Archives of andrology最新文献

The aim of this study was to assess the frequency of AZF microdeletions in peripheral leukocytes and testicular cells in Chinese men with idiopathic infertility. Expression in testicular cells was also determined. In this study, we screened 62 idiopathic infertile patients, in whom karyotype, sperm count and hormonal parameters were evaluated. Genomic DNA was extracted from the peripheral leukocytes. Molecular analysis was performed by two multiplex polymerase chain reactions (PCR) using a set of eight sequence tagged sites (STS) from 3 different regions of the Y chromosome. Total cellular RNA was extracted from the testicular tissue using a Trizol-method. Reverse Transcription (RT) reactions were performed to synthesize cDNA. Amplification of DFFRY, RBM and DAZ genes was performed to analyze their expression in testicular cells. In this cohort, we found 12 submicroscopic deletions (12/62, 19.4%). Nine patients (9/33, 27.2%) were detected in the azoospermic group and three (3/29, 10.3%) in the severe oligozoospermic group. RT-PCR analysis from testicular cells gave normal amplifications for SRY and DFFRY mRNA in 62 idiopathic patients; two patients were negative for RBM expression; no RBM and DAZ were detected for a case; 12 patients had no expression in the AZFc region involving the DAZ gene. Of 12 cases, three patients with normal PCR analysis of DAZ gene on genomic DNA showed no RT-PCR amplification for DAZ mRNA. The use of RT-PCR of specific spermatid expressed genes in conjunction with examining microdeletions using peripheral leukocytes is suggested to avoid the transmission of the Y chromosomal microdeletions from a father to a son via testicular sperm aspiration (TESE), intracytoplasmic sperm injection (JCSI).

A Tris-citric acid-glucose (TCG) diluent containing low concentrations (6%) of egg yolk, and a TCG extender containing lactose (without egg yolk), were compared for use in the cryopreservation of Spanish ibex (Capra pyrenaica) epididymal spermatozoa. To optimize the collection of epididymal spermatozoa, two spermatozoa recovery methods were tested: i) by using small cuts in the cauda epididymides and ii) by the application of air pressure (from a syringe) inside the vas deferens. The percentage of viable spermatozoa recovered was lower (P < 0.05) with the air pressure method. No significant differences were seen in the efficacy of the two diluents as determined by percentage viability of thawed sperm, membrane integrity (as determined by the hypo-osmotic swelling test), or acrosome integrity. The use of the TCG-lactose medium strongly reduced sperm motility (P < 0.001). The sperm samples that had been diluted with TCG-6% egg yolk extender showed a greater incidence (P < 0.05) of morphological abnormalities. TCG-lactose alone, does not well preserve motility when cryopreserving Spanish ibex epididymal spermatozoa.

Testicular microlithiasis (TM) is an unusual ultrasonographic manifestation in testicular parenchyma. Limited information is available about TM in Taiwanese men. We performed a retrospective analysis to investigate the characteristics of TM and its association with testicular cancer and infertility in Taiwan. Male patients who had received scrotal ultrasonography because of scrotal symptoms or infertility between January 2000 and December 2003 were recruited. The incidence of TM was 7.6%. Both testicular microlithiasis and testicular cancer occurred chiefly in the third decade. Patients with TM exhibit a higher chance of testicular cancer (6% vs. 0.9%). No local field effect between TM and testicular cancer was observed. Testicular microlithiasis severity is not positively correlated with sperm quality and sterility. Forty-eight patients (32%) were available at follow-up. No patient developed a testicular tumor or elevated tumor markers (AFP, beta-hCG) during follow-up. We suggest monthly self-examination, annual scrotal ultrasonography and tumor markers screening between the age of 20 and 30 years of patients with TM.

