Redox status assessment in infertile patients with non‐obstructive azoospermia undergoing testicular sperm extraction: A prospective study

Cito, Gianmartin; Becatti, Matteo; Natali, Alessandro; Fucci, Rossella; Picone, Rita; Cocci, Andrea; Falcone, Patrizia; Criscuoli, Luciana; Mannucci, Amanda; Argento, Flavia Rita; Bertocci, Francesco; Serni, Sergio; Carini, Marco; Fiorillo, Claudia; Coccia, Maria Elisabetta

doi:10.1111/andr.12721

Cited by 20 publications

(13 citation statements)

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“…Indeed, DNA breaks and oxidative stress induced by impaired chromatin compaction could be the major reasons of poor semen morphology. 22,23 However, although in c-ICSI cycles the embryologists aim to select an ideal spermatozoa at 400x-power magnification, relying on normal morphology, the percentage of spermatozoa with high DNA fragmentation could be greater than 55%, even in the amount of morphologically normal ones. 24,25 This could be one reason why, in our series, worst sperm morphology is related to lower fertilization rates.…”

Section: Discussionmentioning

confidence: 99%

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Sperm morphology: What implications on the assisted reproductive outcomes?

et al. 2020

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Objective To evaluate the impact of sperm morphology (SM) on laboratory and pregnancy outcomes in conventional intracytoplasmic sperm injection (c‐ICSI) cycles, using the egg donation model to minimize female confounding variables. Materials and methods We retrospectively collected data of oocyte donation cycles from October 2016 to February 2020. Median seminal parameters, total (1‐2‐3PN) fertilization rate (FR), 2PN FR, cleavage rate (CR), implantation rate (IR), pregnancy rate (PR), miscarriage rate (MR), and live birth rate (LBR) were collected. The study population was divided into three groups: Group 1 with SM < 4%, Group 2 with SM between 4% and 6%, and Group 3 with SM > 6%. Results Of 741 fresh ICSI cycles and 4507 warmed oocytes were included. Male age was 46.0 (31.0‐72.0) years, and recipients’ age was 44.0 (29.0‐54.0) years. Normal SM was 5.0% (1.0%‐15.0%). Male age was negatively correlated with normal SM (P = .002; Rho −0.113). Oocyte survival rate was 83.3% (16.7%‐100.0%). Total FR was 75.0% (11.1%‐100.0%), 2PN FR was 66.7% (11.1%‐100.0%) %, and CR was 100% (0.0%‐100%). Comparing samples with SM > 6% and those with SM < 4%, 2PN FR was significantly higher in the first group (P = .04). No significant associations were found among groups in terms of CR. IR was 27.7%, resulting significantly higher when normal SM was > 6% (P < .01). Clinical PR was 36.0%, MR was 23.9%, and LBR was 25.9%. PR and LBR were significantly higher in samples with normal SM > 6%, compared to other groups (P = .02 and P < .01, respectively). Conclusions Although c‐ICSI technique allows the embryologist to select the best quality spermatozoa, male factor plays a key role in achieving successful assisted reproductive outcomes. Normal SM has been shown to have implications not only for laboratory outcomes, in terms of fertilization, but also for clinical findings, as regards implantation, pregnancy, and live birth.

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Section: Discussionmentioning

confidence: 99%

“…Moreover, morphology defects in the spermatozoa seem to be positively correlated with fragmented DNA both in whole semen and single retrieved cells. Indeed, DNA breaks and oxidative stress induced by impaired chromatin compaction could be the major reasons of poor semen morphology 22,23 …”

Section: Discussionmentioning

confidence: 99%

Sperm morphology: What implications on the assisted reproductive outcomes?

et al. 2020

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“…A prospective study by Cito et al revealed that the reactive oxygen species (ROS) production of NOA was significantly higher than that of normozoospermic men, and it may be related to spermatogenesis disorders in NOA patients [ 13 ]. Vatannejad et al published a study revealing that ROS also damage sperm nuclear DNA, displaying a negative effect on sperm DNA fragmentation [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effects of Different Testicular Sperm Extraction Methods on the Embryonic Development of Azoospermic Men in Intracytoplasmic Sperm Injection (ICSI) Cycles: A Retrospective Cohort Study

