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Intracytoplasmic sperm injection versus conventional in-vitro fertilisation in couples with infertility in whom the male partner has normal total sperm count and motility: an open-label, randomised controlled trial
The use of intracytoplasmic sperm injection has increased substantially worldwide, primarily in couples with non-male factor infertility. However, there is a paucity of evidence from randomised trials supporting this approach compared with conventional in-vitro fertilisation (IVF). We aimed to investigate whether intracytoplasmic sperm injection would result in a higher livebirth rate compared with conventional IVF.
This open-label, multicentre, randomised trial was done at two IVF centres in Ho Chi Minh City, Vietnam (IVFMD, My Duc Hospital and IVFAS, An Sinh Hospital). Eligible couples were aged at least 18 years and the male partner's sperm count and motility (progressive motility) were normal based on WHO 2010 criteria. Couples had to have undergone two or fewer previous conventional IVF or intracytoplasmic sperm injection attempts, have used an antagonist protocol for ovarian stimulation, and agree to have two or fewer embryos transferred. Couples were randomly assigned (1:1) to undergo either intracytoplasmic sperm injection or conventional IVF, using block randomisation with variable block size of 2, 4, or 8 and a telephone-based central randomisation method. The computer-generated randomisation list was prepared by an independent statistician who had no other involvement in the study. Embryologists and couples were not masked to study groups because of the type of interventions and differences in hospital fees, but clinicians performing embryo transfer were unaware of study group allocation. The primary outcome was livebirth after the first embryo transfer from the initiated cycle. Analyses were done on an intention-to-treat basis. The trial is registered with ClinicalTrials.gov, NCT03428919.
Between March 16, 2018, and Aug 12, 2019, we randomly assigned 1064 couples to intracytoplasmic sperm injection (n=532) or conventional IVF (n=532). Livebirth after the first embryo transfer from the initiated cycle occurred in 184 (35%) of 532 couples randomly assigned to intracytoplasmic sperm injection and in 166 (31%) of 532 couples randomly assigned to conventional IVF (absolute difference 3·4%, 95% CI −2·4 to 9·2; risk ratio [RR] 1·11, 95% CI 0·93 to 1·32; p=0·27). 29 (5%) couples in the intracytoplasmic sperm injection group and 34 (6%) couples in the conventional IVF group had fertilisation failure (absolute difference −0·9%, −4·0 to 2·1, RR 0·85, 95% CI 0·53 to 1·38; p=0·60).
In couples with infertility in whom the male partner has a normal total sperm count and motility, intracytoplasmic sperm injection did not improve the livebirth rate compared with conventional IVF. Our results challenge the value of the routine use of intracytoplasmic sperm injection in assisted reproduction techniques for this population.
My Duc Hospital and Merck Sharp and Dohme.
Journal Article
Good quality : the routinization of sperm banking in China
\"From its crude and uneasy beginnings thirty years ago, Chinese sperm banking has become a routine part of China's pervasive and restrictive reproductive complex. Today, there are sperm banks in fifteen of China's twenty-two provinces, the biggest of which screen some 2,000-3,000 potential donors each year. With an estimated one to two-million azoospermic men--those who are unable to produce their own sperm--the demand remains insatiable. China's fifteen sperm banks cannot keep up, spurring sperm bank directors to publicly lament chronic shortages and even warn of a national 'sperm crisis' (jingzi weiji). Good quality explores the issues behind the crisis, including declining sperm quality in the country due to environmental pollution, as well as a chronic national shortage of donors. Whalberg also outlines the specific style of Chinese sperm banking that has been shaped by the particular cultural, juridical, economic and social configurations that make up China's restrictive reproductive complex. Good Quality shows how this high-throughput style shapes the ways in which men experience donation and sperm is made available to couples who can afford it\"--Provided by publisher.
Book
Importance of sperm morphology during sperm transport and fertilization in mammals
After natural or artificial insemination, the spermatozoon starts a journey from the site of deposition to the place of fertilization. However, only a small subset of the spermatozoa deposited achieves their goal： to reach and fertilize the egg. Factors involved in controlling sperm transport and fertilization include the female reproductive tract environment, cell-cell interactions, gene expression, and phenotypic sperm traits. Some of the significant determinants of fertilization are known （i.e., motility or DNA status）, but many sperm traits are still indecipherable. One example is the influence of sperm dimensions and shape upon transport within the female genital tract towards the oocyte. Biophysical associations between sperm size and motility may influence the progression of spermatozoa through the female reproductive tract, but uncertainties remain concerning how sperm morphology influences the fertilization process, and whether only the sperm dimensions per se are involved. Moreover, such explanations do not allow the possibility that the female tract is capable of distinguishing fertile spermatozoa on the basis of their morphology, as seems to be the case with biochemical, molecular, and genetic properties. This review focuses on the influence of sperm size and shape in evolution and their putative role in sperm transport and selection within the uterus and the ability to fertilize the oocyte.
Journal Article
Whales
Introduces sperm whales, including their different body parts, how they travel in groups, what they eat, and how they care for their young.
