scholarly journals Male Infertility is a Women’s Health Issue—Research and Clinical Evaluation of Male Infertility Is Needed

Cells ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 990 ◽  
Author(s):  
Katerina A. Turner ◽  
Amarnath Rambhatla ◽  
Samantha Schon ◽  
Ashok Agarwal ◽  
Stephen A. Krawetz ◽  
...  
Keyword(s):  
Male Infertility ◽  
Semen Analysis ◽  
Treatment Options ◽  
Diagnostic Testing ◽  
Reproductive Technology ◽  
Unexplained Infertility ◽  
Treatment Burden ◽  
Improve Treatment ◽  
Natural Conception ◽  
Sperm Dysfunction

Infertility is a devastating experience for both partners as they try to conceive. Historically, when a couple could not conceive, the woman has carried the stigma of infertility; however, men and women are just as likely to contribute to the couple’s infertility. With the development of assisted reproductive technology (ART), the treatment burden for male and unexplained infertility has fallen mainly on women. Equalizing this burden requires reviving research on male infertility to both improve treatment options and enable natural conception. Despite many scientific efforts, infertility in men due to sperm dysfunction is mainly diagnosed by a semen analysis. The semen analysis is limited as it only examines general sperm properties such as concentration, motility, and morphology. A diagnosis of male infertility rarely includes an assessment of internal sperm components such as DNA, which is well documented to have an impact on infertility, or other components such as RNA and centrioles, which are beginning to be adopted. Assessment of these components is not typically included in current diagnostic testing because available treatments are limited. Recent research has expanded our understanding of sperm biology and suggests that these components may also contribute to the failure to achieve pregnancy. Understanding the sperm’s internal components, and how they contribute to male infertility, would provide avenues for new therapies that are based on treating men directly for male infertility, which may enable less invasive treatments and even natural conception.

scholarly journals Understanding Male Infertility for Promising ART

2021 ◽  
Author(s):  
Mahrukh Hameed Zargar ◽  
Faisel Ahmad ◽  
Mohammad Lateef ◽  
Tahir Mohiuddin Malla
Keyword(s):  
Male Infertility ◽  
Physical Examination ◽  
Semen Analysis ◽  
Reproductive Technology ◽  
Male Factor ◽  
Traditional Assessment ◽  
Assisted Reproductive Treatment ◽  
Natural Conception ◽  
The Cost ◽  
Invasive Techniques

Infertility is a serious problem of not being able to conceive despite regular intercourse for more than a year. Natural conception is seen to be achieved in 80%–85% of couples. About 15% of couples suffer infertility with male factor contributing to almost 50% of cases. Paradoxically, on traditional assessment, the underlying etiology of male contribution towards infertility remains unrecognized in 30% of the patients and thereby grouped as idiopathic. Diagnostics of male infertility cannot therefore be limited to usual semen analysis only. The spectrum of the recent research encourages the experts in the field to approach the Clinical, Molecular and cytogenetic shades associated with the problem besides secondary factors like life style and environment. Clinical assessment sums the medical history and physical examination of the affected individual. Molecular and cytogenetic analysis help gain new insights in understanding the problem and thereby an advantage for a successful assisted reproductive treatment (ART). Given the cost and burden ART puts in and prior to application of any invasive techniques, understanding precisely the etiology associated with male infertility is essential for the fertility specialist to circumvent inefficient or any unproductive steps in the fertilization process besides helping in counseling patients on their chance of success with the use of reproductive technology.

scholarly journals Counting sperm does not add up any more: time for a new equation?

Reproduction ◽  
2007 ◽  
Vol 133 (4) ◽  
pp. 675-684 ◽  
Author(s):  
Linda Lefièvre ◽  
Kweku Bedu-Addo ◽  
Sarah J Conner ◽  
Gisela S M Machado-Oliveira ◽  
Yongjian Chen ◽  
...  
Keyword(s):  
Recent Progress ◽  
Semen Analysis ◽  
Reproductive Technology ◽  
Sperm Function ◽  
New Paradigm ◽  
Common Cause ◽  
New Knowledge ◽  
New Equation ◽  
New Biomarkers ◽  
Sperm Dysfunction

Although sperm dysfunction is the single most common cause of infertility, we have poor methods of diagnosis and surprisingly no effective treatment (excluding assisted reproductive technology). In this review, we challenge the usefulness of a basic semen analysis and argue that a new paradigm is required immediately. We discuss the use of at-home screening to potentially improve the diagnosis of the male and to streamline the management of the sub-fertile couple. Additionally, we outline the recent progress in the field, for example, in proteomics, which will allow the development of new biomarkers of sperm function. This new knowledge will transform our understanding of the spermatozoon as a machine and is likely to lead to non-ART treatments for men with sperm dysfunction.

