Evaluation and Management of Male Infertility
Steven R. Bayer, Michael M. Alper, Alan S. Penzias in The Boston IVF Handbook of Infertility, 2017
A semen analysis is the principal laboratory evaluation of the infertile male and helps to define the severity of the male factor. An abstinence period of 2 to 3 days is necessary before semen can be collected by masturbation or by intercourse using special semen collection condoms that do not contain substances detrimental to sperm (i.e., lubricants/spermicide). The specimen may be collected at home or at the laboratory. The specimen should be kept at room temperature or, ideally, body temperature during transport and examined within 1 hour of collection.
Semen Analysis and Sperm Washing Techniques
Claude Gagnon in Controls of Sperm Motility, 2020
If at all possible, semen samples should be provided at the laboratory or clinic so that analysis can start within 30 min of ejaculation. Only wide-mouthed sterile containers made of tissue culture-grade plastic (which is known not to have any detrimental effect upon spermatozoa) should be used for semen collection. Samples should be clearly identified upon receipt in the laboratory and kept at 37°C for 20 to 30 min to liquefy before commencing the analysis.
Male infertility
C. Yan Cheng in Spermatogenesis, 2018
Semen collection for a semen analysis requires 2–5 days of abstinence, collection without the use of spermicidal or toxic lubricants, and processing typically within 1 hour of collection. Semen should be maintained at room or body temperature prior to analysis. No upper limit of normal exists; however, as mentioned earlier, the lower limit of volume is 1.5 mL. The differential diagnosis for men presenting with low semen volume includes incomplete collection, retrograde ejaculation, testosterone deficiency, obstructed ejaculatory ducts, absent seminal vesicles, or congenital bilateral absence of the vas deferens. The latter is diagnosed by physical examination of the scrotum where no vas deferens are palpable. Here, hypoplastic seminal vesicles are often associated. Obstructed ejaculatory ducts is suspected with low volume, acidic semen with low fructose, and absent or few poorly motile sperm. Digital rectal examination may also be positive for a midline cyst at the level of the prostate. Transrectal ultrasound (TRUS) is confirmatory with dilated seminal vesicles >1.5 cm in diameter and often a midline cystic structure. Management of ejaculatory duct obstruction includes TURED with the guidance of TRUS. Low testosterone is diagnosed by serum testing. Men found to have low testosterone cannot be placed on exogenous testosterone. The exogenous testosterone will provide negative feedback to the anterior pituitary and hypothalamus, consequently downregulate the hypothalamic-pituitary-testes (HPT) axis and inhibit release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This suppresses spermatogenesis. Alternatively, many practitioners use selective estrogen receptor modulators (SERMs) such as clomiphene to upregulate the HPT axis and endogenous testosterone production. In central pituitary or hypothalamic abnormalities, human chorionic gonadotropins (hCG), recombinant FSH, or human menopausal gonadotropins (hMGs) may be used.
SARS-CoV-2 effects on male reproduction: should men be worried??
Published in Human Fertility, 2023
Marziye Farsimadan, Mohammad Motamedifar
Another thing to be acknowledged is that semen collection is usually performed by masturbation and it is not a sterile procedure and there is a possibility that specimen containers might be contaminated with respiratory droplets which would result in false-positive results. The caseload presented in some of these studies lacks proper description and needs to be cautiously interpreted (Li, Yin, et al., 2020; Ning et al., 2020). Aside from that, the results of these studies cannot be generalised to men in critical condition. Most of these studies investigated the infected males who were tested several weeks after infection (Song, Wang, et al., 2020; Pan et al., 2020; Rastrelli et al., 2021; Paoli et al., 2020) or suffered from predominantly mild symptoms (Li, Yin, et al., 2020), so it is conceivable that earlier time points or higher viral loads could lead to different results.
The impact of cryopreservation on both sperm HPV-negative and positive subtypes
Published in Systems Biology in Reproductive Medicine, 2023
Maria Anagnostou, Maria Samara, Eleni Thodou, Christina I. Messini, Konstantinos Dafopoulos, Katerina Chatzimeletiou, Eleni Dovolou, Alexandros Daponte, George Koukoulis, George Anifandis
Semen collection was performed within 48 to 72 h of sexual abstinence. For each fresh semen sample, after liquefaction at room temperature, and each aliquot after thawing, semen analysis was performed according to World Health Organization Guidelines (World Health Organization 2010). The total amount of semen sample of every patient was treated with the addition of an equal volume of cryoprotectant solution (Sidney IVF Sperm Cryopreservation Buffer, COOK Medical). The mix was divided into three equal aliquots of 0.4 ml and as soon as homogenizing was performed, the samples were immediately plunged into liquid nitrogen (−196 °C). The thawing process was performed at intervals of 3, 6, and 12 months from day 0 of cryopreservation. Each cryovial with the respective sample, after retrieval from the liquid nitrogen, was placed in a 37 °C water bath for 10 min for further processing.
Comparison between semen parameters in specimens collected early in the morning and in the evening
Published in Systems Biology in Reproductive Medicine, 2020
Yukihito Shimomura, Takeshi Shin, Akiyoshi Osaka, Yasuyuki Inoue, Toshiyuki Iwahata, Yoshitomo Kobori, Hisamitsu Ide, Shigehiro Soh, Hiroshi Okada
There are several limitations in this study. First, the number of men involved in the study was comparatively low; therefore, the conclusions will need to be confirmed by larger sample sizes. Next is the problem of semen collection time. We presume that sexual intercourse most frequently occurs at night rather than in the early evening. Therefore, it would be more appropriate to compare semen collected at night with that collected early in the morning, rather than semen collected in the early evening. However, in the present study, semen collection in the early evening was selected for reasons of convenience in the facility where the study was conducted. It is possible, that if semen were collected at night rather than the early evening, different results would have been obtained. In addition, this study only considered sperm characteristics. As the purpose of assisted reproduction is achieving pregnancy, the preliminary study presented here needs to be extended to determine whether fertilization rates vary between morning and evening sperm collections; a different study design would be required to examine this aspect. Although there are limitations to our study, our findings add to the limited data on diurnal variations in semen quality in the same person. Our analyses indicate that the TMSC of semen collected in the evening is higher than that of semen collected early in the morning. Therefore, we suggest that for IUI, pregnancy might be more easily achieved using semen collected in the evening compared to in the early morning.
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