ABSTRACT: Introduction: Even though cryopreservation of human spermatozoa is known to alter sperm motility and viability, it may also induce nuclear damages. The present study set out to determine whether or not cryopreservation alters motile sperm morphology under high-magnification and/or is associated with chromatin decondensation. Material and Methods: For 25 infertile men, we used high-magnification microscopy to determine the proportions of various types of motile spermatozoa before and after freezing-thawing: morphometrically normal spermatozoa with no vacuole (grade I), ≤ 2 small vacuoles (grade II), at least one large vacuole or > 2 small vacuoles (grade III) and morphometrically abnormal spermatozoa (grade IV). The spermatozoa's chromatin condensation and their viability were also assessed before and after freezing-thawing. Results: Cryopreservation induced sperm nuclear vacuolization. It decreased the proportion of grade I+II spermatozoa (p < 0.001). It induced a decrease in the sperm viability rate (p < 0.001) and increased the proportion of sperm with non-condensed chromatin (p < 0.001). The latter parameter was strongly correlated with sperm viability (r = 0.71; p < 0.001). However, even motile sperm presented a failure of chromatin condensation after freezing/thawing because the proportion of sperm with non-condensed chromatin was correlated with high-magnification morphology (r = -0.49 and +0.49 for the proportions of grade I+II and grades III+IV, respectively; p < 0.001). Conclusions: Cryopreservation alters the organelle morphology of motile human spermatozoa and induces sperm chromatin decondensation. High-magnification microscopy may be useful for evaluating frozen-thawed spermatozoa before use in assisted reproductive technology procedures (such as intrauterine insemination, in vitro fertilization and intracytoplasmic sperm injection) and for performing research on cryopreservation methods. If frozen-thawed sperm is to be used for intracytoplasmic sperm injection, morphological selection under high magnification may be of particular value.
Journal of Andrology 06/2012; · 2.97 Impact Factor
ABSTRACT: Chez un homme, les translocations impliquant les gonosomes sont le plus souvent responsables d'azoospermie ou parfois d'oligospermie,
conduisant les patients à demander une AMP. Nous rapportons ici le cas d'un patient oligosperme, porteur d'une translocation
46,Y,t(X;2)(p21;p25.3) et les modalités spécifiques de prise en charge du couple avant ICSI. Après un conseil génétique, nous
avons proposé une analyse chromosomique des spermatozoïdes par cytogénétique moléculaire (FISH) dans le but de connaître le
mode de ségrégation de la translocation et le risque pour l'embryon et la descendance. Cette étude a montré que 34% des spermatozoïdes
étaient normaux ou équilibrés pour les chromosomes étudiés. Les 66% des spermatozoïdes restant présentaient un déséquilibre
lié à la translocation et/ou à des anomalies de non-disjonction des gonosomes. Devant ce résultat, une nouvelle analyse en
FISH, visant à préciser les risques éventuellement accrus de non-disjonction méiotique des chromosomes X et Y, a été décidée,
et sur 1000 spermatozoïdes analysés 60% seulement étaient normaux pour les gonosomes.
Le risque de déséquilibre pour la descendance concerne donc non seulement la translocation elle-même mais également les gonosomes
(syndrome de Klinefelter ou Turner) par malségrégation des chromosomes sexuels. Suite à ce résultat et en raison de l'âge
de la conjointe (42ans), nous avons déconseillé l'ICSI au couple au cours d'un nouveau conseil génétique
Ce cas souligne l'intérêt qu'il y a à évaluer par FISH, les conséquences d'une translocation dans les spermatozoïdes d'un
patient porteur. L'étude ne doit pas se limiter à l'étude de la translocation elle-même, mais également concerner les anomalies
de non-disjonction des gonosomes, fréquentes au cours de la spermatogenèse et plus particulièrement en présence d'une translocation
impliquant un gonosome.
In men, translocations involving sex chromosomes usually result in azoospermia or sometimes oligospermia. We report the case
of a man with oligospermia with a 46,Y,t(X;2)(p21;p25.3) translocation and the specific modalities of management of the couple
before ICSI. After genetic counselling, we proposed spermatozoa chromosomal analysis using FISH to evaluate the mode of segregation
of the translocation and the risk for the embryo and descendants.