scholarly journals Focus Issue on Male Infertility

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Hideyuki Kobayashi ◽  
Koichi Nagao ◽  
Koichi Nakajima
Keyword(s):  
Male Infertility ◽  
Small Volume ◽  
Semen Analysis ◽  
Reproductive Technology ◽  
World Health ◽  
Nonobstructive Azoospermia ◽  
Successful Pregnancy ◽  
The World ◽  
Health Organization

Male infertility problems can occur when sperms are limited in number or function. In this paper, we describe the clinical evaluation of male infertility. A detailed history, physical examination, and basic semen analysis are required. In addition, ultrasound, karyotyping, and hormonal studies are needed to determine specific causes of infertility. In addition, the World Health Organization (WHO, 2009) has developed a manual to provide guidance in performing a comprehensive semen analysis. Among the possible reasons for male infertility, nonobstructive azoospermia is the least treatable, because few or no mature sperm may be produced. In many cases, men with nonobstructive azoospermia typically have small-volume testes and elevated FSH. Although treatment may not completely restore the quality of semen from men with subnormal fertility, in some cases a successful pregnancy can still be achieved through assisted reproductive technology.

scholarly journals Male Infertility Problem: A Contemporary Review on Present Status and Future Perspective

2019 ◽  
Vol 3 ◽  
pp. 247028971986824 ◽  
Author(s):  
D. M. I. H. Dissanayake ◽  
W. L. R. Keerthirathna ◽  
L. Dinithi C. Peiris
Keyword(s):  
Male Infertility ◽  
Genetic Factors ◽  
Semen Quality ◽  
Semen Analysis ◽  
Treatment Options ◽  
Future Perspective ◽  
Sperm Chromatin ◽  
Industrial Chemicals ◽  
Protective Mechanisms ◽  
Physiological Factors

Semen quality plays a pivotal role in maintaining healthy fertilizing ability of spermatozoa. Male infertility is a rising global problem with an increasing declining in male semen quality among men living in Africa, Europe, North American, and Asia. Though the sperm acquire proactive mechanisms during spermatogenesis and their epididymal maturation, they still remain viable for toxic insult. Declining semen quality is a major contributor to infertility. Studies have postulated that different factors, such as exposure to pesticides, industrial chemicals, heavy metals, obesity, alcoholism, tobacco smoking, sedentary lifestyles, poor nutrient intake, oxidative stress, physiological factors, genetic factors can influence male fertility. Routine semen analysis and assays for sperm chromatin integrity are the most widely utilized and best studied adjunctive diagnostics in male infertility. Over the years, scientists have developed different treatment options for male infertility. Male infertility with known etiology can be treated successfully, but other causes like genetic factors require pragmatic approaches. This article summarizes protective mechanisms of spermatogenesis, causes, diagnosis, and both modern and traditional treatment approaches of male infertility. Further, this article highlights present issues and direction for future exploration of the male infertility problem.

IVF and male infertility

1992 ◽  
Vol 1 (2) ◽  
pp. 151-164 ◽  
Author(s):  
Susan M Avery
Keyword(s):  
Male Infertility ◽  
Semen Quality ◽  
Semen Analysis ◽  
World Health ◽  
Semen Parameters ◽  
Infertile Men ◽  
Health Organization ◽  
Sperm Dysfunction

Male infertility, while having a variety of causes, is generally discussed in terms of semen parameters. While the World Health Organization (WHO) have been able io set limits for semen parameters below which a male can be considered subfertile (20 million/ml; >50% motility; >50% morphologically normal forms), it is well documented thatin vivoconceptions have been achieved where semen quality falls well outside these limits, and that infertile men may have normal semen parameters. Macleod and Gold in comparing 1000 fertile men and 1000 infertile men, found that significantly more infertile men had sperm densities below 20 million/ml, but also that 60% of infertile men had sperm densities of 60 million or more. Jouannet and Feneaux have shown that the conception ratein vivoonly apparently falls significantly at sperm concentrations of less than five million/ml. Although the cause of subnormal semen analysis is unknown in the majority of cases, there is no reason to suppose that abnormal semen parameters on their own are the cause of infertility. Rather the problem may be caused by failure of sufficient numbers of sperm traversing the female tract and reaching the oocyte. Unfortunately, lack of defined diagnoses lead to a lack of direct treatment for subnormal semen parameters. The development ofin vitrofertilization (IVF) resulted in a method that could be used to circumvent the problem since it requires relatively low numbers of sperm and these are placed in the immediate vicinity of the oocyte. It should also be pointed out that normal semen parameters do not imply fertility, since these parameters cannot directly identify dysfunction. IVF offers the advantage that sperm-oocyte interractions can be observed, and in cases of fertilization failure, the point at which sperm dysfunction manifests itself may potentially be identified – if not the nature of the dysfunction. Techniques have now been developed that may overcome certain types of dysfunction, using both biochemical and mechanical means.

