation treatments, 6-dimethylaminopurine (DMAP), cycloheximide (CHX), anisomycin (ANY), and ethanol (EtOH) on the pronuclear formation and embryo development of bovine embryos generated by ICSI. Cumulus-oocyte complexes were aspirated from abattoir ovaries, selected, and matured in 400-µL drops of standard TCM-199 maturation medium for 22 h at 38.5°C and 5% CO2. The ICSI was performed by a standard procedure. Injected oocytes were randomly distributed and activated by 5 µM ionomycin for 5 min (Io) followed by i) 5 µg mL–1 CHX for 5 h (Io/CHX), ii) 3 h window followed by a second Io treatment plus 1.9 mM DMAP for 4 h (2Io/DMAP), iii) 1 µg mL–1 ANY for 5 h (Io/ANY), and iv) 3 h window followed by 7% ethanol (Io/EtoH). Embryos were cultured in 50-µL drops of KSOM medium under mineral oil at 38.5°C and 5% CO2, 5% O2, and 90% N2. Cleavage was recorded at 72 h and blastocyst rate at 192 h. Pronuclear formation analysis was carried out at 18 hpa with Hoechst staining. An oocyte was considered fertilized when 2 polar bodies and 1 female and 1 male pronucleus (or a decondensed sperm head) could be observed. The data were transformed to arcsine, analysed by ANOVA, and means were compared using Tukey's test with Statgraphics Plus 2 Software. Results with a total of 431 injected oocytes (114, 104, 101, and 112 for DMAP, CHX, ANY, and EtOH, respectively) showed differences in cleavage (P < 0.01) in DMAP, CHX, and ANY treatments (86, 72, and 78%, respectively), relative to EtOH (12%). Similarly, the rate of blastocysts/injected oocyte at 192 h was higher with DMAP, CHX, and ANY (41, 20, and 32%, respectively), relative to EtOH (4%). Sham-injected oocytes showed cleavage and blastocyst rates of 67, 43, 68, and 12% and 32, 11, 19, and 5%, for DMAP, CHX, ANY, and EtOH, respectively. Despite the higher developmental rate observed with DMAP, pronuclear formation assessment revealed that fertilization rate was higher in CHX (87%) and ANY (75%) treatments relative to DMAP (35%). In conclusion, the results of the present study show that activation of bovine oocytes after ICSI is more efficient with DMAP and ANY, compared with CHX and EtOH.Provision of ovaries by our local slaughterhouse (Frigorifico Temuco, Chile) and funding support from FONDECYT 1120241 CONICYT, Chile, are gratefully acknowledged.

Assisted fertilization by subzonal insemination and intracytoplasmic sperm injection

1994 ◽  
Vol 6 (1) ◽  
pp. 85 ◽  
Author(s):  
Steirteghem A Van ◽  
J Liu ◽  
H Joris ◽  
Z Nagy ◽  
C Staessen ◽  
...  
Keyword(s):  
Intracytoplasmic Sperm Injection ◽  
Congenital Malformations ◽  
Subsequent Development ◽  
Fertilization Rate ◽  
Subzonal Insemination ◽  
Failed Fertilization ◽  
Assisted Fertilization ◽  
Normal Fertilization

The results of 600 consecutive treatment cycles of subzonal insemination (SUZI) and intracytoplasmic sperm injection (ICSI) are described in couples with failed fertilization after standard IVF or insufficient spermatozoa in the ejaculate for IVF. More oocytes were damaged by ICSI (16.3%) than by SUZI (8.5%) and the normal fertilization rate was substantially higher after ICSI (49.1% v. 16.6%). Subsequent development of two-pronuclear oocytes in vitro was 80% after SUZI and 73.9% after ICSI. Significantly more triple embryo replacements were carried out after ICSI than after SUZI. Embryo transfers were possible in 421 of the 600 cycles. There were 63 pregnancies after ICSI (215 transfers) and 23 after SUZI (156 transfers); 10 additional pregnancies were achieved after 50 transfers of a mixture of SUZI and ICSI embryos. The results of fetal karyotypes and follow-up of the children do not indicate an increase in congenital malformations.

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