Sperm function testing, once commonly performed for the infertile couple before employing assisted reproductive technology （ART）, has fallen out of favour in many reproductive medicine centers throughout the world. ...Sperm function testing, once commonly performed for the infertile couple before employing assisted reproductive technology （ART）, has fallen out of favour in many reproductive medicine centers throughout the world. Indeed, the most recent addition of the ＇World Health Organisation （WHO） Laboratory Manual for the Examination and Processing of Hu- man Semen＇ now groups many of these procedures into a section termed Research Procedures. In large part, this reflects the current clinical practice of bypassing the in-depth evaluation of the male partner, while assuming that if a spermatozoon can be found for intracytoplasmic sperm injection （ICSI）, it must be a healthy cell capable of achieving fertilization. Never- theless, sperm function testing can provide valuable clinical insights into defects causing male infertility. Admittedly, in some cases, functional sperm deficiencies can be overcome using an ART. In other cases, couples will be empowered by the knowledge of the cause of their infertility, and for some couples, perhaps even the likelihood of ICSI success （relative to the spermatozoa）. The knowledge allows them to make truly informed reproductive decisions, including （perhaps） the de- cision to seek donor insemination, to adopt or to remain childless. Knowledge of the cause of their infertility may provide closure for couples and a sense of confidence regarding their choice of reproductive treatment.展开更多
Varicocele is a common medical condition entangled with many controversies. Though it is highly prevalent in men with infertility, still it marks its presence in males who do have normal fertility. Determining which p...Varicocele is a common medical condition entangled with many controversies. Though it is highly prevalent in men with infertility, still it marks its presence in males who do have normal fertility. Determining which patients are negatively affected by varicocele would enable clinicians to better select those men who benefitted the most from surgery. Since conventional semen analysis has been limited in its ability to evaluate the negative effects of varicocele on fertility, a multitude of specialized laboratory tests have emerged. In this review, we examine the role and significance of specialized sperm function tests with regards to varicocele. Among the various tests, analysis of sperm DNA fragmentation and measurements of oxidative stress markers provide an independent measure of fertility in men with varicocele. These diagnostic modalities have both diagnostic and prognostic information complementary to, but distinct from conventional sperm parameters. Test results can guide management and aid in monitoring intervention outcomes. Proteomics, metabolomics, and genomics are areas; though still developing, holding promise to revolutionize our understanding of reproductive physiology, including varicocele.展开更多
Aim: To evaluate the sperm function after vasovasostomy. Methods: Semen samples from 42 subjects aftervasovasostomy (Group A: 1-6 months, Group B: 6-12 months; Group C: 12-18 months after vasectomy rever-sal) were inv...Aim: To evaluate the sperm function after vasovasostomy. Methods: Semen samples from 42 subjects aftervasovasostomy (Group A: 1-6 months, Group B: 6-12 months; Group C: 12-18 months after vasectomy rever-sal) were investigated. Semen from 34 normal fertile men was used as controls. Sperm function tests, including hypo-osmotic swelling test (HOST), acridine orange (AO) fluorescence, acrosome reaction (triple-stain), cervical mucuspenetration test (CMPT), etc were done. Results: After vasectomy reversal, the percentage of HOST was signifi-cantly lower than that of the normal fertile men. In regard to AO, there were no significant differences between thethree vasovasostomy groups and between these 3 groups and the controls. With triple-stain, the percentage of normalacrosome reaction was significantly lower in Group A as compared with the controls, but not in Groups B and C. Therewere no significant differences in the results of CMPT between the vasovasostomy groups and the controls. However,the number of 'poor' type was significantly higher in Groups A and C than in the controls; the percentage of 'nega-tive' type were higher in Groups A and B than in the controls. Conclusion: After vasovasostomy a lower level ofHOST remained for one year and gradually recovered after one year. Six months after vasectomy reversal, the percent-age of acrosome reaction could be changed from lower level to normal range. The data of AO indicated that the geneticmaterial (double-stranded DNA) in spermatozoa was not affected by vasovasostomy. To evaluate the result of CMPTafter