scholarly journals Intracytoplasmic sperm injection: state of the art in humans

Reproduction ◽  
2017 ◽  
Vol 154 (6) ◽  
pp. F93-F110 ◽  
Author(s):  
G D Palermo ◽  
C L O’Neill ◽  
S Chow ◽  
S Cheung ◽  
A Parrella ◽  
...  
Keyword(s):  
Intracytoplasmic Sperm Injection ◽  
Poor Prognosis ◽  
State Of The Art ◽  
Semen Analysis ◽  
Reproductive Technology ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Current Application ◽  
Infertile Couples ◽  
The Impact

Among infertile couples, 25% involve both male and female factors, while male factor alone accounts for another 25% due to oligo-, astheno-, teratozoospermia, a combination of the three, or even a complete absence of sperm cells in the ejaculate and can lead to a poor prognosis even with the help of assisted reproductive technology (ART). Intracytoplasmic sperm injection (ICSI) has been with us now for a quarter of a century and in spite of the controversy generated since its inception, it remains in the forefront of the techniques utilized in ART. The development of ICSI in 1992 has drastically decreased the impact of male factor, resulting in millions of pregnancies worldwide for couples who, without ICSI, would have had little chance of having their own biological child. This review focuses on the state of the art of ICSI regarding utility of bioassays that evaluate male factor infertility beyond the standard semen analysis and describes the current application and advances in regard to ICSI, particularly the genetic and epigenetic characteristics of spermatozoa and their impact on reproductive outcome.

An Insight into Novel Sperm Cell Proteins as Bio-markers for Male Infertility: A Review

2021 ◽  
Vol 21 ◽  
Author(s):  
Naina Kumar ◽  
Namit Kant Singh
Keyword(s):  
Male Infertility ◽  
Sperm Motility ◽  
Zona Pellucida ◽  
English Language ◽  
Semen Analysis ◽  
Meta Analysis ◽  
Sperm Dna Damage ◽  
Sperm Proteins

: Male infertility is rising now-a-days and accounts for major part of infertility cases worldwide. Novel tests are being developed for better detection and management of male infertility. Though there are many tests available for diagnosing male infertility like acrosome reaction rate, hemizona assay, in vivo or in vitro sperm penetration assay, sperm DNA damage tests, but semen analysis is most commonly used initial test for male infertility. It is usually associated with failure to detect cause in many cases, as seminal composition gets affected by a number of factors and can give false reports. Furthermore, it does not give any information about defects in capacitation, sperm Zona Pellucida interaction and sperm’s ability to fertilize oocytes. This results in failure of detection and delayed management of male infertility. Hence, the present review was conducted to identify various sperm proteins that play significant role in spermatogenesis, sperm motility, sperm-Zona Pellucida interaction and fertilization. These proteins can be used in future as markers of male infertility and will aid in better detection and management of male infertility. Methodology: Search for literature was made from 1970 to 2020 from various databases like PUBMED, SCOPUS, Google Scholar on sperm proteins and their role in male fertility using keywords: “sperm protein as bio-markers”, “novel sperm proteins as markers of infertility”, “Sperm proteins essential for capacitation, sperm motility and oocyte fertilization”. Inclusion criteria: All full-length research articles, systematic reviews, meta-analysis or abstracts on sperm proteins and male infertility published in English language in peer-reviewed journals were considered.

