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.

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.

MicroRNA profile comparison of testicular tissues derived from successful and unsuccessful microdissection testicular sperm extraction retrieval in non-obstructive azoospermia patients

2019 ◽  
Vol 31 (4) ◽  
pp. 671 ◽  
Author(s):  
Na Fang ◽  
Congcong Cao ◽  
Yujiao Wen ◽  
Xiaoli Wang ◽  
Shuiqiao Yuan ◽  
...  
Keyword(s):  
Assisted Reproductive Technologies ◽  
Predictive Biomarkers ◽  
Reproductive Technologies ◽  
Small Rna Sequencing ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Altered Expression ◽  
Pathway Analyses

Non-obstructive azoospermia (NOA) is the most severe clinical diagnosis in cases of male infertility. Although in some cases of NOA spermatozoa can be retrieved by microdissection testicular sperm extraction (micro-TESE) to fertilise eggs through intracytoplasmic sperm injection (ICSI), there remains a lack of potential biomarkers for non-invasive diagnosis before micro-TESE surgery. To determine predictive biomarkers for successful sperm retrieval before micro-TESE, the aim of this study was to explore whether microRNAs (miRNAs) were differentially expressed in testicular tissues in NOA patients in whom sperm retrieval had been successful (SSR) versus those in whom it had been unsuccessful (USR) using next-generation small RNA sequencing (RNA-Seq). In all, 180 miRNAs were identified with significantly altered expression levels between SSR and USR testicular tissues. Of these, the expression of 13 miRNAs was upregulated and that of 167 miRNAs was downregulated in the USR compared with SSR group. Unexpectedly, 86 testicular miRNAs were found to be completely absent in the USR group, but showed high expression in the SSR group, suggesting that these miRNAs may serve as biomarkers for micro-TESE and may also play an essential role in spermatogenesis. Furthermore, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses indicated that the miRNAs that differed significantly between the USR and SSR groups were involved in cell apoptosis, proliferation and differentiation, which are of considerable importance during spermatogenesis. In summary, this study identified a panel of miRNAs highly expressed in testicular tissues of SSR but not USR NOA patients, providing new insights into specific miRNAs that may play important roles in epigenetic regulation during spermatogenesis. The findings provide a basis for further elucidation of the regulatory role of miRNAs in spermatogenesis and clues to identifying useful biomarkers to predict residual spermatogenic loci in NOA patients during treatment with assisted reproductive technologies.

Anesthesia for Assisted Reproductive Technologies

2018 ◽  
Author(s):  
Vesela Kovacheva ◽  
Patricia M. Sequeira
Keyword(s):  
Assisted Reproductive Technologies ◽  
Vasovagal Syncope ◽  
Postoperative Nausea And Vomiting ◽  
Oocyte Retrieval ◽  
Reproductive Technologies ◽  
Anesthetic Techniques ◽  
Sperm Retrieval ◽  
Vitro Fertilization ◽  
Dilation And Curettage

This chapter provides a review of the current sedation and anesthetic approaches for in vitro fertilization (IVF). It starts with a concise overview of the medical fundamentals of IVF, including controlled ovarian hyperstimulation (COH), oocyte retrieval (OR), sperm retrieval, embryo transfer, and dilation and curettage. Next follows a description of the facilities and roles of the personnel involved. The main part of the chapter focuses on the sedation goals, risks, and selection of anesthetic techniques for IVF. At the end of the chapter, the most common postsedation considerations—like pain, postoperative nausea and vomiting (PONV), vasovagal syncope, and bleeding—are discussed.

Thickness of endometrium: predictor of the effectiveness of IVF/ICSI programs (literature review)

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 113-116
Author(s):  
L A Bagdasaryan ◽  
I E Korneyeva
Keyword(s):  
Assisted Reproductive Technologies ◽  
Endometrial Thickness ◽  
Molecular Genetic ◽  
Uterine Cavity ◽  
Reproductive Technologies ◽  
Genetic Characteristics ◽  
Vitro Fertilization ◽  
Need To Evaluate ◽  
The Relationship