vasectomy reversal, not only the normal results but also the abnormal results ('poor' and 'negative' types)should also be considered.Aim: To evaluate the sperm function after vasovasostomy. Methods: Semen samples from 42 subjects aftervasovasostomy (Group A: 1-6 months, Group B: 6-12 months; Group C: 12-18 months after vasectomy rever-sal) were investigated. Semen from 34 normal fertile men was used as controls. Sperm function tests, including hypo-osmotic swelling test (HOST), acridine orange (AO) fluorescence, acrosome reaction (triple-stain), cervical mucuspenetration test (CMPT), etc were done. Results: After vasectomy reversal, the percentage of HOST was signifi-cantly lower than that of the normal fertile men. In regard to AO, there were no significant differences between thethree vasovasostomy groups and between these 3 groups and the controls. With triple-stain, the percentage of normalacrosome reaction was significantly lower in Group A as compared with the controls, but not in Groups B and C. Therewere no significant differences in the results of CMPT between the vasovasostomy groups and the controls. However,the number of 'poor' type was significantly higher in Groups A and C than in the controls; the percentage of 'nega-tive' type were higher in Groups A and B than in the controls. Conclusion: After vasovasostomy a lower level ofHOST remained for one year and gradually recovered after one year. Six months after vasectomy reversal, the percent-age of acrosome reaction could be changed from lower level to normal range. The data of AO indicated that the geneticmaterial (double-stranded DNA) in spermatozoa was not affected by vasovasostomy. To evaluate the result of CMPTafter vasectomy reversal, not only the normal results but also the abnormal results ('poor' and 'negative' types)should also be considered.Aim: To evaluate the sperm function after vasovasostomy. Methods: Semen samples from 42 subjects aftervasovasostomy (Group A: 1-6 months, Group B: 6-12 months; Group C: 12-18 months after vasectomy rever-sal) were investigated. Semen from 34 normal fertile men was used as controls. Sperm function tests, including hypo-osmotic swelling test (HOST), acridine orange (AO) fluorescence, acrosome reaction (triple-stain), cervical mucuspenetration test (CMPT), etc were done. Results: After vasectomy reversal, the percentage of HOST was signifi-cantly lower than that of the normal fertile men. In regard to AO, there were no significant differences between thethree vasov展开更多
Since release of the latest WHO manual with the new lower reference values of semen parameters, a lot of discussion has been raised about their usefulness and appropriateness for assessment of male fertility. As with ...Since release of the latest WHO manual with the new lower reference values of semen parameters, a lot of discussion has been raised about their usefulness and appropriateness for assessment of male fertility. As with the previous reference values the new limits do neither allow an andrological diagnosis based on nosological criteria nor clear-cut differentiation between fertility and sub-/infertility. Therefore, considering the fact that fertility is a continuum, the new lower reference limits should not be overestimated. Most probably, more sperm function tests, such as determination of DNA integrity, and--in the future--assessment of biomarkers, such as sperm proteomics will be included into andrological work-up, thus resulting in a more personalized approach of infertility management. On the other hand, the detailed instructions for standard and advanced semen analysis provided in the new manual are very much appreciated and should be adopted by each seriously workin~ laboratory.展开更多
This was a cohort study of in vitro fertilization(IVF)subjects at the University of Utah,Salt Lake City(UT,USA)utilizing partner sperm.Cycles where both the hamster egg penetration test(HEPT)and semen analysis were pe...This was a cohort study of in vitro fertilization(IVF)subjects at the University of Utah,Salt Lake City(UT,USA)utilizing partner sperm.Cycles where both the hamster egg penetration test(HEPT)and semen analysis were performed within 2 years prior to IVF cycles were stratified into four groups based on a normal or an abnormal HEPT and morphology.The mean conventional and intracytoplasmic sperm injection(ICSI)fertilization rates were calculated in each group.We performed a univariate analysis on the primary outcome comparing clinically interesting subjects.We performed a cost-effectiveness analysis of a policy of HEPT versus universal ICSI in couples with an abnormal morphology.Among patients with a normal HEPT,there was no difference in the mean conventional fertilization rates between those with a normal and an abnormal morphology.There was no difference in the mean conventional fertilization rates between subjects with a normal morphology without a hamster test and those with a normal HEPT without a morphology assessment.In 1000 simulated cycles with an abnormal morphology,a policy of HEPT was cost saving compared to universal ICSI,yet produced similar fertilization rates.The HEPT is similar to the World Health Organization edition 5(WHO-5)morphology in predicting successful conventional fertilization while allowing decreased utilization of ICSI.A policy of HEPT for males with abnormal morphology saves cost in selecting couples for a fertilization method.展开更多
