Beneficial Effect of an Oral Antioxidant Supplementation (Fertimax2) on IVF-ICSI Outcomes: A Preliminary Clinical Study

Background: Considerable evidence points towards a significant role of oxidative stress (OS) in the pathogenesis of sperm dysfunction. OS as a result of an inappropriate balance between oxidants and antioxidants in the semen can cause DNA damage and lipid peroxidation leading to failure of conception, miscarriage or potentially even childhood cancer. The objective of this study was to investigate whether a male antioxidant therapy can improve semen parameters and the results of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Methods: A total of forty eight infertile couples were considered. Male participants were administrated Fertimax2 antioxidant treatment for at least two months prior to their partner’s IVF-ICSI cycle. Sperm parameters (volume, concentration, progressive motility) and the IVF-ICSI outcomes were compared before and after the antioxidant treatment. The primary outcome measures were oocyte fertilization, cleavage and good embryo quality rates;the secondary outcomes were biochemical pregnancies, clinical pregnancies and implantation rates. Results: The principal finding that emerged from this study was that antioxidant therapy resulted in significant improvements in fertilization (p = 00.2), cleavage (p = 0.004) and good-embryo quality (p = 0.002) rates accompanied by a marked increase in clinical pregnancy (18.7% versus 2.5%) and implantation (11.8% versus 1.02%) rates. No significant changes in routine sperm parameters were observed. Conclusion: The Fertimax2 antioxidant therapy appears to influence favorably chances of conception in couples undergoing assisted reproduction treatment (ART).

Oxidative stress in male infertility and therapeutic approach: A mini-review

Growing evidence suggests that oxidative stress is a major cause of male infertility.Spermatozoa are highly sensitive cells due to the vulnerability of their membrane fatty acids and the diminished antioxidant defense.Reactive oxygen species(ROS)impact multiple signaling pathways involved in mitochondrial dysfunction,hormonal unbalance and semen quality decline.The origin of ROS is diverse,including generated normal cellular metabolism,environmental exposure,advanced paternal age and inflammation.Research has indicated that antioxidant supplementation can improve oxidative stress and reduce the risk of chronic diseases.Moreover,it is widely known that antioxidant supplementation can enhance sperm quality and increase the pregnancy rate in couples undergoing fertility treatments.The current study highlights the deleterious effect of ROS and its impact on semen function.In addition,it contributes to the development of a clinical approach for the use of antioxidants in the management of male infertility.

Study of gonadic growth factors: Seminal transforming growth factor-β1, epidermal growth factor and insulin-like growth factor-I and their relationship with male infertility

Background: The aim of this study was to establish normal reference values for several growth factors in semen and provide a basis for understanding their physiological significance in fertile and infertile subjects. Methods: 110 infertile men semen was evaluated according to WHO standards and by enzyme immunoassay (ELISA kit protocol) to determine the rate of growth factors (TGFβ1, IGFI, EGF). We have also listed neutrophils by staining with peroxidase to examine the association of inflammation with the levels of these factors. The determination of the epididymal (alpha-1,4-glucosidase) marker was directed according to the technical recommended by the WHO in 2010. Each patient received a hormonal balance including the determination of plasma FSH, LH and Testosterone. Results: Concentrations of TGFβ1 were significantly higher in (severe and extreme azoospermic, oligospermic) pathological groups compared to the control group (P 0.05) between control and pathological groups. The IGFI is partly testicular and/or epididymal as it is lowered in some patients with obstructive azoospermia. Positive correlations were observed between the seminal IGFI, mobility (r = 0.487) and sperm morphology (r = +0.187). Immunological sperm abnormalities and/or idiopathic do not alter the rate of EGF seminal. There is no significant correlation between seminal EGF or with sperm parameters or with plasma levels of FSH and LH. Conclusion: The growth factors are primarily peptides, handling and identification in a complex environment as the seminal plasma, but it requires a lot of precautions if we do not want to expose to the risk of bad farms/interpretations of data obtained.

Impact of the professional exposure on the spermatic parameters and the results of ICSI at Tunisian unfertile couples

Introduction: The association of the professional exposure to the decline of the male reproductive function had been the subject of several studies but without arriving to one envisagement undeniable of its existence. The ICSI, technique of reference in severe male infertilities, is visavis unexplained failures whose environmental and professional exposure could be about its cause partly. In this work, we tried to highlight an association between certain factors of professional exposure and the deterioration of the spermatic parameters, then to evaluate the effect of such factors on the result of the ICSI. Materials and Methods: It is about a study of the exposed type—no exposed, realized through collaboration between the Unit of Medicine of the Reproduction and the Service of Medicine of Work of the CHU Farhat Hached of Sousse. This study was based on a questionnaire of which part of the items was collected medical files of the patients raising the general characteristics, the profile of exposure as well as the spermatic parameters and the biological assessment of ICSI. Results: Significant associations between the deterioration of sperm and the professional risk factors such as the exposure to the formaldehydes (p = 0.01) and heat (p = 0.001) were noted. The exposure to formaldehydes was associated at the higher risk of oli gozoospermy, of asthenozoospermy with a significant reduction in mobility (p = 0.05), whereas the talks with cement had a risk higher of teratozoospermy. In addition an exposure to heat was associated at the high risk of oligoteratozoospermy. The total rate of pregnancies after ICSI among 220 patients of our series was of 14.47%. The ICSI balance showed a reduction in total fertility rate (76.6% exposed vs 75.3% no exposed). Conclusion: In spite of the limited number of the patients, this study had shown a correlation between certain professional exposures of origin and the deterioration of sperm. They are preliminary results which encourage continuing collaboration between the specialists in the reproduction and the doctors of work in order to preserve the fertility of the workers exposed to factors gonadotoxic.

MACS-annexin V cell sorting of semen samples with high TUNEL values decreases the concentration of cells with abnormal chromosomal content:a pilot study

We question whether,in men with an abnormal rate of sperm DNA fragmentation,the magnetic-activated cell sorting(MACS)could select spermatozoa with lower rates of DNA fragmentation as well as spermatozoa with unbalanced chromosome content.Cryopreserved spermatozoa from six males were separated into nonapoptotic and apoptotic populations.We determined the percentages of spermatozoa with(i)externalization of phosphatidylserine(EPS)by annexin V-Fluorescein isothiocyanate(FITC)labeling,(ii)DNA fragmentation by TdT-mediated-dUTP nick-end labeling(TUNEL),and(iii)numerical abnormalities for chromosomes X,Y,13,18,and 21 by fluorescence in situ hybridization(FISH),on the whole ejaculate and selected spermatozoa in the same patient.Compared to the nonapoptotic fraction,the apoptotic fraction statistically showed a higher number of spermatozoa with EPS,with DNA fragmentation,and with numerical chromosomal abnormalities.Compared to the whole ejaculate,we found a significant decrease in the percentage of spermatozoa with EPS and decrease tendencies of the DNA fragmentation rate and the sum of disomy levels in the nonapoptotic fraction.Conversely,we observed statistically significant higher rates of these three parameters in the apoptotic fraction.MACS may help to select spermatozoa with lower rates of DNA fragmentation and unbalanced chromosome content in men with abnormal rates of sperm DNA fragmentation.