Significance of sperm characteristics in the evaluation of male infertility

Center for Advanced Research in Human Reproduction, Infertility and Sexual Function, Glickman Urological Institute, Department of Obstetrics-Gynecology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Fertility and sterility (Impact Factor: 4.59). 04/2006; 85(3):629-34. DOI: 10.1016/j.fertnstert.2005.08.024
Source: PubMed

ABSTRACT To compare sperm characteristics among: patients undergoing infertility evaluation, patients with male factor infertility (MFI), healthy sperm donors, and men with proven fertility; to examine the overlap of sperm characteristics in all four of these groups; and to identify good discriminators of fertility versus infertility among sperm characteristics.
Retrospective study.
Male infertility clinic at a tertiary care hospital.
Proven fertile men (n = 56), normal donors (n = 91), men presenting for infertility evaluation (n = 406), and MFI patients (n = 166).
Routine semen analysis.
Using current World Health Organization (WHO) reference values, a large group of MFI patients presented with higher sperm concentration (27.5 x 10(6) to 99.2 x 10(6)), resulting in broader overlap with fertile men and poor sensitivity (0.48). Similarly, percentage normal morphology (%) using Tygerberg's strict criteria was low in most of the MFI patients (sensitivity 0.83), almost half of the fertile men also presented with abnormal morphology (specificity 0.51). Of all the variables examined, sperm motility (%) was superior, having minimum overlap range (lower and upper cut-off values 46% and 75%) and high sensitivity (0.74) and specificity (0.90). Areas under curve were higher for motility (0.90) and concentration (0.84) compared with morphology (WHO 0.65 and Tygerberg's strict criteria 0.74).
Sperm motility and concentration provide more accurate information than morphology (WHO and Tygerberg's criteria) during infertility evaluation. Redefining the reference values for concentration and morphology may significantly increase the importance of routine semen analysis.

