Effects of pentoxifylline treatment before freezing on motility, viability and acrosome status of poor quality human spermatozoa cryopreserved by the liquid nitrogen vapor method

The objective of the present study was to investigate the effects of the direct addition of pentoxifylline (PF) to the ejaculates of men with poor sperm quality before freezing on post-thaw sperm motility, viability, acrosome integrity, and agonist-induced acrosome reaction. Semen specimens from 16 infertile men with impaired sperm count and motility (oligoasthenozoospermia) were divided into two equal aliquots: one received no treatment (control) while the other was incubated with 5 mM PF (treated). Both aliquots were cryopreserved by the liquid nitrogen vapor method. Motility was assessed according to WHO criteria. Acrosome integrity and spontaneous and calcium ionophore-induced acrosome reactions were assessed with fluorescein isothiocyanate-conjugated peanut agglutinin combined with a supra-vital dye (Hoechst-33258). Cryopreservation impaired sperm motility (percentage reduction: 87.4 (interquartile range, IQ: 70.3-92.9) vs 89.1 (IQ: 72.7-96.0%)), viability (25.9 (IQ: 22.2-29.7) vs 25.6 (IQ: 19.7-40.3%)) and acrosome integrity (18.9 (IQ: 5.4-38.9) vs 26.8 (IQ: 0.0-45.2%)) to the same extent in both treated and control aliquots. However, PF treatment before freezing improved the acrosome reaction to ionophore challenge test scores in cryopreserved spermatozoa (9.7 (IQ: 6.6-19.7) vs 4.8 (IQ: 0.5-6.8%); P = 0.002). These data show that pre-freeze treatment of poor quality human sperm with pentoxifylline did not improve post-thaw motility or viability nor did it prevent acrosomal loss during the freeze-thaw process. However, PF, as used, improved the ability of thawed spermatozoa to undergo the acrosome reaction in response to calcium ionophore. The present data indicate that treatment of poor quality human sperm with PF may enhance post-thaw sperm fertilizing ability.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Laboratório de Reprodução HumanaCentro de Referência em Reprodução MasculinaUNIFESP, EPM, Laboratório de Reprodução HumanaSciEL

Asymptomatic male with grade 3 left varicocele and two children desiring vasectomy with low testosterone

Univ Fed Sao Paulo, Sao Paulo Hosp, Dept Surg, Div Urol,Human Reprod Sect, Rua Napoleao Barros,715-2 Andar, BR-04024002 Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo Hosp, Dept Surg, Div Urol,Human Reprod Sect, Rua Napoleao Barros,715-2 Andar, BR-04024002 Sao Paulo, BrazilWeb of Scienc

Egg donation and the issue of disclosure

The aim of this study was to identify the intention among parents to disclose conception via egg donation to their child, relatives and friends and the underlying reasons. The study considered ten couples to have received oocytes via the Egg Donation Programme at the Federal University of São Paulo. Most couples preferred not to disclose their conception via egg donation to friends or relatives and did not intend to inform their child. Various reasons were reported, as well as fears over the future child's potential reaction. Disclosure regarding gamete donation is a complex issue and approaches should not apply simple and general rules, but rather take into consideration each family's specific circumstances and context.O objetivo deste estudo foi identificar a intenção de revelar ou não para o filho, familiares e amigos a ovodoação e os motivos subjacentes. Participaram do estudo dez casais receptores de oócitos do Programa de Ovodoação da Universidade Federal de São Paulo (UNIFESP). Foram realizadas entrevistas individuais, e os dados foram analisados segundo o método qualitativo. A maioria dos participantes relatou que não havia contado sobre a ovodoação para outras pessoas, assim como não tinha a intenção de contar para o filho. Foram alegados diversos motivos, acompanhados de temores relacionados às possíveis reações das crianças. O sigilo sobre a doação de gametas é uma questão complexa, que não deve ser respondida com regras simples e gerais, devendo-se considerar as especificidades de cada família e o contexto em que vivem.Universidade Federal de São Paulo (UNIFESP) Setor de Reprodução HumanaPontifícia Universidade Católica de São Paulo Faculdade de Ciências Humanas Curso de Psicologia e da SaúdeUniversidade Federal de São Paulo (UNIFESP) Departamento de CirurgiaUNIFESP, Setor de Reprodução HumanaUNIFESP, Depto. de CirurgiaSciEL

Características de espermatozóides de um grupo de adolescentes saudáveis em São Paulo, Brasil

