A Agarwal

Cigarette smoking in infertile men is highly correlated with leukocytospermia and oxidative stress.

CORRELATED WITH LEUKOCYTOSPERMIA AND OXIDATIVE STRESS Ramadan A. Saleh, Rakesh K. Sharma, Engin Kandirali, The Cleveland Clinic Foundation, Donald P. Evenson, South Dakota State University, Anthony J. Thomas, Ashok Agarwal, The Cleveland Clinic Foundation Objective: Epidemiological studies have indicated an association between cigarette smoking and decreased fecundity. However, the impact of smoking on male fertility remains controversial. The objective of this study was to investigate semen quality, levels of seminal oxidative stress (OS) and sperm DNA damage among infertile men with a history of smoking.

Correlation of reactive oxygen species in neat semen with sperm chromatin structure assay-defined sperm DNA damage.

WITH SPERM CHROMATIN STRUCTURE ASSAY-DEFINED SPERM DNA DAMAGE Ramadan A. Saleh, The Cleveland Clinic Foundation, Kjersten L. Larson, South Dakota State University, Rakesh K. Sharma, Anthony J. Thomas, The Cleveland Clinic Foundation, Donald P. Evenson, South Dakota State University, Ashok Agarwal, The Cleveland Clinic Foundation Objective: Artificially induced reactive oxygen species (ROS) has been shown to cause an increase in DNA fragmentation. Increased levels of ROS in neat semen may reflect oxidative stress (OS) status in vivo. The objective of this study was to examine the relationship between ROS levels in neat semen and the susceptibility of sperm chromatin to acid-induced denaturation in situ as measured by sperm chromatin structure assay (SCSA).

Paternal age and assisted reproductive technologies: problem solver or trouble maker?

In our society, the number of couples with advanced reproductive age seeking fertility treatment is increasing steadily. While the negative effect of female age on assisted reproductive technology (ART) outcomes is well established, the impact of paternal age needs to be clarified. We reviewed the current literature to determine whether advanced paternal age affects the results of ART and the health of resulting offspring. We found that the published literature is overall supportive of a positive association between advanced paternal age (>40 years) and semen quality deterioration. However, the existing evidence does not corroborate nor discard the influence of advanced paternal age on ART outcomes. Similarly, the effect of paternal age on the health of ART offspring remains equivocal, although data from naturally-conceived children clearly indicates that advanced paternal age increases the frequency of genetic, neurodevelopmental, and psychiatric diseases in the progeny. Noteworthy, the current literature is limited and subjected to bias due to the impact of maternal age as a critical confounder. Health care providers should discuss with concerned couples the available options to counteract the possible negative influence of advanced paternal age on ART outcomes and health of resulting offspring. These include identification and treatment of underlying conditions with potential negative long-term effects on fertility, sperm freezing at a young age, and use of antioxidant supplements for men at risk of excessive oxidative stress. Aged male partner from couples undergoing ART, in particular men of 50 years and older, should consider use of preimplantation genetic testing as a means to detect embryo abnormalities and select euploid embryos for transfer to the uterine cavity.

Evaluation of reference values of standard semen parameters in fertile Egyptian men

The reference values of human semen, published in the WHOs latest edition in 2010, were lower than those previously reported. The objective of this study was to evaluate reference values of standard semen parameters in fertile Egyptian men. This cross‐sectional study included 240 fertile men. Men were considered fertile when their wives had recent spontaneous pregnancies with time to pregnancy (TTP) ≤12 months. The mean age of fertile men was 33.8 ± 0.5 years (range 20–55 years). The 5th percentiles (95% confidence interval) of macroscopic semen parameters were 1.5 ml for volume and 7.2 for pH. The 5th percentiles of microscopic parameters were 15 million/ml for sperm concentration, 30 million per ejaculate for total sperm count, 50% for total motility, 40% for progressive motility, 62% for vitality, 4% for normal sperm forms and 0.1 million/ml for seminal leucocyte counts. In conclusion, fertile Egyptian men had higher reference values of sperm total motility, progressive motility and vitality, and lower reference values for total sperm counts as compared to those determined by the latest edition of the WHO laboratory manual in 2010. Other semen parameters were identical to those defined by the WHO 2010 manual.

Human sperm handling in intracytoplasmic sperm injection processes: In vitro studies on mouse oocyte activation, embryo development competence and sperm oxidation–reduction potential

Polyvinylpyrrolidone (PVP) and hyaluronic acid (HA) are routinely used in handling spermatozoa for intracytoplasmic sperm injection (ICSI). As there are still concerns about possible adverse effects on the embryo, this study investigated sperm handling in a mouse ICSI model to (i) evaluate oocyte activation after injection of spermatozoa selected for rotational or linear motion in PVP; (ii) assess the effect of sperm selection in PVP, HA and medium on oocyte activation; (iii) examine the effects of PVP and HA on parthenogenetic oocyte activation and embryo development; and (iv) assess the oxidation–reduction potential (ORP) of spermatozoa exposed to PVP, HA or medium. Oocyte activation was higher when spermatozoa exhibited rotational motion rather than linear motion (79% vs. 52%; p = .05). There was no difference in oocyte activation and embryo development after parthenogenetic oocyte activation after sperm injection using PVP, HA or medium‐incubated spermatozoa. PVP‐selected spermatozoa exhibited lower (p < .0001) ORP levels than using HA. Thus, results indicate that the sperm handling method and the type of medium used impact ICSI outcomes. Overall, sperm incubation in PVP, HA and medium yields similar outcomes with regard to oocyte activation and embryo development. However, PVP provides more antioxidative protection than HA and should therefore be preferred for sperm manipulation.

Leukocytospermia is associated with poor semen quality, oxidative stress and increased DNA damage.

QUALITY, OXIDATIVE STRESS AND INCREASED DNA DAMAGE Ramadan A. Saleh, The Cleveland Clinic Foundation, Juan G. Alvarez, Beth Israel Medical Center, Harvard Medical School, Essam A. Nada, Sohag Faculty of Medicine, Mohamed H. El-Tonsy, al-Minya Faculty of Medicine, Donald P. Evenson, South Dakota State University, Ashok Agarwal, The Cleveland Clinic Foundation Objective: The incidence of leukocytospermia ranges from 10% to 20% among infertile men. However, the role of leukocytospermia in the pathogenesis of male infertility remains highly controversial. Our study evaluated the relationship between leukocytospermia and standard semen parameters, levels of seminal reactive oxygen species (ROS), and the extent of sperm nuclear DNA damage.

Increased potential for high reactive oxygen species generation in pure sperm from leukocytospermic patients.

GENERATION IN PURE SPERM FROM LEUKOCYTOSPERMIC PATIENTS Ramadan A. Saleh, Rakesh K. Sharma, Engin Kandirali, The Cleveland Clinic Foundation, Essam A. Nada, Sohag Faculty of Medicine, Anthony J. Thomas, Ashok Agarwal, The Cleveland Clinic Foundation Objective: Phorbol 12-myristate 13-acetate (PMA) is the most powerful stimulant of cellular generation of reactive oxygen species (ROS). Enhanced PMA response has been correlated with poor semen quality, reduced sperm fertilizing potential and male infertility. The objective of this study was to investigate PMA response in pure sperm (free of leukocyte contamination) obtained from leukocytospermic patients.