文摘Sperm function testing, once commonly performed for the infertile couple before employing assisted reproductive technology （ART）, has fallen out of favour in many reproductive medicine centers throughout the world. Indeed, the most recent addition of the ＇World Health Organisation （WHO） Laboratory Manual for the Examination and Processing of Hu- man Semen＇ now groups many of these procedures into a section termed Research Procedures. In large part, this reflects the current clinical practice of bypassing the in-depth evaluation of the male partner, while assuming that if a spermatozoon can be found for intracytoplasmic sperm injection （ICSI）, it must be a healthy cell capable of achieving fertilization. Never- theless, sperm function testing can provide valuable clinical insights into defects causing male infertility. Admittedly, in some cases, functional sperm deficiencies can be overcome using an ART. In other cases, couples will be empowered by the knowledge of the cause of their infertility, and for some couples, perhaps even the likelihood of ICSI success （relative to the spermatozoa）. The knowledge allows them to make truly informed reproductive decisions, including （perhaps） the de- cision to seek donor insemination, to adopt or to remain childless. Knowledge of the cause of their infertility may provide closure for couples and a sense of confidence regarding their choice of reproductive treatment.
文摘Varicocele is a common medical condition entangled with many controversies. Though it is highly prevalent in men with infertility, still it marks its presence in males who do have normal fertility. Determining which patients are negatively affected by varicocele would enable clinicians to better select those men who benefitted the most from surgery. Since conventional semen analysis has been limited in its ability to evaluate the negative effects of varicocele on fertility, a multitude of specialized laboratory tests have emerged. In this review, we examine the role and significance of specialized sperm function tests with regards to varicocele. Among the various tests, analysis of sperm DNA fragmentation and measurements of oxidative stress markers provide an independent measure of fertility in men with varicocele. These diagnostic modalities have both diagnostic and prognostic information complementary to, but distinct from conventional sperm parameters. Test results can guide management and aid in monitoring intervention outcomes. Proteomics, metabolomics, and genomics are areas; though still developing, holding promise to revolutionize our understanding of reproductive physiology, including varicocele.
文摘Aim: To evaluate the sperm function after vasovasostomy. Methods: Semen samples from 42 subjects aftervasovasostomy (Group A: 1-6 months, Group B: 6-12 months; Group C: 12-18 months after vasectomy rever-sal) were investigated. Semen from 34 normal fertile men was used as controls. Sperm function tests, including hypo-osmotic swelling test (HOST), acridine orange (AO) fluorescence, acrosome reaction (triple-stain), cervical mucuspenetration test (CMPT), etc were done. Results: After vasectomy reversal, the percentage of HOST was signifi-cantly lower than that of the normal fertile men. In regard to AO, there were no significant differences between thethree vasovasostomy groups and between these 3 groups and the controls. With triple-stain, the percentage of normalacrosome reaction was significantly lower in Group A as compared with the controls, but not in Groups B and C. Therewere no significant differences in the results of CMPT between the vasovasostomy groups and the controls. However,the number of 'poor' type was significantly higher in Groups A and C than in the controls; the percentage of 'nega-tive' type were higher in Groups A and B than in the controls. Conclusion: After vasovasostomy a lower level ofHOST remained for one year and gradually recovered after one year. Six months after vasectomy reversal, the percent-age of acrosome reaction could be changed from lower level to normal range. The data of AO indicated that the geneticmaterial (double-stranded DNA) in spermatozoa was not affected by vasovasostomy. To evaluate the result of CMPTafter vasectomy reversal, not only the normal results but also the abnormal results ('poor' and 