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Fertility and Sterility Oct 2021To determine the association between vitamin D levels in the male partner and fertility outcomes in couples with mild male factor infertility. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To determine the association between vitamin D levels in the male partner and fertility outcomes in couples with mild male factor infertility.
DESIGN
Secondary analysis of a randomized, controlled trial.
SETTING
Nine fertility centers in the United States.
PATIENT(S)
Men (n = 154) with sperm concentration between 5 and 15 million/mL, motility ≤40%, or normal morphology ≤4% were eligible. Female partners were ovulatory, ≤40 years old, and had documented tubal patency.
INTERVENTION(S)
Men provided semen and blood at baseline for semen analysis and 25-hydroxyvitamin D (25(OH)D) levels. They were randomly assigned to receive a vitamin formulation including vitamin D 2,000 IU daily or placebo for up to 6 months. Couples attempted to conceive naturally during the first 3 months and with clomiphene citrate with intrauterine insemination of the female partner in months 4 through 6.
MAIN OUTCOME MEASURE(S)
Primary: sperm concentration, motility, morphology, and DNA fragmentation at baseline. Secondary: cumulative pregnancy, miscarriage, and live birth rates.
RESULT(S)
Semen parameters and sperm DNA fragmentation were not statistically significantly different between men with vitamin D deficiency and men with 25(OH)D levels ≥20 ng/mL. In addition, clinical pregnancy and live birth rates were similar. Male 25(OH)D level <20 ng/mL was associated with a higher rate of pregnancy loss (adjusted odds ratio 9.0; 95% confidence interval 1.3 to 61.3).
CONCLUSION(S)
Vitamin D deficiency in the male partner did not significantly impact semen parameters or treatment outcomes. Further study is warranted to better characterize the rate of miscarriage in couples with male vitamin D deficiency.
Topics: Abortion, Spontaneous; Adult; Biomarkers; Clomiphene; Dietary Supplements; Double-Blind Method; Female; Fertility; Fertility Agents, Female; Humans; Infertility, Male; Insemination, Artificial, Homologous; Live Birth; Male; Pregnancy; Pregnancy Rate; Prospective Studies; Risk Factors; Semen; Semen Analysis; Time Factors; Treatment Outcome; United States; Vitamin D; Vitamin D Deficiency
PubMed: 34289935
DOI: 10.1016/j.fertnstert.2021.06.035 -
Fertility and Sterility Feb 2020To provide evidence-based recommendations to practicing physicians and others regarding the effectiveness and safety of therapies for unexplained infertility.
OBJECTIVE
To provide evidence-based recommendations to practicing physicians and others regarding the effectiveness and safety of therapies for unexplained infertility.
METHODS
ASRM conducted a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1968 through 2019. The ASRM Practice Committee and a task force of experts used available evidence and informal consensus to develop evidence-based guideline recommendations.
MAIN OUTCOME MEASURE(S)
Outcomes of interest included: live-birth rate, clinical pregnancy rate, implantation rate, fertilization rate, multiple pregnancy rate, dose of treatment, rate of ovarian hyperstimulation, abortion rate, and ectopic pregnancy rate.
RESULT(S)
The literature search identified 88 relevant studies to inform the evidence base for this guideline.
RECOMMENDATION(S)
Evidence-based recommendations were developed for the following treatments for couples with unexplained infertility: natural cycle with intrauterine insemination (IUI); clomiphene citrate with intercourse; aromatase inhibitors with intercourse; gonadotropins with intercourse; clomiphene citrate with IUI; aromatase inhibitors with IUI; combination of clomiphene citrate or letrozole and gonadotropins (low dose and conventional dose) with IUI; low-dose gonadotropins with IUI; conventional-dose gonadotropins with IUI; timing of IUI; and in vitro fertilization and treatment paradigms.
CONCLUSION(S)
The treatment of unexplained infertility is by necessity empiric. For most couples, the best initial therapy is a course (typically 3 or 4 cycles) of ovarian stimulation with oral medications and intrauterine insemination (OS-IUI) followed by in vitro fertilization for those unsuccessful with OS-IUI treatments.