P–728 Can in couples with unexplained infertility the use of a prediction model to triage assisted reproduction technology save costs?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
D K Nguyen ◽  
S OLeary ◽  
M A Gadalla ◽  
R Wang ◽  
W Li ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Prediction Model ◽  
Live Birth ◽  
Birth Rate ◽  
Prognostic Model ◽  
Live Birth Rate ◽  
Good Prognosis ◽  
Unexplained Infertility ◽  
Usual Model ◽  
Natural Conception

Abstract Study question Can in couples with unexplained infertility a prognosis-tailored management strategy, that delays treatment if natural conception prospects are good, reduce costs without affecting live-birth rate? Summary answer In couples with unexplained infertility, use of a prognostic tool for natural conception followed by expectant management in good-prognosis couples is cost-effective. What is known already Few countries have guidelines for the assessment of the likelihood of natural conception to determine access to publicly funded ART. In the Netherlands and New-Zealand, couples with unexplained infertility who have a good prognosis for natural conception are encouraged to delay starting ART. However, the cost-effectiveness of this prognosis-tailored treatment strategy has not been determined. Study design, size, duration We studied couples with unexplained infertility to compare a prognosis-tailored strategy to care-as-usual. In the prognosis-tailored strategy, couples were assessed using Hunault’s prediction model. In good-prognosis couples (12-months natural conception >40%), outcomes without ART were modelled by censoring observations after start of ART. We then assumed that poor-prognosis couples (<40% natural conception) were treated, while good-prognosis couples delayed the start of treatment for 12 months. Data for the care-as-usual model were based on real observations. Participants/materials, setting, methods We studied 272 couples with unexplained infertility. Costs of in vitro fertilisation (IVF) and intra-uterine insemination (IUI) were calculated based on the out-of-pocket costs and Australian Medicare costs. In a cost-effectiveness model, we compared costs and effects of both strategies. Main results and the role of chance The prognostic model classified 272 couples with unexplained infertility as favourable (N = 107 (39.3%) or unfavourable prognosis (N = 165 (60.7%)) for natural conception. In the prognosis-tailored strategy, the cumulative live-birth rate was 71.1% (95% CI 64.7% - 76.4%) while the number of ART cycles was 393 (353 IVF; 40 IUI). In care-as-usual strategy, the cumulative conception rate leading to live-birth for the cohort of 272 couples, who underwent a total of 398 IVF cycles and 48 IUI cycles, was 72.1% (95% CI 65.7% - 77.4%). Mean time to conception leading to live birth was 388 days in the prognosis-tailored strategy and 419 days in the care-as-usual strategy. This translated for the 272 couples into potential savings of 45 IVF cycles and eight IUI cycles, which cost a total of AUD$ 125,817 for out-of-pocket and AUD$ 264,497 for Australian Medicare. The average cost savings per couple was AUD$ 1,435 (out-of-pocket AUD$ 463 per couple and Australian Medicare AUD$ 962 per couple). The incremental cost-effectiveness ratio, which was calculated as the total costs per additional live-births, was AUD$ 143,497 per additional live birth. Limitations, reasons for caution This study was limited to couples at a single IVF clinic. The modelling was also based on several key assumptions, particularly the number of fresh and frozen embryo transfer cycles for each couple. Wider implications of the findings: Our results show that in couples with unexplained infertility the use of a prognostic model guiding the start of an IVF-treatment reduces costs without compromising live birth rates. Trial registration number Not applicable

scholarly journals Improvement in Sperm Parameters With Traditional Iranian Remedy

2016 ◽  
Vol 22 (2) ◽  
pp. 223-226 ◽  
Author(s):  
Farnaz Sohrabvand ◽  
Somaye Mahroozade ◽  
Sodabe Bioos ◽  
Seyed Mohammad Nazari ◽  
Fataneh Hashem Dabaghian
Keyword(s):  
Male Infertility ◽  
Traditional Medicine ◽  
Assisted Reproductive Technology ◽  
Intracytoplasmic Sperm Injection ◽  
Sperm Quality ◽  
Intrauterine Insemination ◽  
Sperm Count ◽  
Reproductive Technology ◽  
Sperm Parameters ◽  
Medicinal Treatment

Introduction. Idiopathic male infertility is a global problem with almost no definite medicinal treatment. Most patients have to go through intrauterine insemination or assisted reproductive technology for achieving fertility. Unfortunately, success rates are low in cases with very low sperm count. Therefore it seems that improvement in sperm quality can have beneficial effects on assisted reproductive technology outcome. Case Report. A 39-year-old man with history of infertility for 6 years was referred to the traditional medicine clinic with a recurrent unsuccessful intracytoplasmic sperm injection trial. His sperm analysis showed severe oligoasthenoteratozoospermia. After taking a traditional remedy he had a remarkable improvement in his sperm parameters, which led to the formation of 8 embryos in the following intracytoplasmic sperm injection cycle. Conclusion. Traditional medicine presents various food and remedy options for treating male infertility. It seems that combination therapy can be beneficial in obtaining better results in treatment of male idiopathic infertility.

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