scholarly journals Predicting the testicular function in non-obstructive azoospermia via targeted gene panel

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Mai Emad ◽  
Hossam El-Din Omar ◽  
Abdel-Razik Khalifa ◽  
Emad A. Ahmed ◽  
Emad Abdel Rhim Taha
Keyword(s):  
Gene Expression ◽  
Semen Analysis ◽  
Quantitative Polymerase Chain Reaction ◽  
Testicular Tissue ◽  
Future Research ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Male Factor ◽  
Sperm Retrieval ◽  
Gapdh Gene

Abstract Background Men with non-obstructive azoospermia constitute a challenging subgroup of male infertility patients in whom a genetic cause of defective spermatogenesis may be a contributing factor. The aim of this prospective observational cohort study was to determine whether assessment of meiotic nuclear division 1 (MND1) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene expression (MND1/GAPDH) in testicular tissue could be a prognostic indicator for sperm retrieval and ICSI outcome in patients with non-obstructive azoospermia. The study participants underwent clinical evaluation, conventional semen analysis, serum follicular stimulating hormone (FSH), testosterone assay, scrotal ultrasound examination, microsurgical testicular sperm extraction (mTESE), and assessment of MND1/GAPDH gene expression levels in testicular tissue via quantitative polymerase chain reaction (qPCR) techniques. Results The MND1/GAPDH level was associated with the likelihood of identifying sperm in testicular biopsies (odds ratio (OR) 1.25, 95% confidence intervals (CI) 1.14 to 1.34, p < 0.0001), which was confirmed by the pairwise comparison of high vs. low levels of MND1/GAPDH (OR 5.34, 95% CI 1.97 to 13.16, p = 0.0006). The level of FSH was inversely associated with a lower chance of finding sperm (OR 0.37, 95% CI 0.20 to 0.65, p = 0.001). Compared with small testicular volume, normal volume was inversely associated with the chance of sperm presence (OR 0.16, 95% CI 0.06 to 0.47, p = 0.0002). However, there was no correlation between MND1/GAPDH levels and ICSI outcome. Conclusion Gene expression analysis to predict the likelihood of sperm retrieval following mTESE in patients with non-obstructive azoospermia provides a new avenue for future research, diagnosis and treatment of male factor infertility. Before its wider clinical application, however, this proof-of-concept should be tested in a large multinational, multicenter observational study.

scholarly journals Prognostic Factors for Successful Microdissection Testicular Sperm Extraction (Micro-TESE)

2021 ◽  
pp. 30-35
Author(s):  
Mohamed Hamdy Mashaly ◽  
Tarek Ahmed Gamil ◽  
Maged Moustafa Ragab ◽  
Mohamed Abo El-Enen Ghalwash
Keyword(s):  
Semen Analysis ◽  
Testicular Volume ◽  
Seminiferous Tubules ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
University Hospitals ◽  
Sperm Retrieval ◽  
Significant Difference ◽  
Detailed Medical History

Background: There are some men suffer from infertility, non-obstructive azoospermia is one of the causes of infertility, these men need sperm retrieval from testes like microdissection testicular sperm extraction (Micro-TESE). This work aims to assess the different preoperative and intraoperative factors that predict successful sperm retrieval with Microdissection Testicular Sperm Extraction (Micro-TESE) in men with non-obstructive azoospermia. Methods: Our study is a cohort prospective one, conducted on 52 male patients with non-obstructive azoospermia who attended to the outpatient andrology and infertility clinic of Urology Department, Tanta University Hospitals during the period between December2018 to November2019. All patients were subjected to detailed medical history, physical examination, two semen analysis on two different laboratories. Microdissection Testicular Sperm Extraction is performed to all patients after Estimation of serum FSH, LH, testosterone, prolactin, estradiol and scrotal Doppler ultrasonography Results: From 52 patients who have done, Patients were divided in to 2 groups according to the result of Micro-TESE procedure: negative SSR group (28 patients) and positive SSR group (24 patients).In comparison between the two groups according to preoperative factors as age, FSH, LH, estradiol, testosterone, prolactin and testicular volume, there was no significant difference between these groups. On comparison of intraoperative size of seminiferous tubules in relation to results of Micro-TESE, we found that presence of large convoluted seminiferous tubules was statistically significant in prediction of successful sperm retrieval with Micro-TESE Conclusions: The chances of sperm retrieval in men with NOA by Micro-TESE are not related to preoperatively age, FSH, LH, testosterone, estradiol, prolactin and testicular volume. The detection of large seminiferous tubules intraoperatively is a good predictor for successful sperm retrieval with Micro-TESE as it was statistically significant.

