Yong-Seog Park

Efficacy of testicular sperm chromatin condensation assay using aniline blue-eosin staining in the IVF-ET cycle

Objective This study was performed to evaluate testicular sperm chromatin condensation using aniline blue-eosin (AB-E) staining and its effects on IVF-ET. Methods Chromatin condensation was analyzed using AB-E staining in 27 cases of testicular sperm extraction. There were 19 cases of obstructive azoospermia (OA) and 8 cases of non-obstructive azoospermia (NOA) in IVF-ET. Mature sperm heads were stained red-pink whereas immature sperm heads were stained dark blue. The percentage of sperm chromatin condensation was calculated from the ratio of the number of red-pink sperm to the total number of sperm analyzed. Results The overall percentages of chromatin condensation in OA and NOA were 31.1±11.2% and 26.3±14.4%, respectively. The fertilization rate was significant higher in OA than NOA (p<0.05); however, the rates of good embryos and clinical pregnancy did not show statistical differences. In OA and NOA, statistical differences were not observed in the rate of chromatin condensation, fertilization, good embryos, and clinical pregnancy between the pregnant group and non-pregnant group. Conclusion Chromatin condensation is less stable than OA and showed a low fertilization rate in NOA. While there were no significant differences in chromatin condensation results between NOA and OA, we propose that a pattern of decreased chromatin condensation in NOA is one of the factors of low fertilization results requiring further study.

Poor sperm quality affects clinical outcomes of intracytoplasmic sperm injection in fresh and subsequent frozen-thawed cycles : potential paternal effects on pregnancy outcomes

OBJECTIVE To evaluate objectively whether poor sperm quality affects sequential events from fertilization to delivery in fresh intracytoplasmic sperm injection (ICSI) and subsequent frozen-thawed embryo transfer (ET) cycles. DESIGN Retrospective study. SETTING University-based centers for reproductive medicine. PATIENT(S) For unbiased comparison, 206 cycles were chosen from 1,999 cycles of patients who underwent ICSI-ET and/or subsequent frozen-thawed ET. Cycles met the following criteria: day 3 ET; female age, <40 y; number of retrieved oocytes, >or=5; no split insemination; and no female factors but tubal factor. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The rates of fertilization, embryo implantation, clinical pregnancy, and delivery and sequential embryonic score (SES) were compared between normal-spermatogenesis patients (NSPs) and defective-spermatogenesis patients (DSPs). RESULT(S) Although sum SES, mean SES, and top SES of transferred embryos on day 3 were similar between NSPs and DSPs, the rates of implantation, clinical pregnancy, and delivery of NSPs were significantly higher than those of DSPs. Furthermore, subsequent ET cycles with frozen-thawed embryos in NSPs and DSPs who failed to achieve pregnancy in their fresh cycles showed that rates of implantation and clinical pregnancy also were significantly lower in DSPs. CONCLUSION(S) Quality of sperm may influence embryo implantation and subsequent pregnancy outcomes without impairment of embryo quality.

Observation of sperm-head vacuoles and sperm morphology under light microscope

Objective The presence of sperm-head vacuoles has been suspected to be deleterious to the outcomes of assisted reproductive technology (ART). It is difficult to accurately distinguish morphologically abnormal sperm with vacuoles under a light microscope. This study was performed to analyze the result of the observation of sperm-head vacuoles using Papanicolaou staining under a light microscope and whether the male partners age affects these vacuoles. Methods Sperm morphology with vacuoles was evaluated using Papanicolaou staining and observed under a light microscope (400×) in 980 men. The normal morphology was divided into three categories (group A, <4% of normal morphology; group B, 4%-14% of normal morphology; and group C, >14% of normal morphology). The criteria for the sperm-head vacuoles were those given in the World Health Organization manual. For the analysis of the age factor, the participants were divided into the following groups: 26-30 years, 31-35 years, 36-40 years, 41-45 years, and 46-50 years. Results The percentage of sperm-head vacuoles increased with normal sperm morphology (group A vs. groups B, C) (p<0.05). In the case of the age factor, a statistically significant difference was not observed across any of the age groups. Conclusion A majority of the sperm-head vacuoles showed a statistically significant difference among normal morphology groups. Therefore, we should consider the probability of the percentage of sperm-head vacuoles not increasing with age but with abnormal sperm morphology. A further study is required to clarify the effect of the sperm-head vacuoles on ART outcomes.

