Ashok Agarwal

Ashok Agarwal
Cleveland Clinic · American Center for Reproductive Medicine

PhD

About

2,313
Publications
808,395
Reads
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64,999
Citations
Introduction
Ashok Agarwal, PhD, HCLD (ABB), ELD (ACE), is the Director of the Andrology Center, and Director of Research at the American Center for Reproductive Medicine since 1993. He holds these positions at The Cleveland Clinic Foundation, USA, where he is a Professor at the Lerner College of Medicine of Case Western Reserve University. Ashok was the Director of Male Infertility Research and an Asst. Professor of Urology at the Brigham and Women's Hospital & Harvard Medical School, Boston from 1988 - 92.
Additional affiliations
January 1993 - present
Cleveland Clinic
Position
  • Managing Director
Description
  • Director of Research in Male Infertility
July 1988 - December 1992
Harvard Medical School
Position
  • Professor (Assistant)
Description
  • Director of Male Infertility Research in the Division of Urology, Harvard Program in Urology, Brigham and Women's Hospital, Boston, MA
July 1975 - November 1983
Banaras Hindu University
Position
  • Research Associate
Education
June 1984 - June 1986
Harvard Medical School
Field of study
  • Reproductive Biology

Publications

Publications (2,313)
Research
Complete list of research publication by Dr. Ashok Agarwal and the members of his team both at Harvard Medical School (1987-1992) and the Cleveland Clinic (1993-2017) is available through Scopus.
Article
Full-text available
Antisperm antibodies (ASA), as a cause of male infertility, have been detected in infertile males as early as 1954. Multiple causes of ASA production have been identified, and they are due to an abnormal exposure of mature germ cells to the immune system. ASA testing (with mixed anti-globulin reaction, and immunobead binding test) was described in...
Article
Recurrence following varicocelectomy is an important cause of treatment failure and persistence of subnormal semen parameters. This original study was combined with a systemic review and meta‐analysis aiming to evaluate the efficacy of redo varicocelectomy on male fertility potential and pregnancy outcome. The retrospective study included 32 patien...
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Purpose Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varico...
Article
Research question Has seminal oxidation-reduction potential (ORP) clinical relevance for reproductive outcome. Design In this prospective observational study a total of 144 couples who had an ICSI cycle between June 2018 and December 2020 were included. The study included patients undergoing fresh ICSI cycles with autologous gametes. Cycles that h...
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Full-text available
Unexplained infertility affects about one-third of infertile couples and is defined as the failure to identify the cause of infertility despite extensive evaluation of the male and female partners. Therefore, there is a need for a multiparametric approach to study sperm function. Recently, we developed a Fluorescence-Based Ratiometric Analysis of S...
Article
Full-text available
Sperm vitality testing is a basic semen examination that has been described in the World Health Organization (WHO) Laboratory Manual for the Examination and Processing of Human Semen from its primary edition, 40 years ago. Several methods can be used to test sperm vitality, such as the eosin-nigrosin (E-N) stain or the hypoosmotic swelling (HOS) te...
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Full-text available
Oxidative stress (OS) due to an imbalance between reactive oxygen species (ROS) and antioxidants has been established as an important factor that can negatively affect the outcomes of assisted reproductive techniques (ARTs). Excess ROS exert their pathological effects through damage to cellular lipids, organelles, and DNA, alteration of enzymatic f...
Article
The ART laboratory is a complex system designed to sustain the fertilization, survival, and culture of the preimplantation embryo to the blastocyst stage. ART outcomes depend on numerous factors, among which are the equipment, supplies and culture media used. The number and type of incubators also may affect ART results. While large incubators may...
Article
Oocyte retrieval, oocyte denudation, and embryo transfer are crucial processes during assisted reproduction (ART). Air quality in the ART laboratory, temperature, pH of the media used and the time interval between oocyte retrieval and insemination are all critical factors. Anesthesia is required for oocyte retrieval, however evidence regarding the...
Article
With the advance of assisted reproduction techniques, and the trend towards blastocyst culture and single embryo transfer, gamete and embryo assessment have gained greater importance in ART treatment. Embryo quality depends mainly on gamete quality and culture conditions. Oocyte maturity identification is necessary in order to plan fertilization ti...
Article
Oocyte retrieval (ovum pick-up) and embryo transfer (ET) are essential steps in IVF and ICSI and over the years, the two procedures were developed in order to improve the clinical outcome. Many suggestions were proposed and applied before, during and after oocyte retrieval such as timing of HCG trigger, pre-operative pelvic scan, vaginal cleansing,...
Article
Over the years, laboratories performing assisted reproductive technologies have been tasked with a growing number of procedures of increased complexity. New technologies, including hardware and software innovations, are constantly evolving, and being evaluated as potential tools to improve laboratory and clinical outcomes. The ART laboratory plays...
Article