scholarly journals Two Decades from the Introduction of Microdissection Testicular Sperm Extraction: How This Surgical Technique Has Improved the Management of NOA

2021 ◽  
Vol 10 (7) ◽  
pp. 1374
Author(s):  
Nahid Punjani ◽  
Caroline Kang ◽  
Peter N. Schlegel
Keyword(s):  
Testicular Tissue ◽  
Seminiferous Tubules ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Vitro Fertilization ◽  
Surgeon Experience ◽  
Patient Optimization

The treatment of men with non-obstructive azoospermia (NOA) has improved greatly over the past two decades. This is in part due to the discovery of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), but also significantly due to improvements in surgical sperm retrieval methods, namely the development of microdissection testicular sperm extraction (mTESE). This procedure has revolutionized the field by allowing for identification of favorable seminiferous tubules while simultaneously limiting the amount of testicular tissue removed. Improving sperm retrieval rates is imperative in this cohort of infertile men as there are a limited number of factors that are predictive of successful sperm retrieval. Currently, sperm retrieval in NOA men remains dependent on surgeon experience, preoperative patient optimization and teamwork with laboratory personnel. In this review, we discuss the evolution of surgical sperm retrieval methods, review predictors of sperm retrieval success, compare and contrast the data of conventional versus mTESE, share tips for optimizing sperm retrieval outcomes, and discuss the future of sperm retrieval in men with NOA.

scholarly journals MICROSCOPIC TESTICULAR SPERM EXTRACTION

2018 ◽  
Vol 25 (02) ◽  
pp. 180-184
Author(s):  
Maher Saleh Moazin ◽  
Muhammad Tahir Bashir Malik ◽  
Muhammad Aslam ◽  
Naif Aldaham ◽  
Muhammad Yahya Alrawi
Keyword(s):  
Chromosomal Abnormalities ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Male Factor ◽  
Sperm Retrieval ◽  
Retrieval Rate ◽  
Medical City ◽  
Infertile Couples ◽  
Small Hematoma

Azoospermia, the complete absence of sperms in the ejaculate is found in 1% ofnormal males and 10-15% of infertile couples. Surgical sperm retrieval (SSR) and use of spermsfor ICSI/IVF offers an opportunity of parenting to the male factor infertile couples. Micro-TESEgives higher surgical sperms retrieval rates in those patients in whom the chances of spermretrieval otherwise are very low. Objectives: To evaluate the outcome of Microscopic TesticularSperm Extraction (Micro-TESE) in different patients groups of non-obstructive azoospermia,in terms of testicular volume, histopathology, hormones levels as well as cytogenetic variants.Study Design: Retrospectively reviewed. Setting: Urology Division, King Fahd Medical City,Riyadh in collaboration with King Abdullah Reproductive Medical Unit (RMU). Period: January2011 to January 2016. Material & Methods: Fifty-four patients of primary and secondary infertilityage range of 29 to 65 years who had undergone Microscopic Testicular Sperm Extraction(Micro-TESE). Outcome measures: Finding of sperm in testicular specimen extracted bymicroscopic testicular dissection. Results: Out of 54 patients, hormonal abnormalities werefound in 45% patients and 65% had low volume testes. Abnormal histology was found in 23%patients and 9% had chromosomal abnormalities. Overall sperm retrieval rate in all groups was33%. Sperm retrieval rate was 34 % in patients with small volume testes (<15ml), 42% patientswith abnormal hormones (FSH), 33% patients with abnormal histology and 38% in patientswith chromosomal abnormalities. Minor complications (small hematoma and orchalgia) wereobserved in two (3.7%) patients. Conclusion: Micro-TESE is a valid option for sperm retrieval inpatients in which probability of sperm retrieval is otherwise very low.

