WHO laboratory manual for the examination and processing of human semen

Background In women, anti-Mullerian hormone (AMH) levels may represent the ovarian follicular pool and could be a useful marker of ovarian reserve. The clinical application of AMH measurement has been proposed in the prediction of quantitative and qualitative aspects in assisted reproductive technologies (ART). In men AMH is secreted in both the serum and seminal fluid. Its measurement may be useful in clinical evaluation of the infertile male. Methods The PubMed database was systematically searched for studies published until the end of January 2009, search criteria relevant to AMH, ovarian reserve, ovarian response to gonadotrophin stimulation, spermatogenesis and azoospermia were used. Results AMH seems to be a better marker in predicting ovarian response to controlled ovarian stimulation than age of the patient, FSH, estradiol and inhibin B. A similar performance for AMH and antral follicular count has been reported. In clinical practice, AMH measurement may be useful in the prediction of poor response and cycle cancellation and also of hyper-response and ovarian hyperstimulation syndrome. In the male, the wide overlap of AMH values between controls and infertile men precludes this hormone from being a useful marker of spermatogenesis. Conclusions As AMH may permit the identification of both the extremes of ovarian stimulation, a possible role for its measurement may be in the individualization of treatment strategies in order to reduce the clinical risk of ART along with optimized treatment burden. It is fundamental to clarify the cost/benefit of its use in ovarian reserve testing. Regarding the role of AMH in the evaluation of infertile men, AMH as single marker of spermatogenesis does not seem to reach a satisfactory clinical utility.

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Anti-Müllerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART)

http://xrm.phys.northwestern.edu/research/pdf_papers/2000/flesch_bba2000.pdf

Dynamics of the mammalian sperm plasma membrane in the process of fertilization.

The human genome encodes 30,000 to 40,000 proteins, and a major challenge is to understand how posttranslational events, such as glycosylation, affect the activities and functions of these proteins in health and disease. Glycosylated proteins are ubiquitous components of extracellular matrices and cellular surfaces where their oligosaccharide moieties are implicated in a wide range of cell-cell and cell-matrix recognition events. The power of ultrahigh-sensitivity mass spectrometric strategies for defining the primary structures of highly complex mixtures of glycoprotein glycoforms is set to revolutionize structural glycobiology in the coming postgenomic era.

https://science.sciencemag.org/content/sci/291/5512/2351.full.pdf

Glycoprotein structure determination by mass spectrometry

UNLABELLED The objectives of this cross-sectional observational study were: (i) to detect DNA damage and plasma membrane translocation of phosphatidylserine in purified sperm populations of high and low motility, and (ii) to analyse their relationship with the endogenous generation of reactive oxygen species. Ejaculates from infertile men were examined following gradient centrifugation. The main outcome measures were: sperm motion parameters (assessed with a computer analyser), generation of reactive oxygen species (measured by chemiluminescence), DNA damage (detected by terminal deoxynucleotidyl transferase-mediated dUDP nick-end labelling and monoclonal antibody labelling of single-stranded DNA) and translocation of membrane phosphatidylserine (examined with annexin V staining). DNA fragmentation and membrane translocation of phosphatidyl-serine were observed in the fractions with low and high sperm motility in all patients. The fractions with low sperm motility had significantly higher proportion of cells with DNA damage and production of reactive oxygen species than the fractions with high sperm motility (P < 0.005). DNA fragmentation was significantly and positively correlated with the generation of reactive oxygen species (r = 0.42; P = 0.02). IN CONCLUSION (i) spermatozoa from infertile men display translocation of membrane phosphatidylserine as diagnosed by annexin V positive staining; (ii) DNA damage (fragmentation and presence of single-stranded DNA) can be detected in ejaculated spermatozoa from infertile men in fractions with low and high sperm motility, and (iii) there is a relationship between DNA damage and oxidative stress.

https://www.researchgate.net/profile/Gerardo_Barroso2/publication/12485729_Analysis_of_DNA_fragmentation_plasma_membrane_translocation_of_phosphatidylserine_and_oxidative_stress_in_human_spermatozoa/links/00463525471a272760000000.pdf

Analysis of DNA fragmentation, plasma membrane translocation of phosphatidylserine and oxidative stress in human spermatozoa

https://www.fertstert.org/article/S0015-0282(97)81449-5/pdf

Clinical significance of human sperm-zona pellucida binding

What is the optimum maximal gonadotropin dosage used in microdose flare-up cycles in poor responders?

https://www.fertstert.org/article/S0015-0282(15)00458-6/pdf

Perinatal outcomes after fresh versus vitrified-warmed blastocyst transfer: retrospective analysis.

This study aimed to determine whether the presence of endometrial polyps discovered during ovarian stimulation affects the outcomes of intracytoplasmic sperm injection (ICSI) cycles. This retrospective descriptive study was conducted in a private assisted reproductive technology unit. Medical records of ICSI cycles performed between January 2003 and December 2004 were reviewed. Patients were divided into three groups: patients with endometrial polyps discovered during ovarian stimulation (group 1, n = 15), patients who underwent hysteroscopic polyp resection prior to their ICSI cycle (group 2, n = 40) and patients without polyps (group 3, n = 956). Main outcome measures were clinical pregnancy rates and implantation rates. Age of the patients, age of the husbands, body mass index, total amount of gonadotrophins used, length of stimulation, peak oestradiol concentrations, peak endometrial thickness and number of embryos replaced were not significantly different between the groups, nor were the pregnancy and implantation rates. Only one patient (12.5%) from the first group experienced miscarriage within 12 weeks of pregnancy. In conclusion, endometrial polyps discovered during ovarian stimulation do not negatively affect pregnancy and implantation outcomes in ICSI cycles.

https://www.rbmojournal.com/article/S1472-6483(10)60861-9/pdf

Endometrial polyps smaller than 1.5 cm do not affect ICSI outcome.

This retrospective study was designed to reveal the effect of smoking on semen parameters in an infertile Turkish population. Two hundred and ninety-six infertile males were triaged as nonsmokers, light smokers and heavy smokers. Semen volume; sperm density, motility and morphology were the main outcome measures. Rapidly progressing sperm ratio of the heavy smokers group was greater than that of the light smokers group (p<0.05). Morphologic evaluation results revealed better results for the nonsmokers than the heavy smokers in terms of tail anomalies and percent of coiled tails (p<0.05) In infertile Turkish men, heavy smoking was found to have detrimental effects on tail of the spermatozoon. Interestingly, heavy smokers have a higher percent of rapidly progressive sperm with respect to light smokers. Prospective studies will help determining the definite effect of smoking on semen quality.

Kemal Ozgur

Papers

Clinical significance of human sperm-zona pellucida binding

What is the optimum maximal gonadotropin dosage used in microdose flare-up cycles in poor responders?

Perinatal outcomes after fresh versus vitrified-warmed blastocyst transfer: retrospective analysis.

Endometrial polyps smaller than 1.5 cm do not affect ICSI outcome.

Semen quality of smoking and non-smoking men in infertile couples in a Turkish population