Topics: Aromatase Inhibitors; Clomiphene; Evidence-Based Practice; Female; Fertilization in Vitro; Gonadotropins; Humans; Infertility, Female; Insemination, Artificial; Pregnancy; Randomized Controlled Trials as Topic
PubMed: 32106976
DOI: 10.1016/j.fertnstert.2019.10.014 -
Lakartidningen Dec 2022Since 1985 only non-anonymous sperm donation (where a child born as a result of treatment can recieve information about the identity of the donor at a mature age) is...
Since 1985 only non-anonymous sperm donation (where a child born as a result of treatment can recieve information about the identity of the donor at a mature age) is performed in Sweden, and from 2003 the same applies to egg donation. Treatment is legal for different groups of patients; man-woman couples, female same sex couples and single women. Treatment can be performed at publicly funded and at private clinics, and for sperm donation it is possible using either insemination or IVF. Treatment with donated gametes is steadily increasing.
Topics: Child; Female; Humans; Male; Insemination, Artificial, Heterologous; Oocyte Donation; Semen; Tissue and Organ Procurement; Tissue Donors; Germ Cells
PubMed: 36519705
DOI: No ID Found -
Philosophical Transactions of the Royal... Sep 2020While only a single sperm may fertilize the egg, getting to the egg can be facilitated, and possibly enhanced, by sperm group dynamics. Examples range from the trains... (Review)
Review
While only a single sperm may fertilize the egg, getting to the egg can be facilitated, and possibly enhanced, by sperm group dynamics. Examples range from the trains formed by wood mouse sperm to the bundles exhibited by echidna sperm. In addition, observations of wave-like patterns exhibited by ram semen are used to score prospective sample fertility for artificial insemination in agriculture. In this review, we discuss these experimental observations of collective dynamics, as well as describe recent mechanistic models that link the motion of individual sperm cells and their flagella to observed collective dynamics. Establishing this link in models involves negotiating the disparate time- and length scales involved, typically separated by a factor of 1000, to capture the dynamics at the greatest length scales affected by mechanisms at the shortest time scales. Finally, we provide some outlook on the subject, in particular, the open questions regarding how collective dynamics impacts fertility. This article is part of the theme issue 'Multi-scale analysis and modelling of collective migration in biological systems'.
Topics: Animals; Fertility; Flagella; Insemination, Artificial; Male; Motion; Sheep, Domestic; Spermatozoa
PubMed: 32713305
DOI: 10.1098/rstb.2019.0384 -
Fertility and Sterility Mar 2020To determine whether antioxidants improve male fertility, as measured by semen parameters and DNA fragmentation at 3 months and pregnancy resulting in live birth after... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To determine whether antioxidants improve male fertility, as measured by semen parameters and DNA fragmentation at 3 months and pregnancy resulting in live birth after up to 6 months of treatment, among couples with male factor infertility.
DESIGN
Multicenter, double-blind, randomized, placebo-controlled trial with an internal pilot study.
SETTING
Nine fertility centers in the United States from December 2015 to December 2018.
PATIENT(S)
Men (N = 174) with sperm concentration ≤15 million/mL, motility ≤40%, normal morphology ≤4%, or DNA fragmentation >25%, and female partners who were ovulatory, ≤40 years old, and had documented tubal patency.
INTERVENTION(S)
Males randomly assigned to receive an antioxidant formulation (n = 85) containing 500 mg of vitamin C, 400 mg of vitamin E, 0.20 mg of selenium, 1,000 mg of l-carnitine, 20 mg of zinc, 1,000 μg of folic acid, 10 mg of lycopene daily, or placebo (n = 86). Treatment lasted for a minimum of 3 months and maximum of 6 months, and couples attempted to conceive naturally during the first 3 months and with clomiphene citrate with intrauterine insemination of the female partner in months 4 through 6.
MAIN OUTCOME MEASURE(S)
Primary outcome was live birth; secondary outcomes included pregnancy within 6 months of treatment. For the internal pilot, the primary outcomes were semen parameters and sperm DNA fragmentation index after 3 months of treatment.