This study showed that 34% of spermatozoa were normal or balanced for the chromosomes studied, and 66% of spermatozoa presented
a chromosome imbalance related to the translocation and/or involving X and Y chromosome non-disjuction. In view of this result,
we decided to perform another FISH analysis to define the increased risk related to the non-disjunction of X and Y chromosomes.
Only 60% of 1,000 spermatozoa were normal for X and Y. The chromosome risk for the offspring is not limited to the translocation,
as the risk of Klinefelter and Turner syndrome is also increased. In view of these results and the woman's age (42 years old),
we advised the couple against ICSI at another genetic counselling session.
This case illustrates the value of spermatozoa FISH analysis to evaluate the consequences of a translocation on spermatogenesis.
The study should not be limited to the translocation alone, but should also evaluate anomalies of non-disjunction of sex chromosomes
that are frequent during normal spermatogenesis, but the risk increases in the case of translocations, especially involving
the sex chromosomes.
Andrologie 04/2012; 15(3):328-333.
ABSTRACT: Il n’existe pas de facteur prédictif fiable permettant de pronostiquer avec certitude la présence ou l’absence de spermatozoïdes
testiculaires chez les hommes atteints d’azoospermie sécrétoire. La proportion de biopsies testiculaires négatives chez ces
patients est élevée, et il est donc préférable de pas pratiquer de manière synchrone la biopsie testiculaire et le cycle d’ICSI.
Nous présentons ici notre expérience concernant 74 biopsies testiculaires effectuées pour azoospermie sécrétoire, ayant donné
lieu à 60 cycles d’ICSI (25 couples). Les résultats sont comparés à ceux obtenus lors de 81 cycles d’ICSI effectués avec du
sperme testiculaire ou épididymaire congelé lors d’indications excrétoires. Les spermatozoïdes sont congelés en petits volumes
(micro-gouttes), ceci facilitant leur recherche après décongélation, et permettant d’augmenter le nombre de paillettes congelées.
II est alors possible de procéder à plusieurs cycles d’ICSI pour une même biopsie testiculaire, y compris lorsque le tissu
testiculaire est très pauvre en spermatozoïdes. Les résultats obtenus sont comparable dans les deux groupes, avec un taux
de grossesse clinique par transfert embryonnaire de 18% dans les indications sécrétoires et de 26% dans les indications excrétoires.
La réalisation systématique de la biopsie testiculaire et du cycle d’ICSI de façon asynchrone préserve les chances de grossesse
du couple quel que soit l’étiologie de l’azoospermie, et permet une meilleur gestion de la prise en charge des couples concernés.
50% or more of non-obstructive azoospermic men have no spermatozoa in their testicular tissue, and no non-invasive predictor
of spermatogenesis is yet available. For this reason, we therefore performed all TESE (74 TESE for non-obstructive azoospermia
and 37 TESE for obstructive azoospermia) prior to initiating ovarian stimulation. 34% (25/74) of TESE performed for non-obstructive
azoospermia were successful. Spermatozoa were retrieved in 100% of cases of obstructive azoospermia. When TESE were positive,
spermatozoa were frozen in 25–50 μl micro-droplets (several straws). 60 ICSI cycles (25 couples) were treated for non obstructive
azoospermia. The clinical pregnancy rate per ICSI cycle was 18%, and the implantation rate per embryo transferred was 9.2%.
81 ICSI cycles (37 couples) were treated for obstructive azoospermia. The fertilization rate was 54%, and embryo transfer
was performed in 89% (72/81) of cycles. The clinical pregnancy rate per embryo ICSI cycle was 26%, and the implantation rate
per embryo transferred was 16%. This management of azoospermic patients, including TESE and multiple testicular tissue freezing
in micro-droplets prior to ovarian stimulation, avoids ova pick-up cancellation and multiple TESE, as several ICSI can be
performed after a single TESE. Our results show that this micro-technique for freezing testicular tissue is effective not
only for obstructive azoospermia, but also for non-obstructive azoospermia when only very few spermatozoa can be extracted
from the testis.
Andrologie 04/2012; 12(4):342-346.
