Findings from a Human Reproduction Update on sperm count trends were used in a recent BBC report, to highlight an ongoing decline in sperm counts. The geographic groups found to have a 50-60% decrease were located in North America, Europe, Australia and New Zealand.
According to the report, potential causes are varied but can include lifestyle factors (diet, smoking, and stress), endocrine disrupting chemicals, heat, medications, and pesticides.
Sperm count is a crucial component of semen analysis, and the first step to identify male factor infertility. It is estimated that male factor is involved in 40-50% of all infertility cases.
With reducing sperm numbers, more couples may have to resort to assisted conception. Even then, determining not only numbers but also quality of the sperm being produced can contribute to better outcomes.
There are various diagnostic tools on the market for sperm analysis, but ORIGIO’s range of andrology products are the only ones available that use Hyaluronan (HA).
The Role of Hyaluronan
Within the female reproductive tract, HA is believed to play a critical role in the selection of functionally competent sperm during fertilization. Only mature spermatozoa have developed specific receptors for HA, enabling them to bind to the cumulus complex, digest HA, reach the oocyte and fertilize it.
HA-bound spermatozoa show lower rates of chromosomal aneuploidies and DNA fragmentation and good nuclear morphology.
How HA Products Work
Placing a prepared or unprepared sperm sample on the grid-marked slide, which is coated with HA, helps identify mature sperm as these will bind.
Designed to provide both a qualitative and quantitative assessment of sperm quality, maturity, and fertilizing potential, the HBA device can be used to decide which treatment is best for patients.
“The HBA score allows us to successfully identify patients who would benefit from PICSI (Physiological Intracytoplasmic Sperm Injection), a specialist technique that enables the embryologists to select only the mature sperm for injection.
“Our trial in March (2016), identified 26.5% of our patients would benefit from PICSI and we were delighted to report a clinical pregnancy rate of 53.1% and the birth of our first seven babies from the technique.”
Nicola Townsend, Laboratory Manager, Herts & Essex Fertility Centre, UK
Within the PICSI Dish, sperm is added to a dot of HA and within minutes bound sperm are attached by their heads to the surface of the dot.
Selecting an individual bound sperm with enhanced genetic and developmental integrity in this way ensures it is of optimal quality.
SpermSlow is used for the selection of an individual sperm with enhanced genetic and developmental integrity, for ICSI. A semi-viscous liquid, it is placed in a dish next to a sperm suspension drop and then the two are connected using a junction. Individual sperm with enhanced genetic and developmental integrity are those that reach the HA first.
Significant improvements in clinical outcomes in the US, Italy and Singapore have been demonstrated using these HA-based products.
“As an alternative to PVP (PolyVinylPyrrolidone), SpermSlow allows easy handling of individual sperm with the huge additional benefit of allowing the selection of sperm that is more likely to be fully mature, and less likely to be genetically compromised. This leads to better treatment outcomes for patients.”
Dr David Morroll, Director of Embryology, CooperSurgical fertility companies
Summary of Conclusions
The HA sperm selection method for ICSI, which is based on a relationship between sperm receptors for zona pellucida and HA, will likely reduce the potential genetic complications and adverse public health effects of ICSI.
In couples where ≤ 65% of sperm-bound HA, the selection of HA-bound sperm for ICSI led to a statistically significant reduction in pregnancy loss rate.
Spematozoa bound to HA show a significant reduction in DNA fragmentation and a significant improvement in nucleus normalcy compared with spermatozoa immersed in PVP.
The higher the HBA score, the better the fertilization, pregnancy, and cleavage rates. This shows that HBA does have the ability to select mature sperm with normal chromosome development and oocyte-binding capability.
“Embryologists are now able to undertake varied types of sperm analysis to help give patients the best chance of success,” says Dr Steven Fleming, Director of Embryology for CooperSurgical fertility companies.
“HBA and sperm DNA fragmentation assays correlate with fertility prognosis whereas PICSI and SpermSlow increase the likelihood of successful ICSI treatment outcomes.”