Book
Sperm Counts
2007 Choice Outstanding Academic Title
Winner of the Passing the Torch Award from the Center for Lesbian and Gay Studies
It has been called sperm, semen, seed, cum, jizz, spunk, gentlemen's relish, and splooge. But however the “tacky, opaque liquid that comes out of the penis” is described, the very act of defining “sperm” and “semen” depends on your point of view. For Lisa Jean Moore, how sperm comes to be known is based on who defines it (a scientist vs. a defense witness, for example), under what social circumstances it is found (a doctor’s office vs. a crime scene), and for what purposes it will be used (in vitro fertilization vs. DNA analysis). Examining semen historically, medically, and culturally, Sperm Counts is a penetrating exploration of its meaning and power.
Using a “;follow that sperm” approach, Moore shows how representations of sperm and semen are always in flux, tracing their twisting journeys from male reproductive glands to headline news stories and presidential impeachment trials. Much like the fluid of semen itself can leak onto fabrics and into bodies, its meanings seep into our consciousness over time. Moore’s analytic lens yields intriguing observations of how sperm is “spent” and “reabsorbed” as it spurts, swims, and careens through penises, vaginas, test tubes, labs, families, cultures, and politics.
Drawn from fifteen years of research, Sperm Counts examines historical and scientific documents, children's “facts of life” books, pornography, the Internet, forensic transcripts and sex worker narratives to explain how semen got so complicated. Among other things, understanding how we produce, represent, deploy and institutionalize semen-biomedically, socially and culturally-provides valuable new perspectives on the changing social position of men and the evolving meanings of masculinity. Ultimately, as Moore reveals, sperm is intimately involved in not only the physical reproduction of males and females, but in how we come to understand ourselves as men and women.
eBook
After the peace
\"How many parents does it take to make a baby? In the case of Rosalind Melrose Smithson it took four: one birth mother; one legal father; one interfering neighbour and one turkey baster filled with the defrosted essence of an anonymous donor. Or not so anonymous as it turned out. For donor no. 116349, '6ft 1in, blue eyes, blond hair, BA (Oxon), action man, aristocrat' is the ninth Earl of Dilberne, who gave his seed back in 1979 as a stripling of twenty-two, and has now conceived a daughter - unknowingly - at the riper age of forty-two. As they say, the truth will out. And what will our Rozzie do when she finds out about dear old dad? All we know is that as a true Millennial, she will not take it lying down... Sharp, insightful and full of Weldon's trademark wit, this is a tale of family life, genetics and class that reflects the way we live our lives now\"-- Publisher's description.
Book
Human spermatozoa migration in microchannels reveals boundary-following navigation
The migratory abilities of motile human spermatozoa in vivo are essential for natural fertility, but it remains a mystery what properties distinguish the tens of cells which find an egg from the millions of cells ejaculated. To reach the site of fertilization, sperm must traverse narrow and convoluted channels, filled with viscous fluids. To elucidate individual and group behaviors that may occur in the complex three-dimensional female tract environment, we examine the behavior of migrating sperm in assorted microchannel geometries. Cells rarely swim in the central part of the channel cross-section, instead traveling along the intersection of the channel walls (\"channel corners\"). When the channel turns sharply, cells leave the corner, continuing ahead until hitting the opposite wall of the channel, with a distribution of departure angles, the latter being modulated by fluid viscosity. If the channel bend is smooth, cells depart from the inner wall when the curvature radius is less than a threshold value close to 150 μm. Specific wall shapes are able to preferentially direct motile cells. As a consequence of swimming along the corners, the domain occupied by cells becomes essentially one-dimensional, leading to frequent collisions, and needs to be accounted for when modeling the behavior of populations of migratory cells and considering how sperm populate and navigate the female tract. The combined effect of viscosity and three-dimensional architecture should be accounted for in future in vitro studies of sperm chemoattraction.
Journal Article
806 : a novel
KT, sixteen, learns that her father was Donor 806, discovers two half-brothers, and travels with them from Missouri to California to meet their biological father, redefining their notions of \"family\" along the way.
Book
Major regulatory mechanisms involved in sperm motility
The genetic bases and molecular mechanisms involved in the assembly and function of the flagellum components as well as in the regulation of the flagellar movement are not fully understood, especially in humans. There are several causes for sperm immotility, of which some can be avoided and corrected, whereas other are related to genetic defects and deserve full investigation to give a diagnosis to patients. This review was performed after an extensive literature search on the online databases PubMed, ScienceDirect, and Web of Science. Here, we review the involvement of regulatory pathways responsible for sperm motility, indicating possible causes for sperm immotility. These included the calcium pathway, the cAMP-dependent protein kinase pathway, the importance of kinases and phosphatases, the function of reactive oxygen species, and how the regulation of cell volume and osmolarity are also fundamental components. We then discuss main gene defects associated with specific morphological abnormalities. Finally, we slightly discuss some preventive and treatments approaches to avoid development of conditions that are associated with unspecified sperm immotility. We believe that in the near future, with the development of more powerful techniques, the genetic causes of sperm immotility and the regulatory mechanisms of sperm motility will be better understand, thus enabling to perform a full diagnosis and uncover new therapies.
Journal Article