Purpose: Azoospermia is defined as the absence of spermatozoa in the pellet of a centrifuged semen sample. In fact, when a basic semen analysis fails to detect sperm in the ejaculate, there is still the possibility of detecting rare sperm after centrifugation of the sample and examination of the pellet. In this study, we assessed the role of Cytos...
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Full-text available
Purpose: The success of vasectomy is determined by the outcome of a post-vasectomy semen analysis (PVSA). This article describes a step-by-step procedure to perform PVSA accurately, report data from patients who underwent post vasectomy semen analysis between 2015 and 2021 experience, along with results from an international online survey on clinic...
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Full-text available
Alcohol abuse disorder is a serious condition, implicating more than 15 million people aged 12 years and older in 2019 in the United States. Ethanol (or ethyl alcohol) is mainly oxidized in the liver, resulting in the synthesis of acetaldehyde and acetate, which are toxic and carcinogenic metabolites, as well as in the generation of a reductive cel...
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Full-text available
Varicocele, a condition associated with increased oxidative stress, negatively affects sperm DNA integrity and reduces pregnancy rates. However, the molecular mechanisms related to DNA integrity, damage, and repair in varicocele patients remain unclear. This study aimed to determine the role of DNA repair molecular mechanisms in varicocele-related...
Article
Full-text available
Semen analysis is the cornerstone of male fertility evaluation with WHO guidelines providing the basis for procedural standardization and reference values worldwide. The first WHO manual was published in 1980, and five editions have been subsequently released over the last four decades. The 6th Edition was published in July 2021. In this review, we...
Article
This retrospective cohort study aimed to explore whether paternal age and semen quality parameters affect the embryological and clinical outcomes of ICSI with oocyte donation. A total of 339 oocyte donation (OD)-ICSI cycles were categorized into four groups according to the semen parameter profiles of the male counterparts: normozoospermia (NS, n =...
Article
To identify the most prevalent chromosomal abnormalities in patients with non‐obstructive azoospermia (NOA), consolidate their surgical sperm retrieval (SSR) rates and determine the significant predictors of positive SSR in this patient population. A systematic review and meta‐analysis were performed following the Preferred Reporting Items for Syst...
Article
Full-text available
Background : The use of herbal medicine and alternative medicine is reported to be in up to 50% of prescriptions for benign prostate hyperplasia (BPH) in Europe, along with an increased global interest for holistic medicinal approaches. This study aimed to systematically review the published evidence investigating the use of herbal medicines as a t...
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Full-text available
Purpose: In response to the COVID-19 pandemic, the American Center for Reproductive Medicine (ACRM) transitioned its annual training in assisted reproductive technology (ART) from a hands-on, laboratory-based training course to a fully online training endorsed by the American College of Embryology. Here we describe our experience and assess the qu...
Article
Immunological infertility contributes significantly to the etiology of idiopathic male infertility. Shielding the spermatogenic cells from systemic immune responses is fundamental to secure normal production of spermatozoa. The body’s immune system is tuned with the host self-components since the early postnatal period, while sperm first develops d...
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The American Center for Reproductive Medicine (ACRM) at Cleveland Clinic is offering unique opportunities for cutting edge research in Human Reproduction and Male Infertility. The researcher will use a variety of approaches and computational tools to participate in research and scientific writing, in collaboration with experts from all over the wor...
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Our study objective was to assess the effect of various sperm DNA fragmentation levels on clinical intracytoplasmic sperm injection outcome. This retrospective study included 392 patients who underwent ICSI and performed sperm DNA fragmentation testing before the procedure. Based on sperm DNA fragmentation cut-off values, the patients were differen...
Article
Full-text available
The advent of intracytoplasmic sperm injection (ICSI) has changed the human reproduction landscape by overcoming several limitations related to both male and female infertility factors. However, despite the development of new technologies, the live-birth rate with ICSI has not exceeded 30%. In order to improve assisted reproductive technology outco...
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Full-text available
Purpose: The use of antioxidants is common practice in the management of infertile patients. However, there are no established guidelines by professional societies on antioxidant use for male infertility. Materials and methods: Using an online survey, this study aimed to evaluate the practice pattern of reproductive specialists to determine the...
Article
Full-text available
Background: Computer-aided sperm analyzers (CASA) are currently used worldwide for semen analysis. However, there are doubts about their reliability to fully substitute the human operator. Therefore, this study aimed to systematically review the current literature comparing results from semen evaluation by both CASA-based and manual approaches. Met...
Article
Full-text available