Effect of testicular spermatozoa on embryo quality and pregnancy in patients with non-obstructive azoospermia

Abstract This study was performed to assess and compare the outcomes of testicular sperm extraction (TESE)-intracytoplasmic sperm injection (ICSI) using spermatozoa from fresh and frozen testicular tissue from men with subgroups of non-obstructive azoospermia (NOA). A total of 110 cycles of TESE-ICSI were performed. Patients were classified into one of the following NOA subgroups: hypospermatogenesis (HS), maturation arrest (MA), or Sertoli cell-only syndrome (SCO). Laboratory (fertilization, cleavage stage of embryo, and good quality embryo) and clinical (pregnancy, clinical pregnancy, implantation, and delivery) outcomes were assessed. No statistically significant differences were observed in any of the other measured parameters between the three subgroups of NOA. No significant differences in laboratory outcomes were observed between spermatozoa from fresh and frozen testicular spermatozoa; however, statistically significant differences were observed in the pregnancy and implantation rates between groups (p < 0.05). The outcomes of using spermatozoa retrieved from fresh testicular tissue in each of the three subgroups were also compared; although clinical outcomes showed low results, no significant differences were observed between the three subgroups. Similarly, no significant differences were observed in spermatozoa retrieved from frozen testicular tissue. Once spermatozoa have been successfully obtained, acceptable laboratory outcomes can be achieved for NOA, whether or not the spermatozoa are cryopreserved. However, satisfactory clinical outcomes may be more difficult to achieve as the results showed in each group of fresh and frozen testicular spermatozoa. Therefore, achieving acceptable clinical pregnancy results and efficient cryopreservation of testicular spermatozoa should be considered in patients with NOA.

Comparison of the clinical outcomes of day 4 and 5 embryo transfer cycles

Objective The majority of embryo transfers (ETs) to date have been performed on day 3 to reduce the potential risk of developmental arrest of in vitro cultured embryos before ET. Development of sequential media has significantly improved culture conditions and allowed blastocyst transfer on day 5. While day 5 ET provides higher clinical pregnancy outcomes with reduced risks of multiple pregnancies, it still has potential risks of developmental arrest of IVF embryos. The aim of this study was to evaluate the clinical outcomes of day 4 ETs and compare the efficacy of day 4 ET with day 5 ET. Methods From 2006 to 2009, a total of 747 fresh IVF-ET cycles were retrospectively analyzed (day 4, n=440 or and day 5, n=307). The cycles with any genetic factors were excluded. The rates of matured oocytes, fertilization, good embryos, and clinical pregnancy of the two groups were compared. The chi-square test and t-test were used for statistical analysis. Results There were no significant differences between the two groups with respect to the mean age of the females and rates of matured oocytes. The pregnancy outcomes of day 4 ET (40.7%) were similar to those of day 5 ET (44.6%). The implantation rate of day 5 ET (24.2%) was significantly higher than that of day 4 ET (18.4%) (p=0.003). Conclusion Day 4 ET can be chosen to avoid ET cancellation in day 5 ET resulting from suboptimal circumstances in the IVF laboratory, but the decremented quality of embryos for transfer and the decreased pregnancy rate must be taken into consideration.

Do cigarette smoking and obesity affect semen abnormality in idiopathic infertile males

Purpose This study was conducted to find the relative risk of semen abnormality with respect to smoking history and obesity. Materials and Methods Subfertile or infertile men were enrolled in this study from July 2010 to June 2011. All participants provided their cigarette use information, self-reported weight, height, semen analysis, physical examination, and sexually transmitted disease status. None of the enrolled patients had any specific pathological reason for infertility. Semen abnormality was defined as a condition in which one or more parameters did not satisfy the World Health Organizations criteria. Results A total of 1,073 male patients were considered for this study. After the application of the inclusion criteria, 193 patients were finally analyzed. These patients were divided into two groups according to semen abnormality: the normal semen group (n=72) and the abnormal semen group (n=121). Baseline characteristics, except age and smoking history, were not significantly different between the two groups. Smoking history and age were risk factors for the semen abnormality of idiopathic infertile male patients. Conclusions Smoking and old age were risk factors for semen abnormality. However, obesity did not affect the semen abnormality. Smoking affected semen quality and is therefore expected to play a negative role in conception.