Spermatoceles are benign cystic dilations of the epididymis. Despite their relatively common occurrence, it is not clear why or when men want this lesion treated. We present a single institution series of men undergoing spermatocelectomy. We describe the clinical characteristics of men with these lesions and hypothesize that men with spermatoceles seek intervention when the lesion approximates the size of a testicle. The characteristics of 24 men who sought excision of symptomatic spermatoceles were reviewed. Specific characteristics included subject age, duration of diagnosis, symptom type, and symptom duration. Spermatoceles were characterized by size, sidedness, and associated findings. Simple descriptive statistics were used for analysis. The mean age of men seeking spermatocelectomy was 46 years. Most men (58%) sought surgery due to a combination of pain and sensation of mass. The mean duration of symptoms was 48 months. At the time of excision, the average size of spermatoceles was 4.2 cm in greatest diameter, and most (71%) were right sided. Men who experienced pain as an isolated symptom were younger by approximately 10 years compared to those who experienced mass. Men in this series appear to tolerate spermatoceles for a relatively long period of time. Once they seek excision, spermatoceles have grown to roughly the size of a normal testicle and men are bothered both by pain and mass symptoms.

The Sperm Quality Analyzer (SQA) IIB, a member of the SQA-II family of machines which uses the scatter of light by sperm as an indicator of sperm motility, was systematically evaluated as a means of analyzing objectively the motility of porcine epididymal sperm. The sperm motility (%) and the Sperm Motility Index (SMI) are calculated by the machine using pre-programmed algorithms designed for human sperm. The machine performed well and was able to detect changes in sperm motility under experimental conditions. However, two major limitations of this machine were identified, (i) the readings obtained were influenced by the concentration of the sperm suspension despite the actual sperm motility remaining constant, and (ii) the machine was unable to differentiate between progressive and non-progressive motility. It should therefore be recognized that (a) the sperm concentration must be kept constant in studies in vitro if differences between treatment groups are to be identified, and (b) the inability to separate progressive motility from that of total motility will restrict the usefulness of this and similar machines to studies monitoring changes in total motility alone.

The present study was carried out on semen samples of human fertile and infertile subjects, teratozoospermics (TZs) and idiopathics (IDs), with neat semen and sperm prepared by swim up or Percoll density gradient centrifugation procedures. Sperm morphology analysis revealed that only head and midpiece defects in TZs and IDs were significantly (P < 0.001) higher compared to fertile subjects. Infertile subjects indicated significantly higher (P < 0.001) sperm DNA damage compared to fertile subjects. Fertile subjects with sperm prepared from neat and Percoll density gradient centrifugation exhibited a comet tail DNA percentage of 20% and 15%, respectively. The TZs and IDs infertile subjects had higher levels of comet tail DNA of 33% and 25% and 25% and 19%, respectively. A significant (F = 24.01; P = 0.0059) decrease in mean comet head DNA percentage or sperm DNA integrity was observed in neat samples from fertile and infertile subjects by Repeated Measures ANOVA. In Percoll prepared samples from fertile, TZs, and IDs, there was a significant increase in sperm DNA integrity. Similarily, there was a decrease in abnormal sperm morphology in swim up and Percoll prepared sperm compared to neat samples. The Percoll density gradient centrifugation procedure yields sperm with an increase in sperm DNA integrity relative to swim up. Sperm DNA damage of TZs with both sperm preparation methods was significantly (P < 0.01) higher when compared to fertile and IDs. But the level of DNA damage was higher in IDs compared to fertile subjects. Compared to the other methods tested, the Percoll method yielded sperm with improved DNA integrity. In conjunction with semen analysis, the assessment of nuclear integrity improves the characterization of the semen sample and may be used as a tool for allocating the patients to specific assisted reproductive treatments.

In vitro maturation (IVM) of immature oocytes for infertile patients is an attractive treatment. It can avoid side effects of ovarian stimulation with gonadotropins. However, at the present the successful results of IVM treatment are lower than conventional in vitro fertilization (IVF) treatment. The key issue may be the IVM medium for immature oocyte maturation. In the present study, we compared 20% (v/v) human follicular fluid (hFF) and 20% (v/v) human umbilical cord serum (hUS) as a supplement to IVM medium. A total of 47 patients with polycystic ovary syndrome (PCOS) underwent 47 IVM treatment cycles. Immature oocytes (349) collected from 32 patients were cultured in IVM medium supplemented with hFF, and immature oocytes (160) collected from 15 patients were culture in IVM medium supplemented with hUS. The results indicate that the final maturation rate of oocytes cultured in IVM medium supplemented with hUS (93.8%) is significantly higher than those cultured in IVM medium supplemented with hFF (77.1%). The percentage of high-quality embryos produced from IVM medium supplemented with hUS (50.0%) is significantly higher than IVM medium supplemented with hFF (23.8%). In addition, the results also indicate that the final maturation rate of oocytes is higher in IVM medium supplemented with hUS and the time course of oocyte maturation is hastened. Following transfer 6 out of 15 patients (40.0%) become pregnant when IVM medium was supplemented with hUS, and 7 out of 31 patients (22.6%) were pregnant when IVM medium was supplemented with hFF. These results suggest that IVM medium containing hUS appears to be a more effective means to stimulate in vitro oocyte maturation and is capable of achieving a promising clinical outcome.