Semen analysis is the first, and frequently, the only step in the evaluation of male fertility. Although the laboratory procedures are conducted according to the World Health Organization (WHO) guidelines, semen analysis and especially sperm morphology assessment is very difficult to standardize and obtain reproducible results. This is mainly due t...
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Paris, le 12 juin 2021 On behalf of the French Society of Andrology
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Certificate of Recognition
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Certificate of Recognition Dr. Ashok Agarwal (Director, American Center for Reproductive Medicine at Cleveland Clinic) is a recipient of the prestigious recognition by the Iranian Society of Reproductive Medicine for his “Exemplary Commitment and Outstanding Global Contribution to Advancing and Educating the Field of Male Reproductive Medicine”.
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Certificate for Work in ACRM Scientific Research, Mahsa
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Certificate for Work in ACRM Scientific Research, Sara
Article
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The current WHO 2010 manual for human semen analysis defines leukocytospermia as the presence of peroxidase-positive leukocytes at a concentration >1×106/mL of semen. Granular leukocytes when activated are capable of generating high levels of reactive oxygen species in semen resulting in oxidative stress. Oxidative stress has been correlated with p...
Chapter
Full-text available
Within the male reproductive system, oxidative stress (OS) has been identified as prevailing etiology of male infertility. The effects of reactive oxygen species (ROS) on male fertility depend on the dimensions, “modus operandi” of the ROS and the oxido-reduction potential (ORP) of the male reproductive tract. Hereupon, for an adequate response to...
Article
Full-text available
In this study, we investigated the prevalence of sexual dysfunction among males with advanced chronic kidney disease and the effect of treating hyperprolactinemia among these patients. In this prospective study, patients were assessed with history, physical examination, hormonal assessment, and two questionnaires, IIEF and AIPE. Patients with hyper...
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Full-text available
Retrograde ejaculation (RE) is a condition defined as the backward flow of the semen during ejaculation, and when present can result in male infertility. RE may be partial or complete, resulting in either low seminal volume or complete absence of the ejaculate (dry ejaculate). RE can result from anatomic, neurological or pharmacological conditions....
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Egyptian Representative Committee of the Royal College of Obstetricians and Gynaecologists
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Semen analysis is a basic test for evaluating male fertility potential, as it plays an essential role in driving the future management and treatment of infertility in couples. Manual semen analysis includes the evaluation of both macroscopic and microscopic parameters, whereas automated semen analysis is conducted through a computer-aided sperm ana...
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Full-text available
Sperm DNA fragmentation (SDF) is implicated in male infertility and adverse reproductive outcomes. With the publication of many studies regarding the etiologies and contributors to SDF, as well as the effects of SDF, guidelines are necessary to aid clinicians in the application of SDF for male fertility evaluation. Two recent clinical practice guid...
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Full-text available
It is widely accepted that oxidative stress plays an important role in the pathophysiology of male infertility and that antioxidants could have a significant role in the treatment of male infertility. The main objectives of this study are: 1) to systematically review the current evidence for the utility of antioxidants in the treatment of male infe...
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Founded in 1993, the American Center for Reproductive Medicine offers research fellowships, hands-on training in human assisted reproduction, and summer mentorship opportunities. It also offers diagnostic services for male infertility and cancer patients and has one of the largest and well recognized Andrology Laboratory in the country. The ACRM re...
Cover Page
Full-text available
Since its inception in 2003, our ART training program has been offering a unique opportunity to learn the latest techniques in routine and advanced andrology along with the full spectrum of embryology-focused technology. In the last 17 years, we have successfully trained over 210 candidates from more than 45 countries. Due to COVID-19 pandemic, we...
Cover Page
Full-text available
Founded in 1993, the American Center for Reproductive Medicine offers research fellowships, hands-on training in human assisted reproduction, and summer mentorship opportunities. It also offers diagnostic services for male infertility and cancer patients and has one of the largest and well recognized Andrology Laboratory in the country. The ACRM re...
Cover Page
Full-text available
Since its inception in 2003, our ART training program has been offering a unique opportunity to learn the latest techniques in routine and advanced andrology along with the full spectrum of embryology-focused technology. In the last 17 years, we have successfully trained over 210 candidates from more than 45 countries. Due to COVID-19 pandemic, we...
Article
The cryopreservation of spermatozoa has the main purpose of preserving male fertility. However, current preservation techniques have shown to produce lesions in the structure and alter sperm functions, probably due to the production of reactive oxygen species (ROS) during cryopreservation. To overcome the damage provoked by ROS, we introduced a nov...