Clinical and Experimental Reproductive Medicine-CERM最新文献

Objective: The use of photobiomodulation (PBM) for tissue repair has gained acceptance. This study investigated and compared the effects of PBM on mice exposed to scrotal hyperthermia and busulfan.

Methods: Forty 8-week-old adult mice were divided into five groups: (I) control, (II) hyperthermia, (III) busulfan, (IV) hyperthermia+PBM, and (V) busulfan+PBM. To induce azoospermia in groups II and IV, the scrotum of the mice was exposed to water at 43 °C every other day for 5 weeks. In groups III and V, a single dose of busulfan (45 mg/kg) was administered intraperitoneally. Mice in groups IV and V received laser irradiation (0.03 J/cm2/sec) every other day for 35 days.

Results: Molecular data analysis revealed that the levels of glutathione and the expression of proliferating cell nuclear antigen (Pcna) and stimulated by retinoic acid gene 8 (Stra8) genes were significantly higher in the busulfan+PBM group than in the hyperthermia+PBM group. Additionally, the number of testicular cells, tissue volume, and sperm parameters were also markedly higher in the busulfan+PBM group. Furthermore, this group exhibited a notable increase in serum testosterone levels.

Conclusion: The results demonstrated that laser therapy enhances testicular function and spermatogenesis by reducing the formation of reactive oxygen species and increasing the expression of mitotic genes following the induction of scrotal hyperthermia and busulfan injection. However, the effectiveness of PBM was greater in the busulfan+PBM group.

Objective: Follicular fluid (FF) oxidation-reduction potential (ORP) has shown promise as a predictor for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes has been demonstrated. This study aimed to determine the association between the ORP in FF and IVF/ICSI outcomes.

Methods: This cross-sectional study involved data collection from 341 couples undergoing IVF/ICSI treatment. The FF sample was taken from the first follicle to exceed 18 mm during oocyte retrieval and was analyzed for ORP using the MiOXSYS system (Caerus Biotechnologies).

Results: ORP in FF exhibited a statistically significant negative correlation with the fertilization rate (correlation coefficient, -0.126; p=0.019). The ORP levels in the FF from the group with a lower fertilization rate (<80%) were significantly higher than those in the group with a higher fertilization rate (≥80%) (89.90 mV vs. 78.98 mV, p=0.030). No significant correlations were found between ORP in FF and other outcomes.

Conclusion: Our findings suggested that the ORP in FF may be correlated with the fertilization rate and could be evaluated as a predictor of fertilization in ICSI.

Objective: The aim of this study was to observe the effect of clomiphene citrate on sperm parameters in infertile men diagnosed with idiopathic oligoasthenozoospermia.

Methods: This randomized controlled trial involved 50 infertile men diagnosed with idiopathic oligoasthenozoospermia, all of whom had normal serum testosterone and follicle-stimulating hormone levels. The participants were divided into two groups. The first group (n=25) received a daily dose of 50 mg of clomiphene citrate in tablet form for 3 months, while the second group (n=25) was given a placebo. Sperm concentration, sperm motility, and serum testosterone levels were measured at the start of the study and after 3 months of treatment. Changes in these parameters were then assessed and compared between the two groups.

Results: There was a significant increase in the mean sperm count (9.17±4.11 million/mL vs. 13.88±7.27 million/mL), progressive motility (14.67±7.03 vs. 21.42±11.9), total motile sperm count (3.53±3.08 million vs. 7.81±7.10 million), and mean serum testosterone levels (371.97±88.51 ng/dL vs. 805.94±290.77 ng/dL) in the clomiphene citrate group. In contrast, the changes in the placebo group were not significant. Post-treatment severe oligozoospermia was substantially lower in the clomiphene citrate group (odds ratio, 0.31) compared to the placebo group. Additionally, half of the participants in the clomiphene citrate group experienced a statistically significant upgrade in World Health Organization (WHO) sperm concentration categories, versus 27.3% in the placebo group.

Conclusion: Clomiphene citrate improves sperm count and motility, leading to upgrades in WHO sperm concentration categories in infertile men with idiopathic oligoasthenozoospermia.

Objective: Laser-assisted hatching (LAH) employs two distinct techniques: thinning and breaching. This study aimed to compare the clinical efficacy of combined thinning and breaching versus breaching alone in vitrified-warmed embryo or blastocyst transfer cycles.

Methods: In total, 110 vitrified-warmed day-3 embryo transfer cycles and 50 vitrified-warmed day-5 blastocyst transfer cycles were retrospectively selected. All transfers were performed between 2021 and 2022 at a university-based infertility center. Combined thinning and breaching involved thinning either one-quarter or one-sixth of the zona pellucida circumference combined with breaching at a single point.

Results: In vitrified-warmed day-3 embryo transfer cycles, the 'thinning and breaching' and 'breaching only' groups were similar regarding the median age of the woman (36 years vs. 37 years, respectively), number of embryos transferred (2 vs. 2), and embryo score (89 vs. 31.5). The clinical pregnancy rate (PR) (23.5% vs. 21.1%), embryo implantation rate (IR) (11.4% vs. 11.3%), and clinical miscarriage rate (25% vs. 37.5%) were also comparable between the two LAH groups. In vitrified-warmed day-5 blastocyst transfer cycles, the combination and breaching-only groups were similar in the median age of the woman (36 years vs. 36.5 years, respectively), number of blastocysts transferred (1 vs. 1), and blastocyst score (45 vs. 31.5). The clinical PR (45.5% vs. 42.9%), IR (35.4% vs. 33.3%), and clinical miscarriage rate (20% vs. 33.3%) were also similar between groups.