'negative' types)should also be considered.Aim: To evaluate the sperm function after vasovasostomy. Methods: Semen samples from 42 subjects aftervasovasostomy (Group A: 1-6 months, Group B: 6-12 months; Group C: 12-18 months after vasectomy rever-sal) were investigated. Semen from 34 normal fertile men was used as controls. Sperm function tests, including hypo-osmotic swelling test (HOST), acridine orange (AO) fluorescence, acrosome reaction (triple-stain), cervical mucuspenetration test (CMPT), etc were done. Results: After vasectomy reversal, the percentage of HOST was signifi-cantly lower than that of the normal fertile men. In regard to AO, there were no significant differences between thethree vasovasostomy groups and between these 3 groups and the controls. With triple-stain, the percentage of normalacrosome reaction was significantly lower in Group A as compared with the controls, but not in Groups B and C. Therewere no significant differences in the results of CMPT between the vasovasostomy groups and the controls. However,the number of 'poor' type was significantly higher in Groups A and C than in the controls; the percentage of 'nega-tive' type were higher in Groups A and B than in the controls. Conclusion: After vasovasostomy a lower level ofHOST remained for one year and gradually recovered after one year. Six months after vasectomy reversal, the percent-age of acrosome reaction could be changed from lower level to normal range. The data of AO indicated that the geneticmaterial (double-stranded DNA) in spermatozoa was not affected by vasovasostomy. To evaluate the result of CMPTafter vasectomy reversal, not only the normal results but also the abnormal results ('poor' and 'negative' types)should also be considered.Aim: To evaluate the sperm function after vasovasostomy. Methods: Semen samples from 42 subjects aftervasovasostomy (Group A: 1-6 months, Group B: 6-12 months; Group C: 12-18 months after vasectomy rever-sal) were investigated. Semen from 34 normal fertile men was used as controls. Sperm function tests, including hypo-osmotic swelling test (HOST), acridine orange (AO) fluorescence, acrosome reaction (triple-stain), cervical mucuspenetration test (CMPT), etc were done. Results: After vasectomy reversal, the percentage of HOST was signifi-cantly lower than that of the normal fertile men. In regard to AO, there were no significant differences between thethree vasov
文摘Since release of the latest WHO manual with the new lower reference values of semen parameters, a lot of discussion has been raised about their usefulness and appropriateness for assessment of male fertility. As with the previous reference values the new limits do neither allow an andrological diagnosis based on nosological criteria nor clear-cut differentiation between fertility and sub-/infertility. Therefore, considering the fact that fertility is a continuum, the new lower reference limits should not be overestimated. Most probably, more sperm function tests, such as determination of DNA integrity, and--in the future--assessment of biomarkers, such as sperm proteomics will be included into andrological work-up, thus resulting in a more personalized approach of infertility management. On the other hand, the detailed instructions for standard and advanced semen analysis provided in the new manual are very much appreciated and should be adopted by each seriously workin~ laboratory.
文摘This was a cohort study of in vitro fertilization(IVF)subjects at the University of Utah,Salt Lake City(UT,USA)utilizing partner sperm.Cycles where both the hamster egg penetration test(HEPT)and semen analysis were performed within 2 years prior to IVF cycles were stratified into four groups based on a normal or an abnormal HEPT and morphology.The mean conventional and intracytoplasmic sperm injection(ICSI)fertilization rates were calculated in each group.We performed a univariate analysis on the primary outcome comparing clinically interesting subjects.We performed a cost-effectiveness analysis of a policy of HEPT versus universal ICSI in couples with an abnormal morphology.Among patients with a normal HEPT,there was no difference in the mean conventional fertilization rates between those with a normal and an abnormal morphology.There was no difference in the mean conventional fertilization rates between subjects with a normal morphology without a hamster test and those with a normal HEPT without a morphology assessment.In 1000 simulated cycles with an abnormal morphology,a policy of HEPT was cost saving compared to universal ICSI,yet produced similar fertilization rates.The HEPT is similar to the World Health Organization edition 5(WHO-5)morphology in predicting successful conventional fertilization while allowing decreased utilization of ICSI.A policy of HEPT for males with abnormal morphology saves cost in selecting couples for a fertilization method.
