Onco-testicular sperm extraction is used to preserve fertility in patients with bilateral testicular tumors and azoospermia. We report the case of a testicular tumor in the solitary testis of a patient who had previously undergone successful contralateral orchiectomy and whose sperm was preserved by onco-testicular sperm extraction. A 35-year-old patient presented with swelling of his right scrotum that had lasted for 1 month. His medical history included a contralateral orchiectomy during childhood. Ultrasonography revealed a mosaic echoic area in his scrotum, suggesting a testicular tumor. The lesion was palpated within the normal testicular tissue along its edge and semen analysis showed azoospermia. Radical inguinal orchiectomy and onco-testicular sperm extraction were performed simultaneously. Motile spermatozoa were extracted from normal seminiferous tubules under microscopy and were frozen. Eventual intracytoplasmic sperm injection using the frozen spermatozoa is planned. Onco-testicular sperm extraction is an important fertility preservation method in patients with bilateral testicular tumors or a history of a previous contralateral orchiectomy.
Shahedi, Abbas;Talebi, Ali Reza;Mirjalili, Aghdas;Pourentezari, Majid
Clinical and Experimental Reproductive Medicine
/
v.48
no.1
/
pp.27-33
/
2021
Objective: The chief outcome of testicular torsion in clinical and experimental contexts is testicular ischemia. Curcumin, a compound with anti-inflammatory and antioxidant properties, has fascinated researchers and clinicians for its promise in the treatment of fertility diseases. Methods: Thirty-five fully grown male mice were randomly classified into five groups: control, sham, testicular torsion, treatment group 1 (testicular torsion+short-term curcumin), and treatment group 2 (testicular torsion+long-term curcumin). Thirty-five days later, spermatozoa from the right cauda epididymis were analyzed with regard to count and motility. Toluidine blue (TB), aniline blue (AB), and chromomycin A3 (CMA3) staining assays were used to evaluate the sperm chromatin integrity. In addition, the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) test was used to assess apoptosis. Results: Treatment group 1 exhibited a remarkably elevated sperm count compared to the testicular torsion group. Additionally, notably lower sperm motility was found in the testicular torsion group compared to the control, treatment 1, and treatment 2 groups. Staining (CMA3, AB, and TB) and the TUNEL test indicated significantly greater testicular torsion in the torsion group compared to the control group (p<0.05). The data also revealed notably lower results of all sperm chromatin assays and lower apoptosis in both treatment groups relative to the testicular torsion group (p<0.05). Significantly elevated (p<0.05) AB and TB results were noted in treatment group 1 compared to treatment group 2. Conclusion: Curcumin can compensate for the harmful effects of testicular ischemia and improve sperm chromatin quality in mice.
Objective: The purpose of this study was to evaluate outcome of intracytoplasmic sperm injection (ICSI) using epididymal and testicular sperm in patients with azoospermia. Methods: From March, 1993 to May, 1999, a retrospective clinical analysis was done of a total of 140 cycles in 112 patients who underwent ICSI. Subjects were divided into three groups: ejaculated-ICSI group included 42 cycles in 34 patients with ejaculated sperm who underwent ICSI due to severe oligospermia and past history of failed or poor fertilization in the previous in vitro fertilization and embryo tranfer (IVF-ET) cycles, microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection (MESA-ICSI) group included 50 cycles in 42 patients with congenital absence of the vas deferens (CAVD) or unreconstructable obstructive azoospermia and testicular sperm extraction and intracytoplasmic sperm injection (TESE-ICSI) group included 48 cycles in 36 patients with no spermatozoa which can be retrieved from epididymis or non-obstructive azoospermia. Results: Normal two-pronuclear fertilization rates were similar in three groups: 64.4% for ejaculated-ICSI group, 59.4% for MESA-ICSI group and 60.4% for TESE-ICSI group. The pregnancy rates were 26.2%, 26.0% and 25.0% respectively. There were no significant differences in the fertilization, cleavage, and clinical pregnancy rates among ICSI cycles using ejaculated, epididymal and testicular sperm. Conclusion: Epididymal and testicular sperm obtained in azoospermic patients can fertilize oocyte successfully and may lead to be similar fertilization rates and clinical pregnancy rates to ejaculated sperm.