ICSI and Sperm Selection Training
Qualitative analysis can only take place using specialized skills, tools and equipment. We run training days that incorporate lectures, demonstrations and hands-on practical sessions for andrology. Follow the links below to find out more about them.
Publications Summary for Further Reading
The impact of drugs on male fertility: a review, M Semet, M Paci, J Saïas-Magnan, C Metzler-Guillemain, R Boissier, H Lejeune, J Perrin, Andrology, The American Society of Andrology, Volume 5, Issue 4, July 2017, Pages 640–663
Elevated seminal plasma myeloperoxidase is associated with a decreased sperm concentration in young men, J M Pullar, A C Carr, S M Bozonet, P Rosengrave, A J Kettle, M C M Vissers, Andrology, The American Society of Andrology, Volume 5, Issue 3, May 2017, Pages 431–438
A new media without animal component for sperm cryopreservation: motility and various attributes affecting paternal contribution of sperm, A Tiwari, M Tekcan, L Sati, W Murk, J Stronk, G Huszar, Journal of Assisted Reproduction and Genetics, Volume 34, Issue 5, March 2017, Pages 647–657
Sperm chemorepulsion, a supplementary mechanism to regulate fertilization, H A Guidobaldi, M Cubilla, A Moreno, M V Molino, L Bahamondes, L C Giojalas, Human Reproduction, Volume 32, Issue 8, June 2017, Pages 1560-1573
Cryopreservation of testicular tissue or testicular cell suspensions: a pivotal step in fertility preservation, J Onofre, Y Baert, K Faes, and E. Goossens, Human Reproduction Update, Volume 22, Issue 6, November 2016, Pages 744–761
Does combining magnetic-activated cell sorting with density gradient or swim-up improve sperm selection? Z Cakar, B Cetinkaya, D Aras, B Koca, S Ozkavukcu, İ Kaplanoglu, A Can, O Cinar, Journal of Assisted Reproduction and Genetics, Volume 33, Issue 8, August 2016, Pages 1059–1065
Does cryopreservation of sperm affect fertilization in nonobstructive azoospermia or cryptozoospermia? N Schachter-safrai, G Karavani, E Levitas, M Friger, A Zeadna, E Lunenfeld, I Har-Vardi, Fertility and Sterility, Volume 107, Issue 5, May 2017, Pages 1148–1152
Effect of semen preparation technique and its incubation on sperm quality in the Moroccan population, S Aboulmaouahib, A Madkour, I Kaarouch, B Saadani, O Sefrioui, N Louanjli, H Copin, R Cadi, M Benkhalifa, Andrologia, Volume 49, Issue 6, August 2017, e12688
Effects of n-6 and n-3 polyunsaturated acid-rich soybean phosphatidylcholine on membrane lipid profile and cryotolerance of human sperm, A A Vireque, A Tata, O FLLO Silva, E G LoTurco, A Azzolini, C R Ferreira, M H Y Dantas, R A Ferriani, R M Reis, Fertility and Sterility, Volume 106, Issue 2, August 2016, Pages 273–283.e6
Healthy offspring from freeze-dried mouse spermatozoa held on the International Space Station for 9 months, S Wakayama, Y Kamada, K Yamanaka, T Kohda, H Suzuki, T Shimazu, M N Tada, I Osada, A Nagamatsu, S Kamimura, H Nagatomo, E Mizutani, F Ishino, S Yano, T Wakayama, PNAS, Volume 114, Issue 23, June 2017, Pages 5988-5993
Hyaluronan-binding system for sperm selection enhances pregnancy rates in ICSI cycles associated with male factor infertility, R Erberelli, R M Salgado, D H Mendes Pereira, P Wolff, JBRA Assisted Reproduction, Jan-Mar 2017, Volume 21, Issue 1, Pages 2-6
Influence of sperm DNA damage on human preimplantation embryo metabolism, S Uppangala, S Pudakalakatti, F D’souza, S R Salian, G Kalthur, P Kumar, H Atreya, S K Adiga, Reproductive Biology, Volume 16, Issue 3, September 2016, Pages 234-241
