The Administration of the Secretome from Mesenchymal Stem Cells Derived from the Umbilical Cord into the Medium used for Sperm Preparation

This study investigates the potential of the secretome of mesenchymal stem cells produced from the umbilical cord (UC-MSCs), which are renowned for their ability to prevent damage caused by oxidation, to improve the quality of sperm.   Superoxide Dismutase (SOD) is an essential antioxidant enzyme present in UC-MSCs that neutralizes reactive oxygen species (ROS).   Our objective is to examine the influence of UC-MSCs secretome, which includes SOD, on spermatozoa. This research has the potential to significantly transform strategies for enhancing sperm quality. Methods: Thirty couples with primary male infertility (asthenozoospermia) and a good DNA fragmentation index (DFI) participated in the study.   The semen samples were subjected to differential gradient centrifugation (DGC) to prepare the sperm. This was followed by the addition of secretome in a 1:1 ratio and incubated for 30 minutes.   Before and after the incubation, the sperm concentration, velocity, and DNA fragmentation index (DFI) were evaluated.   The growth factors in the secretome of UC-MSCs were examined using enzyme-linked immunosorbent assay (ELISA).   The application of secretome therapy in a 1:1 ratio resulted in a substantial enhancement in both sperm concentration and velocity.   The treatment group had a significant decrease in DFI in comparison to the control group.   Nevertheless, the experimental group exhibited a substantial decrease in SOD levels, suggesting a decline in antioxidant capacity.   The decline in levels of Superoxide Dismutase (SOD) indicates a reduction in the ability to counteract harmful free radicals, which may lead to increased oxidative stress in sperm cells and ultimately result in male infertility. Additional research is essential to comprehend the consequences and mechanisms underlying this decrease and investigate its therapeutic possibilities.  Results: The addition of UC-MSCs secretome to the sperm preparation media improves sperm quality by reducing DNA fragmentation.   Nevertheless, the significant reduction in SOD levels underscores the necessity for additional investigation to fully grasp its impact on male infertility and the possibility for its therapeutic application. Conclusion: The findings of this research point to the possibility that the secretome of UC-MSCs could be useful as an additional component in the development of strategies that aim to increase sperm quality

Azoospermia: A Genomic Review

Azoospermia or the absence of sperm in semen is one of the sperm disorders that results in male infertility. There are two types of azoospermia, the first one isazoospermia caused by obstruction of the vas deferens (obstructive azoospermia) and the second one is azoospermia due to the damage of testes (nonobstructive azoospermia). The etiology of azoospermia could be genetic or non-genetic. Genetic factors may occur in genomics starting from chromosome until gene level or single nucleotide polymorphism (SNPs). At the chromosome level, there is Klinefelter’s syndrome (47, XXY) to the Y chromosome microdeletion, whereas at the gene level there is mutation of jsd, Bmp8b and other genes. At the level of SNPs, Genome Wide SNP Association Study (GWAS) had uncovered 20 SNPs which were related significantly to azoospermia. Extensive knowledge of genomics review on male infertility, is expected to promote the development of investigation and management of azoospermia

Sperm DNA Fragmentation Index: A Comparison Study of Success Rates among Natural, Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF)-Intra Cytoplasmic Sperm Injection (ICSI) Pregnancy Programs

Background:   Some studies have reported a relationship between the sperm DNA fragmentation index (DFI) and the rate of fertilization and pregnancy. This study was designed to assess the mean sperm DNA fragmentation in pregnancies that occur in infertile couples, whether in natural pregnancy, intrauterine insemination (IUI), and in vitro fertilization (IVF) – intra cytoplasmic injection (ICSI). Methods: This research is an observational analytic study with a cross-sectional design. The sample taken in this study were infertile patients that underwent natural pregnancy or IUI or IVF-ICSI at Yasmin Infertility Clinic of Dr. Ciptomangunkusumo Hospital period 2018-2020 with a consecutive sampling technique. The research data was processed and analyzed by the Mann-Whitney test using the SPSS application. Results: The mean DFI of sperm in men with infertile couples who successfully conceived naturally was 10.7% (mild), while IUI was 20.4% (moderate), and IVF-ICSI was 30.5% (poor). The mean DFI in semen samples of men from infertile couples who underwent a natural program was significantly lower in those who successfully conceived compared to those who did not. Similar results were also shown in the IUI and IVF-ICSI programs, which showed a significantly lower DFI compared to non-pregnant women. Conclusion: DFI can be applied as a marker for selecting the type of pregnancy program in infertility management

An update in improving erectile dysfunction therapy in Indonesia by using Li-ESWT and tadalafil combination — vascular endothelial growth factor and peak systolic velocity comparison: a randomized clinical trial

Background: Erectile dysfunction (ED) affects men’s life desperately and the incidence increases continuously. There are a few lines of ED therapy, but there are still many ED cases that have not treated utterly. Therefore, research is needed to obtain the most appropriate line of ED therapy, based on the underlying mechanism of ED. The aim of this study is to analyze the effect of oral daily 2.5 mg of tadalafil administration and twice weekly Low Intensity Extracorporeal Shockwave Therapy (Li-ESWT) for 4 weeks in erectile dysfunction patients, based on Peak Systolic Velocity (PSV) and Vascular Endothelial Growth Factor (VEGF). Methods: A 26-sample clinical trial was conducted with pre and post-test control group design. Random allocation was done to divide the samples into two groups. Control group was given 2.5 mg oral daily tadalafil, while the experimental group, additional twice weekly Li-ESWT was given. Therapies were given for 4 weeks. All subjects were assessed using Erection Hardness Score (EHS) score, International Index of Erectile Function (IIEF-5) score, and Color Doppler Ultrasonography (CDUS) penis for PSV, and plasma level of VEGF twice, prior to and after therapy. Results: The experimental group showed significant improvement compared to the control group in EHS (delta) 2 (1–2) vs 1 (0–2); IIEF-5 (delta) 7 (3–15) vs 4 (0–11); PSV (delta) 2.60 ± 1.34 vs 1.28 ± 1.86; and VEGF (delta) 26.69 ± 24.23 vs 6.32 ± 25.43. Conclusions: Li-ESWT and tadalafil combination therapy improved erectile dysfunction, specifically based on PSV and VEGF parameters