Salehi, Peyman;Derakhshan-Horeh, Marzieh;Nadeali, Zakiye;Hosseinzadeh, Majid;Sadeghi, Erfan;Izadpanahi, Mohammad Hossein;Salehi, Mansour
Clinical and Experimental Reproductive Medicine
/
v.44
no.1
/
pp.22-27
/
2017
Objective: Azoospermia owing to testicular disorders is the most severe manifestation of male infertility. The main concern for patients with nonobstructive azoospermia (NOA) is the probability of successful sperm retrieval following testicular sperm extraction (TESE). Therefore, the goal of this study was to determine predictive factors correlated with sperm retrieval. Methods: We assessed the testicular histopathological patterns, the choice of TESE surgical procedure, hormone levels, and chromosomal abnormalities in patients with NOA (n=170). The histopathology specimens were analyzed based on the histopathological patterns of hypospermatogenesis, maturation arrest, and Sertoli cell-only syndrome. Results: The mean rate of sperm retrieval was 48.8%. The rate of sperm retrieval was significantly higher in the hypospermatogenesis group than in the other groups (p<0.001). There was a positive correlation between micro-TESE (vs. conventional TESE) and the sperm retrieval rate (odds ratio, 8.077; p<0.01). A logistic regression model demonstrated that high levels of follicle-stimulating hormone (FSH) and small testicular volume were significantly associated with lower chances of successful sperm retrieval. Conclusion: Some parameters, including testicular histopathology patterns, FSH levels, testicular volume, and method of TESE surgery, may be able to predict the chances of obtaining spermatozoa in patients with NOA. However, despite the efficiency of some predictive models, the hope of retrieving any functioning spermatozoa may be sufficient to disregard predictive factors of the success of intracytoplasmic sperm injection in these patients.
Purpose : These studies were undertaken to evaluate the effects of the Cynomorii Herba (CH) on the spermatogenic abilities such as the concentration, motility and morphological normality of sperm from the testis, and the activities of sperm hyaluronidase, testicular peroxidase and testicular catalase. Materials and Methods : We used the 2-month-old mice and administered 0.2ml extract solution of CH in the 0.1mg/ml, 1mg/ml, 10mg/ml and 100mg/ml once a day for 60days. The control group was administered the distilled water in the same way. After the administration of extract solution, we examined the number of total, motile and normal sperm from the cauda epididymis, the activities of sperm hyaluronidase, testicular peroxidase and testicular catalase. We observed the histological changes of isolated testis and compared to the testicular tissue especially seminiferous tubules between control and CH groups by histochemical method. Results : The concentration of total sperm and the motility of spermatozoa were significantly increased in the 1mg/ml, 10mg/ml and 100mg/ml CH groups, especially in 10mg/ml group, compared to the control group. The significant differences were observed in the normality of spermatozoa of the CH groups compared to the control group. In the histolocal analysis of the testicular tissues, the enlargement of testicular lobe diameter and apparent vasculogenesis between testicular lobes were observed in the CH groups compared to the control group. Also, the activity of hyaluronidase was significantly increased in the CH groups compared to the control group. In the antioxidant activity analysis, the activities of testicular peroxidase and testicular catalase were significantly increased in the CH groups compared to the control group, respectively. Conclusion : This study shows that CH has the beneficial effect on the concentration, morphology and motility of sperm, the activities of sperm hyaluronidase, testicular peroxidase and testicular catalase. We can suggest that CH extract solution be useful for the treatment of male sexual dysfunctions and infertility.