ABSTRACT: La cryoconservation de spermatozoïdes est une technique couramment utilisée en AMP, en particulier dans les cas d’oligospermie
sévère, dans la crainte d’une aggravation ultérieure. L’objectif de notre étude a été de rechercher un effet délétère éventuel
du processus de migration-congélation-décongélation sur la fragmentation de l’ADN des spermatozoïdes évaluée par la technique
L’étude a porté sur 72 patients répartis en 4 groupes selon leurs caractéristiques spermatiques: groupe 1 [n=20] (paramètres
«normaux» selon l’OMS), groupe 2 [n=24] (numération spermatique normale associée à une asthéno et/ou une tératospermie), groupe
3 [n=16] (numération totale comprise entre 5 et 20 millions), groupe 4 [n=12] (numération totale inférieure à 5 millions).
Une évaluation des paramètres spermatiques conventionnels et de la fragmentation de l’ADN (technique TUNEL) a été réalisée
sur le sperme entier (non migré non congelé) et sur le sperme décongelé. Une évaluation des taux de fragmentation a également
été réalisée sur la fraction migrée avant congélation pour 20 patients (10 du groupe 1 et 10 du groupe 2); cette analyse n’a
pas pu être effectuée sur les prélèvements oligospermiques (groupes 3 et 4).
Après l’ensemble du processus de migration, congélation et décongélation du sperme, le taux de fragmentation diminue dans
la population témoin (groupe 1), alors qu’il augmente significativement dans les groupes de patients présentant des paramètres
spermatiques altérés (groupes 2, 3 et 4). En examinant l’étape intermédiaire, la migration diminue les taux de fragmentation
dans les 2 groupes étudiés par rapport au sperme entier.
Donc le taux de fragmentation diminue après migration, puis s’élève après congélation-décongélation à un taux inférieur à
celui du sperme entier dans la population témoin, alors qu’il remonte à un taux plus élevé lorsque le sperme est altéré. Cependant,
cet effet délétère de la congélation sur les spermes altérés reste modéré.
En conclusion, ces résultats sont plutôt en faveur de l’autoconservation de sperme pour les patients oligospermiques sévères.
Ejaculated sperm cryopreservation can be proposed in the course of anART procedure, particularly in the case of severe oligozoospermia likely to deteriorate. The aim of this study was to evaluate
the influence of the freezing-thawing process on sperm DNA fragmentation (analysed by the TUNEL technique).
The first step of this work consisted of adapting the TUNEL technique to perform this analysis on very poor quality sperm.
A study was then performed on 72 patients divided into 4 groups according to their spermatic characteristics: group 1 [n=20]
(“normal” parameters according to WHO), group 2 [n=24] (normal sperm count associated with asthenospermia and/or teratospermia),
group 3 [n=16] (total sperm count between 5 and 20 M) and group 4 [n=12] (total sperm count below 5 M). Spermatic parameters
and DNA fragmentation (performed by TUNEL in situ technique, 400 spermatozoa read per slide) were evaluated on raw semen -
for all patients -, raw migrated sperm - for patients of group 1 and 2 -, migrated frozen-thawed sperm - for all patients-.
A TUNEL technique adapted to oligospermic samples was developed, manipulating spermatozoa directly on the slide rather than
in suspension, to limit spermatic sample loss. After the whole migration-freezing-thawing process, the mean DNA fragmentation
rate decreased for patients in group 1 (2.9 vs 5.1%, p<0.0001) whereas this rate increased for patients in groups 2 (10.5
vs 6.8%, p<0.0001), 3 (10.7 vs 7.6%, p<0.05) and 4 (15.2 vs 8.7%, p<0.005). DNA fragmentation rates from thawed samples were
also correlated with initial spermatic parameters. At the intermediary step, migration decreased DNA fragmentation rate in
comparison with raw semen rate in both groups (1.9 vs 4.7% [p<0.05] in group 1; 2.5 vs 5.4% [p<0.05] in group 2).