The aim of the study is to systematically analyze the data available in the modern literature on the relationship between endometrial thickness and the frequency of pregnancy in the program of assisted reproductive technologies (ART). Materials and methods. The review includes data from foreign and domestic articles found in PubMed on this topic. Results. The article presents data on the relationship between the thickness of the endometrium and the frequency of pregnancy in ART programs. The greatest number of studies is devoted to the evaluation of the relationship between the thickness of the endometrium and the frequency of pregnancy on the day of the ovulation trigger. Data are presented on the existence of a correlation between the thickness of the endometrium measured on the day of the ovulation trigger and the frequency of clinical pregnancy, as well as data on the need to evaluate the structure of the endometrium and the state of subendometric blood flow. The importance of multilayered (three-layered) endometrium as a prognostic marker of success in in vitro fertilization/intracytoplasmic sperm injection programs in the ovum is emphasized. The conclusion. The thickness of the endometrium can not be used as an argument for canceling the cycle or abolishing embryo transfer to the uterine cavity. Further studies in this direction are needed with a study of the morphological and molecular genetic characteristics of the endometrium, which in the future will allow us to evaluate the relationship between the thickness of the endometrium and the probability of pregnancy.

Legal restrictions on pre-implantation genetic diagnostics in the framework of in vitro fertilization procedure: foreign experience and Russian perspective

2019 ◽  
Author(s):  
N.A. Altinnik , S.S. Zenin , V.V. Komarova et all
Keyword(s):  
In Vitro Fertilization ◽  
Assisted Reproductive Technologies ◽  
Genetic Diseases ◽  
Genetic Diagnosis ◽  
Reproductive Technologies ◽  
Legal Regulation ◽  
Genetic Diagnostics ◽  
Vitro Fertilization ◽  
Medical Indications

The article discusses the factors that determine the content of the legal limitations of pre-implantation genetic diagnosis in the framework of the in vitro fertilization procedure, taking into account international experience and modern domestic regulatory legal regulation of the field of assisted reproductive technologies. The authors substantiates the conclusion that it is necessary to legislate a list of medical indications for preimplantation genetic diagnosis, as well as the categories of hereditary or other genetic diseases diagnosed in the framework of this procedure.

scholarly journals Prevalence of pathogenic copy number variants among children conceived by donor oocyte

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sandra Monfort ◽  
Carmen Orellana ◽  
Silvestre Oltra ◽  
Mónica Rosello ◽  
Alfonso Caro-Llopis ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Copy Number ◽  
Assisted Reproductive Technologies ◽  
Copy Number Variants ◽  
Reproductive Technologies ◽  
Significant Excess ◽  
Vitro Fertilization ◽  
Donor Oocyte ◽  
Increased Risk

AbstractDevelopment of assisted reproductive technologies to address infertility has favored the birth of many children in the last years. The majority of children born with these treatments are healthy, but some concerns remain on the safety of these medical procedures. We have retrospectively analyzed both the fertilization method and the microarray results in all those children born between 2010 and 2019 with multiple congenital anomalies, developmental delay and/or autistic spectrum disorder (n = 486) referred for array study in our center. This analysis showed a significant excess of pathogenic copy number variants among those patients conceived after in vitro fertilization with donor oocyte with respect to those patients conceived by natural fertilization (p = 0.0001). On the other hand, no significant excess of pathogenic copy number variants was observed among patients born by autologous oocyte in vitro fertilization. Further studies are necessary to confirm these results and in order to identify the factors that may contribute to an increased risk of genomic rearrangements, as well as consider the screening for genomic alterations after oocyte donation in prenatal diagnosis.

scholarly journals GAMETE DONATION. ETHICAL AND LEGAL ASPECTS

2020 ◽  
pp. 13-19
Author(s):  
L. Chalova ◽  
V. Lokshin ◽  
A. Guseva ◽  
A. Kinzhibayev
Keyword(s):  
In Vitro Fertilization ◽  
Literature Review ◽  
World Literature ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Legal Aspects ◽  
Gamete Donation ◽  
Vitro Fertilization ◽  
National Legislation

This world literature review tries to determine the significance of the gamete donation in the field of assisted reproductive technologies as well as the availability of treatment methods using donation in in vitro fertilization programs. Gamete donation is regulated by every country's national legislation system, and quite often the laws vary between the states. There are practically no universal standards and/or rules in this area, which, in turn, leads to an ambivalent reaction towards reproductive practices.

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

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