The aim of this study was to evaluate the improvement of testicular sperm motility following different culture conditions such as human follicular fluid (hFF) and temperature. Testicular tissues obtained from azoospermia (n=21) were minced into small pieces by blade and recovered sperm suspension were cultured in Ham's F10 with or without 40% hFF at different temperatures (Group I: 37$^{\circ}C$/with hFF, Group II: 32$^{\circ}C$/withGroup III: 37$^{\circ}C$/without, Group IV:32$^{\circ}C$ /without The motility and viability of sperm were monitored during culture for 48 hours. Initial motility of testicular sperm was 10.9$\pm$1.9%. After 24 hours culture, sperm motility was 23.5$\pm$2.1% (Group I), 8.1$\pm$1.1% (Group II), 10.4$\pm$ 1.4% (Group III) and 4.0$\pm$0.8% (Group IV), respectively. After 48 hours, the motility had been changed as 32$\pm$2.3% (Group I), 14.3$\pm$1.7% (Group II), 5.3 $\pm$1.4% (Group III) and 4.3$\pm$0.9% (Group IV). In hFF group (I and II), sperm motility of group I cultured at 37$^{\circ}C$ was higher than those of group II at 32$^{\circ}C$. But, sperm viability of group I cultured at 37$^{\circ}C$ was lower than those of group II at 32$^{\circ}C$ (54.4$\pm$4.1% vs. 59.4$\pm$3.7%) after cultured for 48 hours. We acquired the best motility of testicular sperm when performed in vitro culture for 48 hours in hFF supplemented medium at 37$^{\circ}C$. Increase of sperm motility by in vitro culture could be useful tool fur human TESE-ICSI program.
Purpose : These studies were undertaken to evaluate the effects of the administration of different concentrated Morindae officinalis Radix extract solution on the spermatogenic abilities such as concentration, motility and morphological normality of sperm from the testis and the activities of sperm hyaluronidase, testicular peroxidase and testicular catalase. Methods : We used the 2-month-old mice and administered the extract solution of Morindae officinalis Radix in the different concentration once a day for 60 days. The control group was administered the normal saline in the same way and duration. We examined the number of total, motile and normal sperm from the cauda epididymis, the activities of sperm hyaluronidase, testicular peroxidase and testicular catalase. Also we observed changes of isolated testis before and after administration of Morindae officinalis Radix extract solutions the mice. And we compared to the testicular tissue especially seminiferous tubules between control and treated group by histochemical methods. Results : The significant dose-dependent differences were observed in the concentration of total sperm, the motility and normality of spermatozoa of Morindae officinalis Radix extract solution administered groups compared to the control group, respectively. In the histological analysis of the testicular tissues, the enlargement of testicular lobe diameter and apparent vasculogenesis between testicular lobes were observed in the Morindae officinalis Radix extract solution administered groups compared to the control group, respectively. Also, the activity of hyaluronidase was significantly increased in the Morindae officinalis Radix extract solution administered groups compared to the control group. In the antioxidant activity analysis, the activity of testicular peroxidase was significantly increased in the Morindae officinalis Radix extract solution administered groups compared to the control group, respectively. Conclusion : This study shows that Morindae officinalis Radix has the beneficial effect on the concentration, morphology and motility of sperm, the activities of sperm hyaluronidase and testicular peroxidase. We can suggest that Morindae officinalis Radix extract solution be useful for the treatment of male sexual dysfunctions and infertility.
Purpose : These studies were undertaken to evaluate the effects of Allii tuberosi Semen (ATS) on the spermatogenic abilities such as concentration, motility and morphological normality of sperm from the testis and the activities of sperm hyaluronidase, testicular peroxidase and testicular catalase. Materials and Methods : We used the 8-week-old mice and administered the 0.2 ml extract solution of ATS in the different concentration (0.1 mg/ml, 1 mg/ml, 10 mg/ml and 100 mg/ml) once a day for 60 days. The control group was administered the distilled water in the same way. After the administration of each extract solution, we examined the number of total, motile and normal sperm, the activities of sperm hyaluronidase, testicular peroxidase and testicular catalase. Also we observed the histological changes of isolated testis. And we compared to the testicular tissue especially seminiferous tubules between control and treated group by histochemical methods. Results : The concentration of total sperm, the motility and normality of spermatozoa were significantly increased in ATS groups, especially in 1 and 10 mg/ml groups, compared to control group. In the histological analysis of the testicular tissues, the enlargement of testicular lobe diameter and apparent vasculogenesis between testicular lobes were observed in the ATS groups compared to the control group, respectively. Also, the activity of hyaluronidase was significantly increased in the ATS groups compared to the control group. In the antioxidant activity analysis, the activity of testicular peroxidase was significantly increased in the ATS groups compared to the control group, especially in 1 mg/ ml group. The activity of testicular catalase was increased in ATS groups. Conclusion : This study shows that ATS has the beneficial effect on the concentration, morphology and motility of sperm, the activities of sperm hyaluronidase and testicular peroxidase. We can suggest that ATS extract solution be useful for the treatment of male sexual dysfunctions and infertility.