DNA fragmentation rate decreases after migration and then increases after freezing-thawing so that this rate is lower than
the raw semen rate for “normal“ sperms and higher than the raw semen rate for altered sperms. Nevertheless, this DNA damage
induced by cryopreservation on altered sperms remains moderate. Sperm “resistance” to cryopreservation also appears to depend
on spermatic parameters. Cryopreservation may positively select spermatozoa, accelerating elimination of senescent spermatozoa
by necrosis, so that early apoptotic spermatozoa from fresh ejaculate are not found in thawed samples.
These results, that need to be completed by a study on a larger sample of oligospermic patients, encourage us to continue
cryopreserving severely altered sperms.
Andrologie 04/2012; 17(1):55-70.
ABSTRACT: For non-obstructive azoospermic (NOA) patients with a normal karyotype or for Klinefelter syndrome (47,XXY) patients, intracytoplasmic sperm injection is associated with an increased aneuploidy risk in the offspring. We examined testicular cells from patients with different azoospermia aetiologies, in order to determine the origin of the aneuploid spermatozoa. The incidence of chromosome abnormalities was investigated in all types of azoospermia. Four study subgroups were constituted: Klinefelter patients (group 1), NOA patients with spermatogenesis failure but a normal karyotype (group 2), obstructive azoospermic patients with normal spermatogenesis (group 3) and control patients with normal sperm (group 4). The pachytene stage (in the three azoospermic groups) and postmeiotic cells (in all groups) were analysed with fluorescence in situ hybridisation. No aneuploid pachytene spermatocytes were observed. Postmeiotic aneuploidy rates were higher in the two groups with spermatogenesis failure (5.3% and 4.0% for groups 1 and 2, respectively) than in patients with normal spermatogenesis (0.6% for group 3 and group 4). Whatever the aetiology of the azoospermia, the spermatozoa originated from euploid pachytene spermatocytes. These results strengthen the hypothesis whereby sperm aneuploidy in both Klinefelter patients and NOA patients with a normal karyotype results from meiotic abnormalities and not from aneuploid spermatocytes. The fact that sperm aneuploidy was more frequent when spermatogenesis was altered suggests a deleterious testicular environment. The study results also provide arguments for offering preimplantation genetic diagnosis or prenatal diagnosis when a pregnancy occurs for fathers with NOA (whatever the karyotype).
Journal of Andrology 04/2012; · 2.97 Impact Factor
ABSTRACT: Obtaining an adequate number of high-quality oocytes is a major challenge in controlled ovarian hyperstimulation (COH). To date, a range of hormonal and clinical parameters have been used to optimize COH but none have significant predictive value. This variability could be due to the genetic predispositions of single-nucleotide polymorphisms (SNPs). Here, we assessed the individual and combined impacts of thirteen SNPs that reportedly influence the outcome of in vitro fertilisation (IVF) on the ovarian response to rFSH stimulation for patients undergoing intracytoplasmic sperm injection program (ICSI).
Univariate analysis revealed that only FSHR, ESR2 and p53 SNPs influenced the number of mature oocytes. The association was statistically significant for FSHR (p=0.0047) and ESR2 (0.0017) in the overall study population and for FSHR (p=0.0009) and p53 (p=0.0048) in subgroup that was more homogeneous in terms of clinical variables. After Bonferroni correction and a multivariate analysis, only the differences for FSHR and ESR2 polymorphisms were still statistically significant. In a multilocus analysis, only the FSHR and AMH SNP combination significantly influenced oocyte numbers in both population (p<0.01).
We confirmed the impact of FSHR and ESR2 polymorphisms on the IVF outcome. Furthermore, we showed for the first time that a p53 polymorphism (which is already known to impact embryo implantation) could influence the ovarian response. However, given that this result lost its statistical significance after multivariate analysis, more data are needed to draw firm conclusions. Only the FSHR and AMH polymorphism combination appears to influence mature oocyte numbers but this finding also needs to be confirmed.
A 13 gene polymorphisms: FSHR(Asn680Ser), p53(Arg72Pro), AMH(Ile49Ser), ESR2(+1730G>A), ESR1(-397T>C), BMP15(-9C>G), MTHFR1(677C>T), MTHFR2(1298A>C), HLA-G(-725C>G), VEGF(+405G>C), TNFα(-308A>G), AMHR(-482 A>G), PAI-1 (4 G/5 G), multiplex PCR assay was designed to genotype women undergoing ICSI program. We analyzed the overall study population (n=427) and a subgroup with homogeneous characteristics (n=112).