The purpose of this study was to examine the effect of sperm preparation by density gradient on the intra-individual variation in sperm motility. Patients presenting for density gradient (DG) sperm preparation were analyzed retrospectively. Patients who had more than one preparation were included. The variation within each patient was studied using the coefficient of variation (CV = standard deviation/mean x 100). Density gradient preparation resulted in a reduction in the CV of sperm motility (CV motility before DG: 19.8 +/- 15.82% vs. CV motility after DG: 15.9 +/- 17.97%, p < 0.001). However, CV of sperm concentration (44.2 +/- 26.51%) and CV progressively motile sperm (49.2 +/- 28.48%) remained very high after DG. This variability should be reflected in counseling patients undergoing intrauterine insemination.

The aim of this study was to prospectively investigate the spermatozoa ultrastructure in relation to the results of in vitro fertilization-embryo transer (IVF-ET). Forty-nine consecutive couples admitted for IVF-ET were prospectively evaluated for electron microscopic spermatozoa morphology and the outcome of IVF-ET. Thirty-four couples revealed successful fertilization, defined as presence of two pronuclei 14-16 hours after spermatozoa administration, while the remaining 15 formed the failure group. Spermatozoa fixed with 2.5% glutaraldehyd and embedded in Spurr's resin were analyzed with JAM 100 S transmission electron microscope (TEM) for the following ultrastructure abnormalities: head deformity, cytoplasmic residues, chromatin condensation failures, acrosomal alterations, neck defects, mid-piece defects, principal piece and end-piece defects and immature forms. Successful IVF-ET couples revealed a significantly higher percentage of normal spermatozoa utrastructure (32.0 +/- 13.1% versus 17.1 +/- 13.4%, p < 0.001). Failed IVF-ET couples represented a significantly higher percentage of chromatin condensation failures (9.8 +/- 5.1% versus 5.7 +/- 5.3%, p < 0.05) and tail defects (16.7 +/- 11.5% versus 7.2 +/- 7.2%, p < 0.001). A positive correlation between normal ultrastructure spermatozoa percentage and fertilized oocytes percentage was found (r = 0.35, p < 0.05). Our data suggest that spermatozoa TEM findings correlate with IVF-ET results. Ultrastructural estimation of spermatozoa can improve the diagnosis of male fertility and may explain some reasons of failure in assisted reproduction methods. We consider systematic TEM spermatozoa examination in cases with failed IVF-ET prior to intracytoplasmic sperm injection (ICSI).

Administration of testosterone undecanoate (TU) over 12 months to men with sexual dysfunction and signs of the metabolic syndrome, restored their plasma testosterone (T) levels to the mid-range of reference values. This had a beneficial effect on their sexual functioning as evidenced by an improvement of their scores on the International Index of Erectile Function. The scores on the Aging Male Symptoms score, AMS, were also improved. Most impressive were the improvements in the parameters of the metabolic syndrome; they all improved and appeared largely correlated (i.e., decline in waist circumference with declines of plasma cholesterol and LDL and increase in plasma HDL). Sex hormone binding globulin, SHBG, may be considered as an indicator of the severity of the metabolic syndrome; levels of SHBG initially fell, probably as a result of rising plasma T levels. But over the last six months of the observation period when plasma T rose further, there was a significant increase in plasma SHBG which may be interpreted to indicate an improvement of the metabolic syndrome. Blood pressure improved slightly but significantly. In this cohort of elderly men (54-76 years; median 64 years) there were no safety concerns over a one year period of T administration. Prostate specific antigen, PSA, levels remained stable; the International Prostate Symptoms Score, IPSS, improved slightly. Liver functions and plasma glucose remained stable. Hemoglogin and hematocrit values increased significantly but remained within reference values.