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Available from: Nabil Aziz, Sep 28, 2015
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    • "Infertility is the inability to contribute conception after 12 months of unprotected intercourse; this may be due to male, female or some unexplained factors. Males alone contribute 35% to 40 % of infertile cases [1] [2] . "
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    ABSTRACT: Objective To elucidate the effect of age and sexual abstinence on semen quality (semen volume, total count, progressive motility, vitality and morphology). Methods A total of 730 semen samples were analyzed. Subjects were grouped according to the age (20-29, 30–34, 35–39 and 40–50) and abstinence (2–3, 4–5 and 6–7). Semen parameters were evaluated following WHO standard criteria. Results Analysis of 730 semen samples showed negative correlation of progressive motility (r=-0.131, P< 0.01), vitality (r=-0.173, P< 0.01), morphology (r=-0.324, P< 0.01) with age. With increase in age percentage of progressive motility, vitality and normal morphology in mean values declined after the age group of 35–39 to 40–50 years, but no change in volume and count were observed. Increase in abstinence with individual days significantly affected semen volume (H= 20.65, P< 0.001), count (H= 36.67, P<0.01), progressive motility (H= 13.53, P<0.05) and vitality (H= 15.33, P< 0.01). But, no effect was found on sperm morphology. Mann Whitney U test confirmed the changes in semen volume, total count and vitality in paired grouping from 2–7 days (P<0.05), but changes in sperm motility were observed after 5 days of abstinence in each paired group upto 7 days (P<0.05). Mean values of semen parameters among three abstinence groups (2–3, 4–5 and 6–7 days) also showed similar result. Conclusions In the present study, age negatively affected progressive motility, vitality and morphology of human sperm. Semen samples showed intra varied results within WHO amended abstinence period.
    06/2014; 3(2):134-141.. DOI:10.1016/S2305-0500(14)60017-8
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    • "Increasing incidence of infertility has been a global health as well as a social problem, where 35-40% of male partners are solely responsible.[1] Apart from the well-known conventional causes, i.e., disturbance in the endocrine system, anatomy, genetic makeup, varicocele or torsion, occurrence of diabetes and subtle unknown infections, chronic exposure to toxic chemicals and differential unhygienic lifestyle patterns too contribute to male infertility.[2] Tobacco consumption is one of the lifestyle factors that is often detrimental to human health as a whole.[3] "
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    ABSTRACT: AIM:The aim of the following study is to find out the prevalence of abnormal spermatozoa and associated functional parameters in clinical semen samples of sub-fertile males with the tobacco chewing habit.SETTINGS AND DESIGN:Retrospective study was conducted at infertility unit of a tertiary health care center, in a period of 3 years.MATERIALS AND METHOD:Semen of 642 males were analyzed; of them 194 men (30.2%) were tobacco chewers and they were grouped according to their intensity of chewing (<10 and ≥ 10 packets/day). Counts, motility, vitality, and morphology of sperms were analyzed.RESULTS:In tobacco chewers, 66% of subjects were oligozoospermic, 85% asthenozoospermic and 28% teratozoospermic. Sperm counts (odds ratio [OR] =2.2; 95% confidence interval [CI]: 1.5-3.09), motility (OR = 3.2; 95% CI: 2.05-4.9), and normal morphology (OR = 8.4; 95% CI: 4.9-14.6) were significantly affected (P = 0.001) in tobacco chewers than the non-chewing group. Further, in comparison to the intensity of tobacco chewing, patients with the intensive practice of using ≥10 packets/day had a significant effect on sperm morphology (P = 0.003, OR = 2.7; 95% CI = 1.41-5.08) only. Structural defects in head (P = 0.001) and cytoplasmic residues (P = 0.001) were found to be positively correlated with the intensive chewing, but no significant changes were found in anomalies in mid-piece and tail.CONCLUSION:The adverse impact of tobacco chewing on semen parameters was evident even with mild chewers, but with the intensive chewing practice, phenotypes of sperms, mainly defects in the head and cytoplasmic residue were severely affected.
    Journal of Human Reproductive Sciences 04/2014; 7(2):136-42. DOI:10.4103/0974-1208.138873
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    • "Its highly condensed and insoluble nature plays a protective role during the transfer of the paternal genetic information through the male and female reproductive tracts (10, 34), adjusting to the extremely limited volume of the sperm nucleus (35). The organization of sperm chromatin is depicted by the model proposed by Ward and Coffey (36), starting as long strands of DNA that are gradually packaged at four subsequent levels: (1) chromosomal anchoring, ie. the attachment of DNA to the nuclear annulus; (2) formation of DNA loop domains, as a result of the attachment of DNA to the nuclear matrix; (3) replacement of histones by protamines, which condense the DNA into compact "doughnut"-shape configurations and (4) chromosomal organization (35, 37). "
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    ABSTRACT: The initial step in the diagnostic investigation of male infertility has been traditionally based on the conventional seminal profile. However, there are significant limitations regarding its ability to determine the underlying mechanisms that cause the disorder. Sperm DNA fragmentation has emerged as a potential causative factor of reproductive failure and its assessment has been suggested as a useful adjunct to the laboratory methodology of male infertility evaluation, especially before the application of assisted reproduction technology (ART). A review of recent bibliography was carried out in PubMed by the use of relevant keywords, in order to evaluate the possible correlation between the conventional seminal parameters and sperm DNA fragmentation assessment as diagnostic tools in male infertility evaluation. A comprehensive diagnostic approach of male infertility should be based on a combination of diagnostic attributes, derived from the conventional semen analysis, as well as the investigation of genomic integrity testing. Due to its strong correlation with several aspects of ART procedures and further consequences for the offspring, sperm DNA fragmentation is a parameter worth integrating in routine clinical practice. However, additional large scale studies focusing on specific subgroups of infertile men who may benefit from an efficient therapeutic management based on the optimization of sperm DNA integrity are needed.
    Journal of Reproduction and Infertility 03/2014; 15(1):2-14.
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