Magnetic cell sorting of semen containing spermatozoa with high DNA fragmentation in ICSI cycles decreases miscarriage rate, P Sánchez-Martín, M Dorado-Silva, F Sánchez-Martín, M G Martínez, S D Johnston, J Gosálvez, Reproductive BioMedicine Online, Volume 34, Issue 5, May 2017, Pages 506-512
miR-424/322 is downregulated in the semen of patients with severe DNA damage and may regulate sperm DNA damage, K Zhao, Y Chen, R Yang, Y Bai, C Li, H Li, C Xiong, Reproduction, Fertility and Development, Volume 28, Issue 10, April 2015, Pages 1598-1607
Optimization of microelectrophoresis to select highly negatively charged sperm, L Simon, K Murphy, K I Aston, B R Emery, J M Hotaling, D T Carrell, Journal of Assisted Reproduction and Genetics, Volume 33, Issue 6, June 2016, Pages 679–688
Predicting the clinical outcome of ICSI by sperm head vacuole examination, K Pocate-Cheriet, I Heilikman, R Porcher, V Barraud-Lange, N Sermondade, C Herbemont, J P Wolf, C Sifer, Systems Biology in Reproductive Medicine, Volume 63, Issue 1, February 2017, Pages 29-36
Role of the Na+/K+-ATPase ion pump in male reproduction and embryo development, D R Câmara, J P Kastelic, J C Thundathil, Reproduction, Fertility and Development, Volume 29, Issue 8, July 2016, Pages 1457-1467
Sedimentation properties in density gradients correspond with levels of sperm DNA fragmentation, chromatin compaction and binding affinity to hyaluronic acid, F Torabi, A Binduraihem, D Miller, Reproductive BioMedicine Online, Volume 34, Issue 3, March 2017, Pages 298-311
Separation efficiency of a microfluidic sperm sorter to minimize sperm DNA damage, K Shirota, F Yotsumoto, H Itoh, H Obama, N Hidaka, K Nakajima, S Miyamoto, Fertility and Sterility, Volume 105, Issue 2, February 2016, Pages 315-321
Sperm DNA fragmentation and mitochondrial membrane potential combined are better for predicting natural conception than standard sperm parameters, S Malić Vončina, B Golob, A Ihan, A Nataša Kopitar, M Kolbezen, B Zorn, Fertility and Sterility, Volume 105, Issue 3, March 2016, Pages 637-644
Sperm processing for advanced reproductive technologies: Where are we today? K L Rappa, H F Rodriguez, G C Hakkarainen, R M Anchanf, G L Mutter, W Asghar, Biotechnology Advances, Volume 34, September-October 2016, Pages 578-587
Status of sperm-born oocyte activating factors (PAWP, PLCζ) and sperm chromatin in uncapacitated, capacitated and acrosome-reacted conditions, M Tavalaee, K Parivar, AH Shahverdi, K Ghaedi, M H Nasr-Esfahani, Human Fertility, Volume 20, Issue 2, January 2017, Pages 96-103
Supplementation of freezing and thawing media with brain-derived neurotrophic factor protects human sperm from freeze-thaw-induced damage, A Najafi, E Asadi, A R Moawad, S Mikaeili, F Amidi, E Adutwum, M Safa, A G Sobhani, Fertility and Sterility, Volume 106, Issue 7, Pages 1658–1665
The pellet swim-up is the best technique for sperm preparation during in vitro fertilization procedures, A Volpes, F Sammartano, S Rizzari, S Gullo, A Marino, A Allegra, Journal of Assisted Reproduction and Genetics, Volume 33, Issue 6, June 2016, Pages 765–770
Variation of DNA Fragmentation Levels During Density Gradient Sperm Selection for Assisted Reproduction Techniques – A Possible New Male Predictive Parameter of Pregnancy? M Muratori, N Tarozzi, M Cambi, L Boni, A L Lorio, C Passaro, B Luppino, M Nadalini, S Marchiani, L Tamburrino, G Forti, M Maggi, E Baldi, A Borini, Medicine, Volume 95, Issue 20, May 2016, Pages e36246