PLoS ONE 01/2012; 7(6):e38700. · 4.09 Impact Factor
ABSTRACT: To study the chromosomal risk in sperm from Robertsonian translocation (RobT) carriers as a function of the sperm count and translocation type.
Departments of reproductive biology, cytogenetics, gynecology, and obstetrics.
A total of 29 RobT patients (8 normozoospermic and 21 oligozoospermic) and 20 46,XY patients (10 normozoospermic and 10 oligozoospermic).
Sperm fluorescence in situ hybridization with probes for translocation malsegregation and chromosome 13, 18, 21, X, and Y probes for studying the interchromosomal effect (ICE).
Translocation malsegregation and ICE aneuploidy rates.
In RobT carriers, the sperm translocation malsegregation rate was significantly lower in normozoospermic patients (9.7%) than in oligozoospermic patients (18.0%). Considering only oligozoospermic patients, sperm malsegregation rates were significantly lower for rob(14;21) than for rob(13;14) (11.4% vs. 18.9%). In turn, the rates were significantly lower for rob(13;14) than for rare RobTs (18.9% vs. 25.3%). In sperm from normozoospermic RobT, an ICE was suggested by higher chromosome 13 and 21 aneuploidy rates than in control sperm. Conversely, chromosome 13 and 21 sperm aneuploidy rates were lower in oligozoospermic RobT patients than in oligozoospermic 46,XY patients, but higher than in control subjects.
Both translocation type and sperm count influence the RobT malsegregation risk. Of the chromosomes analyzed (13, 18, 21, X, and Y), only chromosomes 13 and 21 were found to be associated with an ICE. Relative to the RobT effect, idiopathic alterations in spermatogenesis in 46,XY patients appear to be more harmful for meiosis.
Fertility and sterility 09/2011; 96(6):1337-43. · 3.97 Impact Factor
ABSTRACT: Preconception diagnosis requires first polar body biopsy. When the hole in the zona pellucida is made with a laser beam, heat propagation could, like the biopsy itself, be deleterious. Our aim was to evaluate the effect of this technique on human in vitro matured oocyte and embryo development.
One hunded fifty five retrieved immature oocytes from 75 women, matured in vitro, were distributed in 3 groups: 50 oocytes in a control group, without laser drilling and first polar body biopsy, 52 oocytes in a group with only laser drilling, and 53 oocytes in a group with both laser drilling and first polar body biopsy. Safety was evaluated using four criteria:  oocyte lysis rate,  oocyte activation rate,  oocyte development after calcium ionophore treatment,  and embryo chromosome breakage incidence after Tarkowski preparation.
No difference in the four criteria was observed between the 3 oocyte groups.
We did not find evidence of deleterious effect of laser drilling and first polar body biopsy on in vitro matured oocytes, according to our criteria.
Journal of Assisted Reproduction and Genetics 07/2010; 27(7):423-7. · 1.84 Impact Factor
ABSTRACT: To localize the different proteins involved in the executioner step of apoptosis in the human testicular tissue: effector caspases (3, 6, and 7), caspase inhibitors called inhibitor of apoptosis proteins (IAPs, such as XIAP), and IAP inhibitors such as Smac/DIABLO and to investigate XIAP and Smac expression and activation of caspase-3 in azoospermia.
The Biology of Reproduction Center of Poissy and Inserm U407, France.
Twenty-five patients diagnosed as azoospermic and 4 patients with normal testicular histology.
Testicular biopsies for histopathological assessment.
Localization of proteins by immunohistochemistry.
Effector caspase-7 seemed to be absent from normal human testes, whereas procaspase-3 and procaspase-6 were detected in both somatic and germ cells. XIAP was mainly expressed in Sertoli cells, whereas its inhibitor Smac was detected in pachytene spermatocytes. On the other hand, although few apoptotic germ cells were detected in biopsies from patients with obstructive azoospermia, increased levels of apoptotic germ cells were detected in spermatogenetic arrest. This increase in apoptotic germ cells was associated with increased levels of active caspase-3 in patients with spermatogenetic arrest, whereas the expression of XIAP and Smac/DIABLO was at similar levels in all groups.
