The aim of this study was to determine if a relationship exists between the levels of sperm DNA fragmentation and necrospermia in infertile men. Semen samples obtained from 70 men consulting for infertility evaluation were analyzed according to World Health Organization (WHO) guidelines. Patients were subdivided into three groups according to the percentage of necrotic spermatozoa: normozoospermia (<30%; n = 20), moderate necrozoospermia (50-80%; n = 30), and severe necrozoospermia (>80%; n = 20). DNA fragmentation was detected by the terminal desoxynucleotidyl transferase-mediated deoxyuridine triphosphate biotin nick-end labeling (TUNEL) assay. The sperm DNA fragmentation index (DFI) was 9.28 ± 2.98% in patients with a normal level of necrotic spermatozoa, 20.25 ± 3.21% in patients with moderate necrozoospermia, and 35.31 ± 5.25% in patients with severe necrozoospermia. There was a statistically significant increase of DNA fragmentation in the necrozoospermic group (P < 0.01). A strong correlation was found between the degree of necrozoospermia and sperm DNA fragmentation. We concluded that patients with necrozoospermia showed a high level of DNA fragmentation compared to normozoospermic men. Severe necrozoospermia (>80%) is a predictive factor for increased sperm DNA damage.
In the present work, we aim to determine the frequency of Y microdeletions and to study the clinical and biological characteristics in idiopathic azoospermic and oligozoospermic men originating from the center of Tunisia. A sample of 163 infertile men with normal karyotype was screened for Y chromosome microdeletion. This research was done by two multiplex PCR reactions. The multiplex A where STSs: Sy82 (AZFa), Sy134 (AZFb), Sy254 (AZFc) markers are amplified and the multiplex B where STSs: Sy81 (AZFa), Sy127 (AZFb), Sy255 (AZFc) markers are amplified. All patients had primary spermatogenic failure with normal or elevated plasma FSH level. AZF microdeletion was found in 14 patients (8.58%). The microdeletions affect AZFc in 9 cases, AZFa in one case, AZFb + c in two cases and AZFa + b + c in two cases. An epididymal obstruction is associated in five patients with Y chromosome microdeletion. The incidence of Yq microdeletions in the studied population falls within the range published in other countries. Association between Yq microdeletions and epididymal abnormalities is frequent. Yq microdeletions are inherited when an intracytoplasmic spermatozoa injection (ICSI) is possible which justifies a genetic counseling consultation in order to inform couples about possible risks and to refer them to the most appropriate treatment.
results in the production of high quality follicles, which in turn, would be responsible for a higher oocyte recovery rate.Furthermore the GnRH agonist treatment is significantly less costly than antagonist treatment.Costs, effectiveness and comfort can be brought together using GnRH agonist treatment in alternate days, allowing the delivery of additional ART cycles in developing countries.
AIM evaluation of our experience in assisted fertilization by ICSI with analysis of prognostic factors. METHODS retrospective study of 199 cycles of ICSI during a 2 years and half period between September 2001 and February 2004. The procedure of ICSI included several stages: collection and preparation of the semen, stake in culture of oocytes, removing of cumulus cells and microinjection of oocytes, control of the fertilization and embryo transfer respectively 18 to 22 hours and 48 hours after the microinjection. RESULTS the mean age of the patients was 32,4 years and the mean duration of infertility was 7 years. The mean fertilization rate was 50%. The mean number of embryos transferred was 2,46. We got 41 pregnancies of which 36 were clinical pregnancies (87,8%). The pregnancy rate was 26,1% by transfer and 21% by retrieval. The women age was the first prognostic factor of ICSI. The pregnancy rate was 27% before the age of 35 years, decreases with age and annul himself after 40 years (P=0,02). The other prognostic factor was the number of 4 cells embryos transferred. The pregnancy rate increases with significant way with the number of 4 cells embryos transferred: 15% after transfer of only one embryo versus 43% after transfer of 3 embryos or more (P=0,04). The ICSI prognostic has not been influenced with significant way by the origin or the sperm mobility, by the duration of infertility and by the total number of embryos transferred. CONCLUSION the ICSI represents currently the treatment of choice of couple having extreme spermatic changes. The results of our study are comparable to those reported in the literature. The women age and the number of 4 cells embryos transferred are the main factors predicting of the ICSI prognostic.