152 research outputs found
Replacing IUI with IVF for initial treatment of unexplained infertility: why this NICE recommendation is cause for concern
CASA::tracking the past and plotting the future
The human semen sample carries a wealth of information of varying degrees of accessibility ranging from the traditional visual measures of count and motility to those that need a more computational approach, such as tracking the flagellar waveform. Although computer-aided sperm analysis (CASA) options are becoming more widespread, the gold standard for clinical semen analysis requires trained laboratory staff. In this review we characterise the key attitudes towards the use of CASA and set out areas in which CASA should, and should not, be used and improved. We provide an overview of the current CASA landscape, discussing clinical uses as well as potential areas for the clinical translation of existing research technologies. Finally, we discuss where we see potential for the future of CASA, and how the integration of mathematical modelling and new technologies, such as automated flagellar tracking, may open new doors in clinical semen analysis.</jats:p
2016 Laboratory guidelines for postvasectomy semen analysis: Association of Biomedical Andrologists, the British Andrology Society and the British Association of Urological Surgeons
Post-vasectomy semen analysis (PVSA) is the procedure used to establish whether sperm are present in the semen following a vasectomy. PVSA is presently carried out by a wide variety of individuals, ranging from doctors and nurses in general practitioner (GP) surgeries to specialist scientists in andrology laboratories, with highly variable results.Key recommendations are that: (1) PVSA should take place a minimum of 12 weeks after surgery and after a minimum of 20 ejaculations. (2) Laboratories should routinely examine samples within 4 h of production if assessing for the presence of sperm. If non-motile sperm are observed, further samples must be examined within 1 h of production. (3) Assessment of a single sample is acceptable to confirm vasectomy success if all recommendations and laboratory methodology are met and no sperm are observed. Clearance can then be given. (4) The level for special clearance should be <100 000/mL non-motile sperm. Special clearance cannot be provided if any motile sperm are observed and should only be given after assessment of two samples in full accordance with the methods contained within these guidelines. Surgeons are responsible both preoperatively and postoperatively for the counselling of patients and their partners regarding complications and the possibility of late recanalisation after clearance. These 2016 guidelines replace the 2002 British Andrology Society (BAS) laboratory guidelines and should be regarded as definitive for the UK in the provision of a quality PVSA service, accredited to ISO 15189:2012, as overseen by the United Kingdom Accreditation Service (UKAS).</jats:p
Doing more with less: the flagellar end piece enhances the propulsive effectiveness of human spermatozoa
Spermatozoa self-propel by propagating bending waves along a predominantly
active elastic flagellum. The organized structure of the "9 + 2" axoneme is
lost in the most-distal few microns of the flagellum, and therefore this region
is unlikely to have the ability to generate active bending; as such it has been
largely neglected in biophysical studies. Through elastohydrodynamic modeling
of human-like sperm we show that an inactive distal region confers significant
advantages, both in propulsive thrust and swimming efficiency, when compared
with a fully active flagellum of the same total length. The beneficial effect
of the inactive end piece on these statistics can be as small as a few percent
but can be above 430%. The optimal inactive length, between 2-18% of the total
length, depends on both wavenumber and viscous-elastic ratio, and therefore is
likely to vary in different species. Potential implications in evolutionary
biology and clinical assessment are discussed.Comment: To Appear, Physical Review Fluids. 25 pages, 14 figure
Coarse-graining the fluid flow around a human sperm
The flagellar beat is extracted from human sperm digital imaging microscopy and used to determine the flow around the cell and its trajectory, via boundary element simulation. Comparison
of the predicted cell trajectory with observation demonstrates that simulation can predict fine-scale
sperm dynamics at the qualitative level. The
flow field is also observed to reduce to a time-dependent
summation of regularized Stokes
flow singularities, approximated at leading order by a blinking
force triplet. Such regularized singularity decompositions may be used to upscale cell level detail
into population models of human sperm motility
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