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      • Record: found
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      Tissue and sperm handling before assisted reproductive technology (ART): A systematic review

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          ABSTRACT

          Objective

          : To explore the medical literature on techniques of tissue and sperm handling after surgical retrieval for intracytoplasmic sperm injection (ICSI).

          Methods

          : A search was performed in PubMed and Google Scholar databases, according to a modified Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guideline, considering the studies investigating tissue handling and sperm selection techniques for ICSI.

          Results

          : Overall, 42 articles were included in this study, investigating sample handling, methods for sperm selection, and the use of chemical compounds to improve sperm motility and fertilisation rates.

          Conclusion

          : The ideal sperm handling method should provide a high sperm count, high vitality and appropriate sperm function, without side-effects. In this review the most common and useful techniques are described and the best combination strategies discussed in clinical scenarios.

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          Most cited references67

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          A unique view on male infertility around the globe

          Ashok Agarwal, Aditi Mulgund, Alaa Hamada … (2015)
          Background Infertility affects an estimated 15% of couples globally, amounting to 48.5 million couples. Males are found to be solely responsible for 20-30% of infertility cases and contribute to 50% of cases overall. However, this number does not accurately represent all regions of the world. Indeed, on a global level, there is a lack of accurate statistics on rates of male infertility. Our report examines major regions of the world and reports rates of male infertility based on data on female infertility. Methods Our search consisted of systematic reviews, meta-analyses, and population-based studies by searching the terms “epidemiology, male infertility, and prevalence.” We identified 16 articles for detailed study. We typically used the assumption that 50% of all cases of infertility are due to female factors alone, 20-30% are due to male factors alone, and the remaining 20-30% are due to a combination of male and female factors. Therefore, in regions of the world where male factor or rates of male infertility were not reported, we used this assumption to calculate general rates of male factor infertility. Results Our calculated data showed that the distribution of infertility due to male factor ranged from 20% to 70% and that the percentage of infertile men ranged from 2·5% to 12%. Infertility rates were highest in Africa and Central/Eastern Europe. Additionally, according to a variety of sources, rates of male infertility in North America, Australia, and Central and Eastern Europe varied from 4 5-6%, 9%, and 8-12%, respectively. Conclusion This study demonstrates a novel and unique way to calculate the distribution of male infertility around the world. According to our results, at least 30 million men worldwide are infertile with the highest rates in Africa and Eastern Europe. Results indicate further research is needed regarding etiology and treatment, reduce stigma & cultural barriers, and establish a more precise calculation.
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            Testicular sperm extraction: microdissection improves sperm yield with minimal tissue excision.

            Peter Schlegel (1998)
            Testicular sperm extraction (TESE) is often an effective method for sperm retrieval from men with non-obstructive azoospermia. However, TESE has been a blind procedure that does not identify the focal sperm-producing areas of the testicle until after tissue has been excised from the patient. Experience with a new technique of microdissection of testicular tubules is presented here that identifies sperm-containing regions before their removal. Identification of spermatogenically active regions of the testicle is possible by direct examination of the individual seminiferous tubules. The underlying concept for this technique is simple: seminiferous tubules containing many developing germ cells, rather than Sertoli cells alone, are likely to be larger and more opaque than tubules without sperm production. In a sequential series of TESE cases for men with non-obstructive azoospermia, the ability to find spermatozoa increased from 45% (10/22) to 63% (17/27) after introduction of the microdissection technique. Microdissected samples yielded an average of 160,000 spermatozoa per sample in only 9.4 mg of tissue, whereas only 64,000 spermatozoa were found in standard biopsy samples that averaged 720 mg in weight (P < 0.05 for all comparisons). For men where microdissection was attempted, successful identification of enlarged tubules was possible in 56% (15/27) of cases. However, spermatozoa were retrieved with microdissection TESE for six men in whom sperm retrieval was unsuccessful with standard TESE approaches (35% of all men with spermatozoa retrieved). These findings suggest that microdissection TESE can improve sperm retrieval for men with non-obstructive azoospermia over that achieved with previously described biopsy techniques.
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              Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte.

              Kiliaan van Wees, H Joris, P. Devroey … (1992)
              Intracytoplasmic sperm injection (ICSI) is a promising assisted-fertilisation technique that may benefit women who have not become pregnant by in-vitro fertilisation (IVF) or subzonal insemination (SUZI) of oocytes. We have used ICSI to treat couples with infertility because of severely impaired sperm characteristics, and in whom IVF and SUZI had failed. Direct injection of a single spermatozoon into the ooplasm was done in 47 metaphase-II oocytes: 38 oocytes remained intact after injection, 31 became fertilised, and 15 embryos were replaced in utero. Four pregnancies occurred after eight treatment cycles--two singleton and one twin pregnancy, and a preclinical abortion. Two healthy boys have been delivered from the singleton pregnancies and a healthy boy and girl from the twin pregnancy.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Arab J Urol
                Title: Arab Journal of Urology
                Publisher: Taylor & Francis
                ISSN (Print): 2090-598X
                ISSN (Electronic): 2090-5998
                Publication date (Electronic, pub): 22 July 2021
                Publication date (Electronic, collection): 2021
                Publication date PMC-release: 22 July 2021
                Volume: 19
                Issue: 3 , Men’s Health. Guest Edited by, Ashok Agarwal, Ahmad Majzoub, Mohamed Arafa and Haitham ElBardisi
                Pages: 238-246
                Affiliations
                [a ]Urology Department at Centro Universitario Em Saude Do ABC – FMABC, Santo André, Brazil
                [b ]Ideia Fertil Institute of Human Reproduction; , Santo André, Brazil
                [c ]Crio Brasil/Fairfax Cryobank Brasil; , São Paulo, Brazil
                Author notes
                CONTACT Rafael Favero Ambar rf.ambar@ 123456gmail.com Urology Department at Centro Universitario Em Saude Do ABC – FMABC; , Santo André, Brazil
                Author information
                https://orcid.org/0000-0002-3496-2895
                Article
                Publisher ID: 1954801
                DOI: 10.1080/2090598X.2021.1954801
                PMC ID: 8451624
                SO-VID: 03a38269-d9ce-496b-a8d8-bcbbffbab619
                Copyright © © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 1, Tables: 1, References: 68, Pages: 9
                Categories
                Subject: Review Article
                Subject: Review Article

                Keywords: male infertility,sperm selection,assisted reproduction,cryopreservation,azoospermia,sperm retrieval
                Data availability:
                Keywords: male infertility, sperm selection, assisted reproduction, cryopreservation, azoospermia, sperm retrieval

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