Andrology

Sperm Cryobanking

We habitually have a back-up bodily fluid sample frozen for couples UN agency area unit undergoing treatment just in case of inability to present a sample on the day of the IUI, IVF or ICSI. Men experiencing cancer treatment before radiation and therapy can even benefit of our cryopreservation facilities. Those undergoing ICSI are inspired to freeze their sperm cell so we’ve adequate range of sperm cell at the time of ICSI. We have a tendency to habitually cryopreserve epididymal sperm cell and testicular, so recurrent makes an attempt at getting recent epididymal and gonad sperm cell is also avoided.

Donor insemination

In Donor insemination, the sperm is backed by a donor male whose uniqueness is withheld. Intra uterine insemination is same as that of donor insemination, where placing of sperms into the female uterus. Below are the following fascinating points The female is that the biological mother and genetic contributor, however the husband isn’t the biological father, except for all alternative considerations (legal and psychological), he’s the accepted father. He’s concerned within the physiological condition preparation right from the pre pregnancy counsel to insemination to the physiological condition, delivery and rearing of the kid thenceforth. The procedure is straightforward and no surgery is concerned in insemination The procedure could also be treated as adoption from conception with one partner being sharing the genes with the total support and agreement of the husband. Couples must be ready to settle for an anonymous gamete. Currently there’s a discussion whether or not the kid should learn of his biological father when he / she reaches adulthood. With the increase of HIV and alternative sexually transmitted diseases (STD, the importance of exploitation properly tested and segregated body fluid, for the treatment of sterility, has gained nice importance. In developed countries, the use of contemporary untested seed for donor insemination has been discontinued to forestall the unfold of those diseases through insemination procedures. These samples are selected for HIV, serum hepatitis and C so segregated in deep freeze (liquid nitrogen) to make sure safe donor insemination. Donor semen is employed solely when re-screening after 7 months for HIV. All the records of semen samples and donors are accurately preserved beneath strict confidentiality. Therapeutic donor insemination is indicated in couples where the male partner:
  • Could not produce sperm cells
  • Does not have quality sperms
  • Presence of genetic disorders

PICSI

In vitro fertilization, PICSI Sperm Selection Device offers important benefits in selecting sperm for the ICSI (Intra Cytoplasmic Sperm Injection) method. PICSI In the ICSI procedure, a seperate sperm cell is chosen and vaccinated into a gametocyte. The PICSI is a sterilised, plastic culture dish with 3 to 3.5 microdots of hyaluronan colloidal gel connected to all-time base interior of the dish. Hyaluronan may be a present as biopolymer found altogether in human cells, together with the gel layer close the gametocyte. Mature human sperm cell attaches by themselves to the hyaluronan over exact receptors found on the spermatozoa semipermeable membrane. Hyaluronan-bound sperm cell exhibits no progressive movement, though their tails beat and are capable of motility. Hyaluronan-bound sperm cell are simply hand-picked and off from the hyaluronan by micropipette to be used in intracytoplasmic sperm cell injection (ICSI). The PICSI spermatozoan Selection Device truly mimics a key phase within the natural fertilization method, the binding of mature spermatozoan to the gametocyte advanced. As a consequence, the chosen spermatozoan is basically a similar that will achieve success within the natural procreative method. Hyaluronan-bound PICSI-selected spermatozoan are, within the overwhelming majority of cases, a lot of mature, exhibit less polymer harm, and have fewer body aneuploidies.

ROS

In Human ejaculate, there is a dynamic interaction between anti-oxidant and pro oxidant. If ROS (Reactive Oxygen Species) is low, plays an vital physiological role by modulating gene and protein activities for proliferation, function and differentiation.

There is a dynamic interplay between pro- and anti-oxidant substances in human ejaculate. Reactive oxygen species (ROS) in low, controlled levels in the extracellular space play an important physiological role, modulating gene and protein activities vital for sperm proliferation, differentiation, and function. Excessive reactive oxygen species (ROS) generation can overwhelm protective mechanism and initiate changes in lipid and/or protein layers of sperm plasma membranes. Additionally, changes in DNA can be induced.

Oxidative stress (OS) is outlined as a cellular condition related as disparity between the assembly of free radicals, mainly ROS, and their sifting capability by antioxidants. Once the assembly of ROS exceeds the antioxidant defence, important oxidative destruction happens to several cellular organelles by destructive proteins, lipids, carbohydrates and DNA, so ultimately resulting in death of the cell. The Oxidative Stress-induced sperm cell destructive has been urged to be a major causative attributes in 40-70% of all circumstances of male physiological condition. The cohort of ROS may be impaired by infectious, environmental and manner aetiologies.

DFI/SCSA

Sperm-DNA-Fragmentation If couples have trouble in conceiving, the factors affecting are due to
  • Sperm count
  • Motility (speed)
  • Morphology (shape) – is usual
  • It might me also due to sperm.
By talking to the fertility specialist regarding DNA fragmentation of sperm, provides an insight for not getting pregnant. The possibility of a successful pregnancy is due to the high level of DNA fragmentation. Our doctor says “Reproductive toxicants in the environment increase the level of DNA fragmentation.” Those people’s working with heavy metals like lead and nickel as well as pesticides, though, cities with high levels of documentation of miscarriages and infertility and air pollution, increases the level of sperm DNA fragmentation. According to the research, while there presently is not any tried role for routine DNA integrity testing within the analysis of sterility, sperm cell DNA Damage is an additional common in sterile men and will have an effect on reproductive outcomes in selected pairs, together with those with repeated spontaneous miscarriage or disorder (unexplained) sterility.