The article presents preliminary data from a prospective investigation in a sample of healthy 14-17-year-old students from a technical school in São Paulo, Brazil. Ninety-six Tanner stage 5 and thirty-one Tanner stage 4 adolescents were evaluated: testicular volume was measured using a Prader orchidometer, and semen analysis was performed according to standard procedures. Median testicular volume was 20.0ml among Tanner 5 students and 15.0ml in Tanner 4 students in both the right and left testes. No significant differences were found in sperm volume or motility. Median concentration was 66.0 million/ml for Tanner 5 and 47.0 million/ml for Tanner 4 subjects. Morphological patterns showed abnormal forms in 81.9% of Tanner 5 and 93.6% of Tanner 4 adolescents. Oligospermia (sperm concentration < 5 million/ml) was observed in 7.3% of Tanner stage 5 and 12.9% of Tanner stage 4 individuals. Azoospermia was observed in 3 students (1.8%), with counts less than 1.0 in 8 students (4.8%). The authors discuss the observed results, analyzing the potential implications arising from biological development and potential environmental exposures.O artigo apresenta dados preliminares de um estudo prospectivo com uma amostra de alunos saudáveis variando de idade entre 14 e 17 anos, de uma escola técnica em São Paulo. Foram avaliados 96 adolescentes estágio Tanner 5 e 31 estágio Tanner 4: o volume testicular foi medido utilizando um orquidômetro de Prader, e o espermograma foi realizado de acordo com os procedimentos padronizados. O volume testicular mediano, tanto direito quanto esquerdo, era 20,0ml nos alunos Tanner 5 e 15,0ml nos alunos Tanner 4. Não foram constatadas diferenças significativas no volume ou motilidade espermática. A concentração mediana era 66,0 milhões/ml para Tanner 5 e 47,0 milhões/ml para Tanner 4. Os padrões morfológicos evidenciaram formas anormais em 81,9% dos adolescentes Tanner 5 e 93,6% dos Tanner 4. A oligospermia (concentração espermática < 5 milhões/ml) foi observada em 7,3% dos indivíduos Tanner 5 e 12,9% dos Tanner 4. A azoospermia foi observada em 3 alunos (1,8%), além de uma contagem abaixo de 1,0 em 8 alunos (4,8%). Os autores discutem os resultados observados, analisando as implicações para o desenvolvimento biológico a partir de possíveis exposições ambientais.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de CirurgiaFundação Oswaldo Cruz Escola Nacional de Saúde Pública Departamento de Epidemiologia e Métodos Quantitativos em SaúdeUNIFESP, EPM, Depto. de CirurgiaSciEL

Effects of the technique of cryopreservation and dilution/centrifugation after thawing on the motility and vitality of spermatozoa of oligoasthenozoospermic men

OBJECTIVE: Comparing in human semen samples with low initial quality, the effects of 2 techniques of cryopreservation and dilution/centrifugation after thawing on the spermatic motility and vitality. MATERIALS AND METHODS: Semen samples from 15 oligo and/or asthenozoospermic individuals assisted in the infertility sector of a tertiary hospital were obtained through masturbation. The samples were divided into 2 portions of equal volume, and diluted (1:1; v/v) with the cryoprotector containing glycerol (Test yolk buffer). One portion was frozen through the technique of liquid nitrogen vapor with static phases (group I - GI), while the other was frozen through a programmable biological freezer with linear speed (Planer, Kryo 10, series III) (group II - GII). The following parameters were assessed before freezing and after thawing: percentage of spermatozoa with progressive motility (Prog%) and percentage of live spermatozoa (Vit%). After defrosting, Prog% was assessed before and after removal of cryoprotector diluent, in different time intervals (zero, 3 h, and 24 h). The statistical analysis has been accomplished by using the non-parametric tests of Wilcoxon and Friedman. RESULTS: There was significant reduction of Prog% and Vit% from before freezing to after defrosting in both groups, I and II (p < 0.001). Values of Prog% and Vit% were not statistically different between groups, after thawing. It has been observed a significant reduction in Prog% among portions frozen with the automated technique after dilution and centrifugation for removal of cryoprotector (p = 0.006). After cryoprotector removal, Prog% has been kept unaltered, in both groups, during the first 3 hours of incubation, although being superior in group I (p = 0,04). There was a significant decrease in Prog% after 24 hours of incubation, in both groups (p < 0,01). CONCLUSION: For human semen samples with low initial quality, freezing through vapor technique or through the automated technique showed to be equivalent in regarding recovery of live spermatozoa with progressive motility. The effects of dilution and centrifugation to remove the cryoprotector had a negative impact only in samples frozen through the automated technique. In both techniques, progressive motility is kept constant during the first 3 hours after thawing and removal of the cryoprotector, but is drastically diminished by the end of an incubation period of 24 hours.Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Division of UrologyUNIFESP, EPM, Division of UrologySciEL