Can Testicular Size Be a Predictive Factor for Successful Sperm Retrieval in Patients with Non Obstructive Azoospermia?

2019 ◽  
pp. 1
Author(s):  
Omer Yumusak ◽  
Mehmet Cinar ◽  
Serkan Kahyaoglu ◽  
Yasemin Tasci ◽  
Gul Nihal Buyuk ◽  
...  
Keyword(s):  
Follicle Stimulating Hormone ◽  
Significant Risk ◽  
High Serum ◽  
Testicular Volume ◽  
Testicular Sperm Extraction ◽  
Total Testosterone ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Stimulating Hormone

<p><strong>Objective:</strong> Non-obstructive azoospermia, defined as absence of spermatozoa in the ejaculate caused by impaired spermatogenesis, is the most severe cause of male infertility. It is typically presented as high serum follicle stimulating hormone levels and atrophic testis. The combination of intracytoplasmic sperm injection and Microdissection testicular sperm extraction allows these infertile men the opportunity to have their own children from their own testis. Our aim was to evaluate the outcomes of micro-Testicular sperm extraction in men with atrophic testis.</p><p><strong>Study Design:</strong> The medical records of 80 non-obstructive men with azoospermia who underwent micro-TESE were retrospectively evaluated. We assessed clinical parameters; age, duration of infertility, smoking, chromosomal karyotype, Y chromosome microdeletion, follicle stimulating hormone, luteinizing hormone, total testosterone and testicular volume in relation with Microdissection testicular sperm extraction results.</p><p><strong>Results:</strong> Testicular sperm retrieval rate was 53% in 80 patients. Testicular volume, serum follicle stimulating hormone and total testosterone concentrations showed correlation with the results of sperm retrieval. These three parameters were found to be significant risk factors with testicular sperm extraction negative patients (p&lt;0.001). The odds ratios (95% CI) were 6.39 (1.25–26.58), 1.24 (1.11-1.36), 1.13 (0.99-1.21) respectively. Testicular volume was found to be a discriminative parameter in patients with negative sperm retrieval. The cut-off point was established as 6.75 ml for testicular volume with 88.1% sensitivity, 62.1% specificity.</p><p><strong>Conclusion:</strong> Microdissection testicular sperm extraction is the most effective procedure for patients with non-obstructive azoospermia. Testicular volume, serum follicle stimulating hormone and testosterone levels can be predictive factors for sperm retrieval in men with non-obstructive azoospermia.</p>

scholarly journals Sperm Selection Procedures for Optimizing the Outcome of ICSI in Patients with NOA

2021 ◽  
Vol 10 (12) ◽  
pp. 2687
Author(s):  
Kaan Aydos ◽  
Oya Sena Aydos
Keyword(s):  
In Vitro Selection ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Sperm Retrieval ◽  
Vitro Fertilization ◽  
Great Hope ◽  
Future Fertility

Retrieving spermatozoa from the testicles has been a great hope for patients with non-obstructive azoospermia (NOA), but relevant methods have not yet been developed to the level necessary to provide resolutions for all cases of NOA. Although performing testicular sperm extraction under microscopic magnification has increased sperm retrieval rates, in vitro selection and processing of quality sperm plays an essential role in the success of in vitro fertilization. Moreover, sperm cryopreservation is widely used in assisted reproductive technologies, whether for therapeutic purposes or for future fertility preservation. In recent years, there have been new developments using advanced technologies to freeze and preserve even very small numbers of sperm for which conventional techniques are inadequate. The present review provides an up-to-date summary of current strategies for maximizing sperm recovery from surgically obtained testicular samples and, as an extension, optimization of in vitro sperm processing techniques in the management of NOA.