RESULT(S)
In the Males, Antioxidants, and Infertility (MOXI) study, after 3 months of treatment, the change in sperm concentration differed between the antioxidant group (median -4.0 [interquartile range-12.0, 5.7] million/mL) and placebo group (+2.4 [-9.0, 15.5] million/mL). However, there were no statistically significant differences between the two groups for changes in sperm morphology, motility, or DNA fragmentation. Among the 66 oligospermic men at randomization, sperm concentration did not differ at 3 months between the antioxidant and control groups: 8.5 (4.8, 15.0) million/mL versus 15.0 (6.0, 24.0) million/mL. Of the 75 asthenospermic men, motility did not differ at 3 months: 34% ± 16.3% versus 36.4% ± 15.8%. Among the 44 men with high DNA fragmentation, DNA fragmentation did not differ at 3 months: 29.5% (21.6%, 36.5%) versus 28.0% (20.6%, 36.4%). In the entire cohort, cumulative live birth did not differ at 6 months between the antioxidant and placebo groups: 15% versus 24%.
CONCLUSION(S)
Antioxidants do not improve semen parameters or DNA integrity among men with male factor infertility. Although limited by sample size, this study suggests that antioxidant treatment of the male partner does not improve in vivo pregnancy or live-birth rates.
CLINICAL TRIAL REGISTRATION NUMBER
NCT02421887.
Topics: Adult; Antioxidants; Double-Blind Method; Female; Humans; Infant, Newborn; Infertility, Male; Insemination, Artificial, Homologous; Male; Ovulation Induction; Pilot Projects; Pregnancy; Pregnancy Rate; United States
PubMed: 32111479
DOI: 10.1016/j.fertnstert.2019.11.008 -
International Journal of Molecular... Apr 2021Seminal plasma (SP), the non-cellular component of semen, is a heterogeneous composite fluid built by secretions of the testis, the epididymis and the accessory sexual... (Review)
Review
Seminal plasma (SP), the non-cellular component of semen, is a heterogeneous composite fluid built by secretions of the testis, the epididymis and the accessory sexual glands. Its composition, despite species-specific anatomical peculiarities, consistently contains inorganic ions, specific hormones, proteins and peptides, including cytokines and enzymes, cholesterol, DNA and RNA-the latter often protected within epididymis- or prostate-derived extracellular vesicles. It is beyond question that the SP participates in diverse aspects of sperm function pre-fertilization events. The SP also interacts with the various compartments of the tubular genital tract, triggering changes in gene function that prepares for an eventual successful pregnancy; thus, it ultimately modulates fertility. Despite these concepts, it is imperative to remember that SP-free spermatozoa (epididymal or washed ejaculated) are still fertile, so this review shall focus on the differences between the in vivo roles of the SP following semen deposition in the female and those regarding additions of SP on spermatozoa handled for artificial reproduction, including cryopreservation, from artificial insemination to in vitro fertilization. This review attempts, including our own results on model animal species, to critically summarize the current knowledge of the reproductive roles played by SP components, particularly in our own species, which is increasingly affected by infertility. The ultimate goal is to reconcile the delicate balance between the SP molecular concentration and their concerted effects after temporal exposure in vivo. We aim to appraise the functions of the SP components, their relevance as diagnostic biomarkers and their value as eventual additives to refine reproductive strategies, including biotechnologies, in livestock models and humans.
Topics: Animals; Female; Fertility; Humans; Insemination, Artificial; Male; Pregnancy; Reproduction; Semen; Sperm Motility
PubMed: 33922047
DOI: 10.3390/ijms22094368 -
Poultry Science Nov 2020The increased consumption of protein derived from poultry demands greater poultry production, but increased poultry production (meat and eggs) is dependent on the... (Review)
Review
The increased consumption of protein derived from poultry demands greater poultry production, but increased poultry production (meat and eggs) is dependent on the fertility of the parent flocks. Clearly, the fertility of poultry flocks is associated with the fertility of both males and females, but the low numbers of males used for natural or artificial insemination mean that their role is more important. Thus, enhancing the semen volume, sperm concentration, viability, forward motility, and polyunsaturated fatty acids in sperm, as well as protecting against oxidative damage, could help to optimize the sperm membrane functionality, mitochondrial activity, and sperm-egg penetration, and thus fertility. Therefore, this review summarizes the nutritional factors that could improve the fertility of poultry males as well as their associated mechanisms to allow poultry producers to overcome low-fertility problems, especially in aging poultry males, thereby obtaining beneficial impacts on the poultry production industry.