Effects of acupuncture and moxa treatment in patients with semen abnormalities

Aim: To evaluate the effect of Chinese Traditional Medicine, acupuncture and moxa treatment, on the semen quality in patients with semen abnormalities. Methods: In a prospective, controlled and blind study, nineteen patients, aged 24 years similar to 42 years and married for 3 years similar to 11 years without children with semen abnormalities in concentration, morphology and/or progressive motility without apparent cause, were randomized into two groups and submitted to acupuncture and moxa treatment at the therapeutic (Study Group) and the indifferent points (Control Group), respectively, for 10 weeks. Semen analyses were performed before and after the treatment course. Results: The patients of the Study Group presented a significant increase in the percentage of normal-form sperm compared to the Control Group (calculated U = 16.0, critical U = 17.0). Conclusion: The Chinese Traditional Medicine acupuncture and moxa techniques significantly increase the percentage of normal-form sperm in infertile patients with oligoastenoteratozoospermia without apparent cause. (Asian J Androl 2003 Dec; 5: 345-348).Univ Fed Sao Paulo, Paulista Sch Med, Human Reprod Div, Discipline Urol, Sao Paulo, BrazilUniv Fed Sao Paulo, Paulista Sch Med, Human Reprod Div, Discipline Urol, Sao Paulo, BrazilWeb of Scienc

Male infertility in spinal cord trauma

Every year there are 10 thousand new cases of patients victimized by spinal cord trauma (SCT) in the United States and it is estimated that there are 7 thousand new cases in Brazil. Eighty percent of patients are fertile males. Infertility in this patient group is due to 3 main factors resulting from spinal cord lesions: erectile dysfunction, ejaculatory disorder and low sperm counts. Erectile dysfunction has been successfully treated with oral and injectable medications, use of vacuum devices and penile prosthesis implants. The technological improvement in penile vibratory stimulation devices (PVS) and rectal probe electro-ejaculation (RPE) has made such procedures safer and accessible to patients with ejaculatory dysfunction. Despite the normal number of spermatozoa found in semen of spinal cord-injured patients, their motility is abnormal. This change does not seem to be related to changes in scrotal thermal regulation, frequency of ejaculation or duration of spinal cord damage but to factors related to the seminal plasma. Despite the poor seminal quality, increasingly more men with SCT have become fathers through techniques ranging from simple homologous insemination to sophisticated assisted reproduction techniques such as intracytoplasmic sperm injection (ICSI).Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Department of UrologySan Francisco Home School Section of UrologyUNIFESP, EPM, Department of UrologySciEL

Microdissection testicular sperm extraction causes spermatogenic alterations in the contralateral testis

Testicular sperm extraction (TESE) associated with intracytoplasmic sperm injection has allowed many men presenting non-obstructive azoospermia to achieve fatherhood. Microdissection TESE (microTESE) was proposed as a method to improve sperm retrieval rates in these patients; however, there have been failures. Little is known about whether microTESE leads to spermatogenic alterations in the contralateral testis. We assessed histological outcomes of experimental microTESE in the contralateral testis of adult male rabbits. Nine adult male rabbits were divided into three groups: control (testicular biopsy to observe normal histological and morphometric values), sham (incision of the tunica vaginalis, and a contralateral testicular biopsy to observe histological and morphometric patterns, 45 days later), and study (left testicular microTESE, and a right testicular biopsy to observe histological and morphometric patterns, 45 days later). Sections were assessed by calculating Johnsen-like scores, and measuring total tubule diameter, lumen diameter and epithelial height. the results were compared using ANOVA and Bonferroni's statistical analysis. Morphometric evaluation of the seminiferous tubules did not demonstrate differences between the three groups. However, microTESE caused spermatogenic alterations, leading to maturation arrest in the contralateral testis.Universidade Federal de São Paulo, Dept Cirurgia, Div Urol, Secao Reprod Humana, São Paulo, BrazilUniv Estadual Paulista, Dept Biol, Inst Biociencias Letras & Ciencias Exatas Sao Jos, Sao Jose Do Rio Preto, SP, BrazilUniversidade Federal de São Paulo, Dept Cirurgia, Div Urol, Secao Reprod Humana, São Paulo, BrazilWeb of Scienc