Active caspase-3 might be important in the apoptotic process observed in spermatogenetic arrest.
Fertility and sterility 02/2008; 90(5):1723-31. · 3.97 Impact Factor
ABSTRACT: Although spermatogenesis is a complex process under hormonal control, which includes mainly follicle stimulating hormone (FSH) and androgens, little is known about the intra-testicular mediators of these hormones. In the present study, galectin-3 (Gal-3) expression has been identified in human, rat and porcine testes where it is under hormonal control. Gal-3 is present in Sertoli cells and appears to be absent in human and (probably) in rat germ cells. Gal-3 expression was evidenced in the testes, in terms of both mRNA and protein (31 kDa). Gal-3 expression in cultured porcine Sertoli cells was shown to be under the positive control of FSH as well as of two cytokines epidermal growth factor (EGF) and tumour necrosis factor-alpha (TNF-alpha). Gal-3 expression in Sertoli cells is also potentially under the control of mature germ cells as an increased expression was observed in adult rat testes depleted in spermatocytes or spermatids. Although the function of testicular Gal-3 remains to be investigated, a potential role of Gal-3 in germ cell survival/regeneration is suggested based on its increased expression 1 month after a transient germ cell death process triggered by 10 days of treatment with the antiandrogen flutamide. Finally, although in the normal human testes, Gal-3 is exclusively located in the Sertoli cell cytoplasm, a nuclear localization is observed in the infertile testes. Together, the present findings have shown that (i) Gal-3 is expressed in the porcine, rat and human Sertoli cells; (ii) Gal-3 is under the positive control of FSH as well as of EGF and TNF-alpha and possibly of adult germ cells. These observations are compatible with a potential pro-survival role of Gal-3 in the testes.
International Journal of Andrology 03/2007; 30(1):28-40. · 3.59 Impact Factor
ABSTRACT: L’analyse d’ADN dans un contexte médico-légal a trois indications essentielles: premièrement l’identification de traces biologiques
(de sperme dans le cas qui nous préoccupe ici), deuxièmement son corollaire, l’identification de suspects, et troisièmement
les recherches en paternité, par leur application dérivée autorisant l’identification du père biologique d’un foetus.
Ces analyses sont encadrées par des dispositions législatives.
Les contraintes techniques inhérentes à de telles analyses imposent, aux cliniciens amenés à prêter sous serment leur concours
à la justice, un certain nombre de précautions.
The 3 main objectives of DNA analysis in forensic cases are: first, to establish the genetic profile of an evidence sample
(the present study deals with semen stains); second, to identify suspects by comparison with the evidence sample genotype;
and third, to identify the biological father of a foetus or child by paternity testing.
These tests are very strictly controlled in France. Clinicians must be aware of the technical specificities and requirements
to avoid interfering with subsequent analysis and/or use of the data in court.
Andrologie 08/2006; 16(3):240-246.
Andrologie 05/2005; 15(2):208-217.
ABSTRACT: Although intrauterine insemination (IUI) is one of the most common assisted reproductive technology methods in the world, the relative influence of various semen characteristics on the likelihood of a successful outcome is controversial. The aim of our study was to assess the results of IUI as a function of both the number of motile spermatozoa inseminated (NMSI) and the percentage of morphologically normal spermatozoa after preparation.
This was a retrospective study of 889 couples who underwent 2564 IUI cycles of ovarian stimulation with HMG or recombinant FSH in our centre between January 1991 and December 2000.
A total of 331 clinical pregnancies were obtained, for a pregnancy rate/cycle of 12.91%. When the NMSI was < 1 x 10(6), the pregnancy rate/cycle was significantly lower (3.13%) than in any of the subgroups with NMSI > or = 2 x 10(6). Sperm morphology, assessed before or after preparation, was not in itself a significant factor that affected the likelihood of IUI success. Nonetheless, when the post-migration rate of normal sperm was < 30%, the pregnancy rate/cycle was 5.43% when NMSI was < 5 x 10(6) and 18.42% when NMSI was > or = 5 x 10(6) (P = 0.008). Pregnancy rates did not differ significantly according to NMSI when the percentage of normal sperm after preparation was > or = 30%, or according to percentage of normal sperm when the NMSI was > or = 5 x 10(6).