Conclusion: Breaching alone displayed similar efficacy to combined thinning and breaching in terms of clinical PR, IR, and miscarriage rate. Thus, breaching alone appears sufficient to achieve favorable pregnancy outcomes.

Objective: The aim of this study is to investigate the effects of granulocyte-macrophage colony-stimulating factor (GM-CSF) treatment on the autophagy process and sperm parameters in individuals with asthenoteratozoospermia.

Methods: Twenty semen samples from patients diagnosed with asthenoteratozoospermia were divided into control and treatment groups. Subsequently, 2 ng/mL of GM-CSF was added to the treatment group samples. All samples were then incubated for 1 hour. Post-incubation, the protein levels of light chain 3 II (LC3-II)/LC3-I and autophagy related 7 (Atg7), which are well-known autophagy markers, along with sperm motility, viability, and sperm DNA fragmentation, were analyzed in both study groups.

Results: Our study demonstrated significant increases in LC3-II/LC3-I and Atg7 levels, as well as in sperm motility, in the GM-CSF group compared to the control group (p<0.0001). Furthermore, GM-CSF treatment significantly reduced necrotic cell death in the GM-CSF group relative to the control group (p<0.01). There were no significant differences between the groups in terms of sperm viability and DNA fragmentation (p>0.05).

Conclusion: These results revealed that GM-CSF has the potential to significantly induce autophagy in sperm and enhance sperm motility in patients with asthenoteratozoospermia, without adversely affecting sperm viability and DNA integrity. These findings suggest that modifying autophagy with physiological and safe components like GM-CSF may become a promising therapeutic strategy for treating male infertility in the near future.

Adult stem cell therapy has emerged as a prominent area of interest in regenerative medicine, drawing attention from numerous researchers who are investigating its potential for treating degenerative diseases, especially those affecting the reproductive system. Despite the growing focus, critical elements such as the optimization of treatment parameters (e.g., transplantation [Tx] route, cell dosage) and enhancement of therapeutic efficacy are still areas of uncertainty. This review paper presents a thorough analysis of recent preclinical and clinical studies on adult stem cell therapy for ovarian dysfunction, specifically targeting conditions like polycystic ovary syndrome (PCOS). By examining these studies, the review seeks to clarify the current state of knowledge and pinpoint gaps in understanding, thereby establishing a robust foundation for future advancements in adult stem cell therapies aimed at ovarian dysfunction. Ultimately, this paper aims to offer valuable insights that could lead to improved treatment strategies in the field of reproductive system diseases.

Objective: This study emphasizes the role of oxidative stress in the pathogenesis of male infertility-including varicocele-and supports the utility of antioxidant supplementation. The aim of our study is to evaluate the effectiveness of multiantioxidant therapy in improving semen quality, reducing the DNA fragmentation index, and increasing pregnancy rates in oligoasthenozoospermic (OA) patients with different grades of varicocele.

Methods: We conducted a prospective study of infertile men with OA and varying grades of varicocele. Serum and semen samples were collected at baseline and after 6 months of treatment from subjects with varicocele grades 0, 1, 2, and 3. Sperm DNA damage, reproductive hormones, and pregnancy rates were evaluated.

Results: Significant differences in mean sperm count, total sperm count, sperm motility, and normal sperm morphology were observed among groups G1, G2, G3, and G4 (p<0.0001). Sperm DNA integrity improved significantly in patients with varicocele after oral antioxidant therapy. Pregnancy achieved by intrauterine insemination was observed in 11%, 9%, 1%, and 0.7% of couples in groups G1, G2, G3, and G4, respectively. Additionally, spontaneous pregnancy occurred in 6% and 3% of couples with varicocele grade 0 and grade 1, respectively, after multiantioxidant supplementation. No significant pregnancy rate was observed in groups G3 and G4.

Conclusion: Multiantioxidant therapy produced marked therapeutic benefits in patients with grade 0 and grade 1 varicocele and served as a useful adjuvant in managing varicocele-related infertility.

Objective: The choice between utilizing testicular or ejaculatory sperm for intracytoplasmic sperm injection (ICSI) in men with severe oligozoospermia or cryptozoospermia is a crucial aspect of managing male infertility. This study aimed to identify a predictive factor that could guide this decision-making process.

Methods: Seventy-five infertile men with severe oligozoospermia or cryptozoospermia were included in the analysis. On the day of ovum pick-up, these participants were divided into three groups (n=25 each) based on their sperm concentrations: cryptozoospermia, 0.1-1 million/mL and 1-5 million/mL. Patients in each group underwent ICSI, which involved the insemination of sibling oocytes using either ejaculated spermatozoa or testicular spermatozoa obtained via fine-needle aspiration. We evaluated the rates of fertilization, cleavage, high-quality embryo production, and blastocyst formation.

Results: In patients with sperm concentrations below 1 million/mL, testicular sperm demonstrated higher rates of fertilization (p<0.001), cleavage (p=0.01), high-quality embryo formation (p=0.003), and blastocyst development (p=0.04) compared to ejaculated sperm. In cases of cryptozoospermia, testicular sperm was associated with a higher fertilization rate (p<0.001) and a marginally higher rate of high-quality embryos (p=0.06). Conversely, in patients with sperm concentrations exceeding 1 million/mL, ejaculated sperm yielded superior outcomes.

Conclusion: This study underscores the significance of considering sperm concentration when advising on sperm retrieval techniques to improve ICSI outcomes in men diagnosed with severe oligozoospermia or cryptozoospermia. Further research is necessary to confirm predictive factors that assist in decision-making regarding the source of sperm, whether from ejaculate, testicular aspiration, or biopsies.