Park, Yong-Seog;Lee, Hyoung-Song;Song, Sang-Jin;Kim, Jeong-Wook;Kang, Inn-Soo;Seo, Ju-Tae
Clinical and Experimental Reproductive Medicine
/
v.27
no.3
/
pp.267-273
/
2000
Objectives: We have previous reported that thawed testicular sperm and sperm extracted from seminiferous tubule could achieved optimal fertilization and pregnancy in azoospermic patients. However, thawed testicular sperm did not show motility in many cases. Therefore we studied viability of immotile sperm extracted from frozen-thawed seminiferous tubule using hypo-osmotic swelling (HOS) test and eosin-Y test. Materials and Methods: After sperm extraction using for ICSI, the remained sections of seminiferous tubules were frozen with a computerized freezer. For thawing and preparation of testicular sperm, the seminiferous tubules were thawed by removing from $LN_2$ and letting them at room temperature for 10 min followed by %37^{\circ}C$ water bath for 10 min. The prepared samples were washed for free of preservation medium and sperm preparation method described previous. Sperm was suspended in 0.1 ml hypoosmotic solution. After 30 minutes, the type of distally coiled sperm were assessed. Results: In 44 cases of cryopreservation of seminiferous tubules in obstructive azoospennic patients, the fertilization rates with 2PN were 71.4% and pregnancy rates were 34.1%. The presence of motile spermatozoa on subsequent post-thaw testicular sperm remarked 15.1% and were increased to 77.3% just before ICSI. After sperm extracted from frozen-thawed seminiferous tubule, 3 hrs later in in vitro culture, the cases of presence of motile sperm, reaction of hypo-osmotic swelling test and viable sperm were 63.6% (28/44), 93.2% (41/44), and 77.3% (34/44), respectively. Conclusions: Just after post-thawed testicular sperm did not showed motility. Although motility was gained after in vitro culture, many cases showed non-motile sperm until optimal insemination time. However, HOS test showed positive reaction in non-motile sperm. Therefore, HOS test is an alternative method for the selection of viable sperm for ICSI.
Objective: Testicular fat deposition has been reported to affect animal reproduction. However, the underlying mechanism remains poorly understood. The present study explored whether sperm meiosis and testosterone synthesis contribute to mouse testicular fat deposition-induced reproductive performance. Methods: High fat diet (HFD)-induced obesity CD1 mice (DIO) were used as a testicular fat deposition model. The serum hormone test was performed by agent kit. The quality of sperm was assessed using a Sperm Class Analyzer. Testicular tissue morphology was analyzed by histochemical methods. The expression of spermatocyte marker molecules was monitored by an immuno-fluorescence microscope during meiosis. Analysis of the synthesis of testosterone was performed by real-time polymerase chain reaction and reagent kit. Results: It was found that there was a significant increase in body weight among DIO mice, however, the food intake showed no difference compared to control mice fed a normal diet (CTR). The number of offspring in DIO mice decreased, but there was no significant difference from the CTR group. The levels of follicle-stimulating hormone were lower in DIO mice and their luteinizing hormone levels were similar. The results showed a remarkable decrease in sperm density and motility among DIO mice. We also found that fat accumulation affected the meiosis process, mainly reflected in the cross-exchange of homologous chromosomes. In addition, overweight increased fat deposition in the testis and reduced the expression of testosterone synthesis-related enzymes, thereby affecting the synthesis and secretion of testosterone by testicular Leydig cells. Conclusion: Fat accumulation in the testes causes testicular cell dysfunction, which affects testosterone hormone synthesis and ultimately affects sperm formation.
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