Our results show that a minimum of 5 x 10(6) motile spermatozoa should be inseminated when the normal morphology of the sperm after preparation is < 30%; the quantity compensates at least in part for the defective quality. If this threshold of NMSI cannot be obtained, IVF should be recommended.
Human Reproduction 10/2004; 19(9):2060-5. · 4.47 Impact Factor
ABSTRACT: To study the effects of undetectable inhibin B concentrations on the outcomes of testicular sperm extraction (TESE) and of intracytoplasmic sperm injection (ICSI).
Obstetrics, gynecology, and reproductive biology departments.
We carried out TESE on 75 men with nonobstructive azoospermia: 42 men had an inhibin B concentration of <m15 pg/mL (group 1), and 33 had an inhibin B concentration of > or = 15 pg/mL (group 2). Twenty-five ICSI cycles were carried out using sperm from men in group 1 (group A1), and 35 ISCI cycles were carried out using sperm from men in group 2 (group A2). The outcomes of ICSI in groups A1 and A2 were compared with those of 81 ICSI cycles performed for obstructive azoospermia (group B).
Testicular sperm extraction, testicular spermatozoa cryopreservation, and ICSI.
Testicular sperm extraction outcome, pregnancy, and delivery.
Sperm were significantly less likely to be successfully recovered from men in group 1 than from those in group 2 (21% vs. 48%). The inhibin B concentration was significantly lower in men in whom TESE failed, but the FSH concentration did not differ. The implantation rate per embryo transferred was twofold lower in group A1 (7.4%) than in group B (16%), but this difference is not statistically significant.
Patients with undetectable inhibin B concentration should be informed of the low chances of positive testicular biopsy, and more embryos should be transferred to improve the success rate.
Fertility and Sterility 05/2003; 79(4):905-8. · 3.56 Impact Factor
ABSTRACT: To describe a successful pregnancy and delivery after testicular sperm extraction (TESE) despite an undetectable concentration of serum inhibin B in a man with nonobstructive azoospermia.
Obstetrics and gynecology and reproductive biology departments.
A 31-year-old woman and a 32-year-old man with nonobstructive azoospermia and an undetectable inhibin B serum level.
TESE, testicular spermatozoa cryopreservation, intracytoplasmic sperm injection (ICSI).
Pregnancy and delivery.
Successful pregnancy and delivery of a normal healthy child following a third ICSI cycle with frozen-thawed spermatozoa extracted from the testis.
This case report shows that there is no minimal level of inhibin B below which TESE is always unsuccessful. The delivery of a normal healthy baby is strong evidence to perform TESE in these circumstances.
Fertility and Sterility 06/2002; 77(5):1077-8. · 3.56 Impact Factor
ABSTRACT: A testis biopsy was performed for four non-mosaic 47,XXY azoospermic patients. Spermatozoa were found in three cases and frozen before ICSI. We analysed the various cells found in the four samples by multicolour fluorescence in-situ hybridization (FISH), to evaluate the meiosis and spermatogenesis possibilities of the 47,XXY and 46,XY testis cell lines, and to estimate aneuploidy rate in the resulting spermatids and spermatozoa.
Testis diploid cells (either somatic or premeiotic), meiotic, and post-meiotic haploid germ cells were hybridized with probes for chromosomes X, Y and 18. The only patient with no spermatozoa had a homogeneous diploid XXY constitution in the testis; the three other patients presented two cell populations (46,XY and 47,XXY) among their diploid testis cells. All the observed pachytene figures were XY; no XXY pachytene figure was found. The aneuploidy rate among post-meiotic cells for chromosomes X,Y and 18 was 6.75% (5/74). This rate was 1.5% (2/133) for control. Three couples underwent ICSI; four attempts were made, one healthy baby was born.
FISH results suggest that only 46,XY cells can undergo meiosis.
Human Reproduction 02/2002; 17(1):32-7. · 4.47 Impact Factor