Cao

et al. 2021

BioMed Research International

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Background. The effects of different testicular sperm extraction methods on the embryonic development and clinical outcome of azoospermic men in intracytoplasmic sperm injection (ICSI) cycles have not been researched. Our goal was to evaluate the effect of different sperm retrieval methods used for patients with OA or NOA on the embryonic development and clinical outcomes during the ICSI cycles. Methods. This was a retrospective cohort study. A total of 530 azoospermic patients who underwent 570 ICSI cycles met the study criteria. ICSI was performed using testicular sperm by TESA in 282 cycles (TESA group); ICSI with testicular sperm by mTESE was performed due to NOA in 90 cycles (mTESE group); ICSI with testicular sperm by MESA was performed in 198 cycles (MESA group). The embryonic development and clinical outcomes of the three groups were counted. Results. The general characteristics of the three groups were comparable. Our findings showed that the three groups were matched in terms of infertility durations and age. The mean age and the mean BMI of the female partners were similar in the three groups. Also, our findings showed there were no significant differences in the three groups regarding day 3 of the menstrual cycle FSH and days of stimulation. The research results showed that the total dose of FSH and E2 on the HCG administration day was also not statistically different in the three groups. The number of oocytes retrieved had no significant differences in the three groups. However, the number of 2PNs per cycle and the number of cleavages per cycle were higher in the MESA group than in the other two groups; the TESA group and mTESE group were similar. The number of good quality D3 embryos and the number of good quality D5 embryos were significantly decreased in the mTESE group as compared to the other two groups. Good quality D3 embryos and the rate of good quality D5 embryos in the mTESE group were lower than those in the other two groups. Moreover, the clinical pregnancy rates of the TESA group (50.71%) and the MESA group (51.52%) were similar, but both were much higher than that of the mTESE group (32.22%). Conclusions. The mTESE provides a good clinical outcome for NOA patients with severe spermatogenic impairment, including the rate of good quality D3 embryos, the rate of good quality D5 embryos, and the clinical pregnancy rate. However, our data suggested that both the TESA and MESA groups had better embryonic development and clinical outcomes than the mTESE group.

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“…The elevated concentrations of macrophages and sperm fragments in the distal epididymis may affect the sperm quality [17]. Moreover, according to previous authors, higher levels of reactive oxygen species and sperm DNA fragmentation could mediate the reproductive toxicity [18]. In our patients, the presence of high levels of polyunsaturated fatty acids on the sperm membrane; the low quantities of glutathione peroxidase, superoxide dismutase, and cytoplasm; and the presence of inactive, highly condensed chromatin could have led to a reduction in fertilization competence, motility, and viability, as well as a loss of DNA repair capacity [19].…”

Section: B Amentioning

confidence: 91%

Sperm retrieval by conventional testicular sperm extraction for assisted reproduction in patients with Zinner syndrome

Cito

Lepri

Giachini

et al. 2021

Clin Exp Reprod Med

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We present data from three Caucasian men with Zinner syndrome who attended our center for the treatment of primary couple’s infertility. Each patient was scheduled for multiple conventional testicular sperm extraction (cTESE) and cryopreservation. The mean duration of infertility was 243 months. Sperm analysis confirmed absolute azoospermia. In patient 1, imaging revealed right and left testis volumes of 24 mL and 23 mL, respectively; dilatation of the right caput epididymis, corpus, and cauda; left seminal vesicle agenesis; severe right seminal vesicle hypotrophy; right renal agenesis; and left nephroptosis. The patient’s levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and total testosterone (TT) were 3.2 IU/L, 5.2 IU/L, and 22.3 nmol/L, respectively. Patient 2 exhibited right and left testis volumes of 18 mL and 16 mL, respectively; a left seminal vesicle cyst of 3228 mm; ipsilateral kidney absence; and right seminal vesicle agenesis. The patient’s levels of FSH, LH, and TT were 2.8 IU/L, 4.2 IU/L, and 14.3 nmol/L, respectively. In patient 3, ultrasound showed a testicular volume of 10 mL bilaterally, a 6546 mm left seminal vesicle cyst, right seminal vesicle enlargement, and left kidney agenesis. The patient’s levels of FSH, LH, and TT were 32.0 IU/L, 16.3 IU/L, and 9.0 nmol/L, respectively. Sperm retrieval via cTESE was successful in all patients. It may be advisable to perform cTESE to obtain fresh sperm on the day of oocyte retrieval. Sperm cryopreservation should be avoided, since thawing could further compromise the sperm quality.

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Redox status assessment in infertile patients with non‐obstructive azoospermia undergoing testicular sperm extraction: A prospective study

Cited by 20 publications

References 56 publications

Sperm morphology: What implications on the assisted reproductive outcomes?

Sperm morphology: What implications on the assisted reproductive outcomes?

Comparison of the Effects of Different Testicular Sperm Extraction Methods on the Embryonic Development of Azoospermic Men in Intracytoplasmic Sperm Injection (ICSI) Cycles: A Retrospective Cohort Study

Sperm retrieval by conventional testicular sperm extraction for assisted reproduction in patients with Zinner syndrome

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