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

Predictive Factors for Sperm Retrieval in Males With Non-obstructive Azoospermia

2021 ◽  
Author(s):  
Wei-Hsun Hsu ◽  
Marcelo Chen ◽  
Pai-Kai Chiang ◽  
Wei-Kung Tsai ◽  
Allen W Chiu ◽  
...  
Keyword(s):  
Sertoli Cell ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Testicular Volume ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Retrieval Rate ◽  
Normal Spermatogenesis

Abstract The aim of the current study was to investigate the predictive markers for males with non-obstructive azoospermia (NOA) before they received conventional testicular sperm extraction (cTESE) or microdissection testicular sperm extraction (microTESE). Between January 2010 and December 2020, a total of 56 patients who received cTESE or microTESE surgery at the Urology department of the MacKay Memorial Hospital were included. Our univariate analysis revealed that the following parameters was associated with sperm retrieval: Follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, testicular volume, histopathology of maturation arrest and Sertoli cell-only. The multivariate analysis showed that Sertoli cell-only was significantly less likely to harvest spermatozoa than normal spermatogenesis (OR = 0.03 (0.002-0.42); p = 0.01). A comparison of cTESE and microTESE revealed that the overall successful sperm retrieval rate was not significantly different between the two methods (74.1% vs. 58.6, p = 0.22). This study demonstrated that lower levels of FSH, LH and prolactin, and a higher testicular volume and better histopathology were associated with a higher sperm retrieval rate in the univariate analysis. In the multivariable analysis, only Sertoli cell-only syndrome appeared to have a significantly negative effect on the successful harvesting of sperm when compared with normal spermatogenesis.

Evaluation of Appropriate Reference Genes For Investigating Gene Expression in Chlorops oryzae (Diptera: Chloropidae)

2019 ◽  
Vol 112 (5) ◽  
pp. 2207-2214 ◽  
Author(s):  
Ping Tian ◽  
Lin Qiu ◽  
Ailin Zhou ◽  
Guo Chen ◽  
Hualiang He ◽  
...  
Keyword(s):  
Gene Expression ◽  
Ribosomal Protein ◽  
Reference Genes ◽  
Molecular Mechanisms ◽  
Developmental Stages ◽  
Quantitative Polymerase Chain Reaction ◽  
Housekeeping Genes ◽  
Future Research ◽  
Economic Damage ◽  
Physiological Processes

Abstract Reverse transcription quantitative polymerase chain reaction (PCR) has become an invaluable technique for analyzing gene expression in many insects. However, this approach requires the use of stable reference genes to normalize the data. Chlorops oryzae causes significant economic damage to rice crops throughout Asia. The lack of suitable reference genes has hindered research on the molecular mechanisms underlying many physiological processes of this species. In this study, we used quantitative real-time PCR to evaluate the expression of eight C. oryzae housekeeping genes glyceraldehyde-3-phosphate dehydrogenase (GAPDH), β-actin (βACT), beta-tubulin (βTUB), Delta Elongation factor-1 (EF1δ), ribosomal protein S11 (RPS11), RPS15, C-terminal-Binding Protein (CtBP), and ribosomal protein 49 (RP49) in different developmental stages and tissues in both larvae and adults. We analyzed the data with four different software packages: geNorm, NormFinder, BestKeeper, and RefFinder and compared the results obtained with each method. The results indicate that PRS15 and RP49 can be used as stable reference genes for quantifying gene expression in different developmental stages and larval tissues. GAPDH and βACT, which have been considered stable reference genes by previous studies, were the least stable of the candidate genes with respect to larval tissues. GAPDH was, however, the most stable reference gene for adult tissues. We verified the candidate reference genes identified and found that the expression levels of Cadherins (Cads) changed when different reference genes were used to normalize gene expression. This study provides a valuable foundation for future research on gene function, and investigating the molecular basis of physiological processes, in C. oryzae.

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