Topics: Animal Husbandry; Animal Nutritional Physiological Phenomena; Animals; Fertility; Insemination, Artificial; Male; Poultry; Spermatozoa
PubMed: 33142481
DOI: 10.1016/j.psj.2020.06.083 -
Scientific Reports May 2021Non-lethal methods for semen collection from elasmobranchs to better understand species reproduction has accompanied the development of artificial insemination....
Non-lethal methods for semen collection from elasmobranchs to better understand species reproduction has accompanied the development of artificial insemination. Ejaculates (n = 82) collected from whitespotted bamboo sharks Chiloscyllium plagiosum (n = 19) were assessed and cold-stored raw or extended at 4 °C. Females (n = 20) were inseminated with fresh or 24-48 h cold-stored raw or extended semen and paternity of offspring determined with microsatellite markers. Insemination of females with fresh semen (n = 10) resulted in 80 hatchlings and 27.6% fertility. Insemination of females with semen cold-stored 24 h (n = 4) and 48 h (n = 1) semen resulted in 17 hatchlings and fertilization rates of 28.1% and 7.1% respectively. Two females inseminated with fresh or cold-stored semen laid eggs that hatched from fertilization and parthenogenesis within the same clutch. Parthenogenesis rate for inseminated females was 0.71%. Results demonstrate artificial insemination with cold-stored semen can provide a strategy for transport of male genetics nationally and internationally, precluding the need to transport sharks. Production of parthenotes in the same clutch as sexually fertilized eggs highlights the prevalence of parthenogenesis in whitespotted bamboo sharks and poses important considerations for population management.
Topics: Animals; Ejaculation; Female; Fertility; Insemination, Artificial; Male; Microsatellite Repeats; Oviposition; Parthenogenesis; Paternity; Semen Analysis; Semen Preservation; Sharks; Sperm Motility; Spermatozoa; Zygote
PubMed: 33980873
DOI: 10.1038/s41598-021-88568-y -
Journal of Feline Medicine and Surgery Sep 2022Despite substantial advances in assisted reproductive techniques having been recently reported in cats, the use of these is limited and routine application is still far...
PRACTICAL RELEVANCE
Despite substantial advances in assisted reproductive techniques having been recently reported in cats, the use of these is limited and routine application is still far from being a reality in veterinary clinics. Nevertheless, there is an increasing demand from domestic cat breeders for artificial insemination (AI) techniques that are already commonly used in dogs. Where natural breeding is not possible in tom cats and queens of high breeding value, AI could offer a solution. Clinical challenges: AI in cats is more difficult than in other species - both in terms of semen collection/handling and oestrous cycle management given that ovulation must be induced.
AIM
For practitioners wishing to perform AI in queens, there are challenges to overcome, and a good understanding of the techniques and procedures involved is pivotal. This review aims to contribute to improved knowledge by providing an overview of AI protocols, encompassing choice of breeding animals, procedures for semen collection, oestrus and ovulation induction, AI techniques and equipment.
EQUIPMENT AND TECHNICAL SKILLS
Depending on the animals involved and the specific AI technique chosen, essential equipment may include an artificial vagina, electroejaculator, endoscope (sialendoscope, which can be fairly expensive) and special catheters for transcervical insemination. Other instrumentation and materials needed are typically readily available in a veterinary clinic. In general, no particular skills are needed to perform the procedures described in this review, with the exception of endoscopic transcervical catheterisation, where the ability to use an endoscope is required.
EVIDENCE BASE
The information and advice/recommendations provided are based on specific feline research and reviews published in scientific peer-reviewed journals, animal reproduction textbooks, and presentations at national and international congresses. The authors also drew on their own clinical experience with regard to the choice of protocols and procedures presented in this review.
Topics: Animals; Cats; Dogs; Female; Insemination, Artificial; Ovulation; Ovulation Induction; Review Literature as Topic; Vagina
PubMed: 36002144
DOI: 10.1177/1098612X221118756 -
Human Reproduction (Oxford, England) May 2023
Topics: Pregnancy; Female; Male; Humans; Semen; Insemination, Artificial; Fertilization in Vitro; Sexual and Gender Minorities; Reward; Spermatozoa
PubMed: 37009807
DOI: 10.1093/humrep/dead062