Sperm DNA Fragmentation

The hereditary material, DNA, present in both humans and various other organisms. The DNA consists of polymers, which are long, made up of simple units called phosphate and sugars. In DNA, information is stored as codes, which are made up of 4 types of molecules called bases. These bases are attached to strands of DNA. The order of the bases defines the information accessible for maintain and building organisms. If there is any change in the bases or physical break or both in the DNA strands then DNA fragmentation occurs. The physical breakings of DNA strands in sperm chromosomes are called Sperm DNA fragmentation. If Sperm DNA fragmentation occurs in a gene, for egg growth and cannot be repaired, then the consequence leads to the death of the embryo.

Sperm DNA Fragmentation Testing

Sperm DNA Fragmentation testing is same as that of regular semen analysis method at fertility clinic. A sample of semen is taken and sent for testing at sperm DNA fragmentation centre. Test includes Halosperm kit, which is based on technique called Sperm Chromatin Decondensation. This technique is more than 100 sperm are differentiated depending upon the expanded nuclei with expansion of five grades or without expansion. New Sperm DNA fragmentation tests are developed with the following test, which includes
  • Comet test
  • Tunel test and
  • Light microscope based SCD test
With the precision flow cytometer instrumentation, thousands of sperm per sample have much better numerical sturdiness than light microscope tests. Sperm DNA fragmentation testing can be done in the fertility centre along with semen analysis. A fresh sample of semen is positioned in a small vial, in an cold freezer or nitrogen container to diagnostic laboratory for testing. Currently, the SCSA is that the solely check of sperm cell DNA/chromatin that valid clinical interpretation criteria. With the SCSA check, 5,000 distinct sperm cell are rationed in a very high-precision flow cytometer. The check trials the presence of deoxyribonucleic acid strand breaks and also the proportion of sperm cell with abnormal proteins that constrain maternity success. The check regulates the proportion of sperm cell with fragmented deoxyribonucleic acid and also the degree of deoxyribonucleic acid injury and provides a deoxyribonucleic acid Fragmentation Index (DFI) score to point the probability of sperm cell tributary to sterility issues. The subsequent scores indicate fertility potential for natural conception and intrauterine insemination:
  • Greater than 24% DFI: Fair to Poor fertility potential
  • 14%to 24% DFI: Good to Fair fertility potential
  • Less than or equal to 14% DFI: Excellent to Good fertility potential

Causes for Sperm DNA Fragmentation

In regarding 30% of couples seeking clinical examination of infertility, the lads have spermatozoon DNA fragmentation at tier that places the person into the class of an extended time to natural or IUI physiological state (greater than 24% DFI). Oxidative stress – stress on the body that’s produced by the accumulative injury of free radicals that’s not sufficiently neutralised by antioxidants, which could be a main contributor to spermatozoan DNA fragmentation. Spermatozoon polymer fragmentation is related to infections, drug use, butt smoking, exposure to environmental and activity pollutants, advanced age, varicocele, diseases with high fevers, elevated male reproductive gland temperature (laptop computers, hot tubs), chronic diseases like polygenic disease, cancer treatment, cancer and poor diet. The major factor contributing to sperm damage is epidemic of obesity, which is very much common among obese man or overweight person.

Treatment for Sperm DNA Fragmentation

With the growth of ICSI (Intracytoplasmic Sperm Injection), few fertility surgeons will not focus on the quality of the sperm as the sole sperm can be vaccinated into the egg for insemination. Few other fertility doctors will evade ICSI and try to reduce sperm DNA fragmentation to certain level, which is well-matched with natural fertility. Other recommendations for treatment
  • Discontinue smoking
  • Keep the testes cool – no hot tubs or long hot baths, and wear boxer shorts
  • Avoiding medications such as SSRIs
  • Having healthy diet
  • Examinations for urogenital infections
  • Enquiring doctor about supplementary vitamins and antioxidants

CASA (Computer Assisted Semen Analysis)

The use of CASA (Computer Assisted Semen Analysis) has radical the flexibility to review and perceive spermatozoon function because it relates to humanoid infertility. The foremost advances are within the ability to a lot of accurately verify spermatozoon concentration (counts) and motility (movement). Generally, spermatozoon is “looked” at by a processed digitizing pill through a magnifier. The computer has been “taught” by the laboratory personnel what spermatozoon appear, and the way they move. Once the computer “sees” a spermatozoon underneath the magnifier, it’s ready to draw a digitized image of every individual spermatozoon, together with the speed and path this spermatozoon takes whereas moving underneath the magnifier.
CASA-Computer-Assisted-Semen-Analysis
An excellent deal has been learned concerning the traditional and abnormal “micro” characteristics of spermatozoon using this technique. The strategy is, however, not fool proof. The computer is as intelligent as its programmer. Little changes within the program will alter the spermatozoon calculations considerably. The computers should perpetually be monitored and rationalized. In most research laboratory, all grossly abnormal CASA are perpetually verified by repeat analysis yet like a “hands on” human review opinion. We tend to feel that any abnormal spermatozoon count should be verified by a manual count and assessment technique.

Embryo Adoption

The technology has advanced a lot and found solution many issues. One of the most complicated issues, infertility, has also got solution. That is called embryo adoption. The term ‘embryo adoption’ has become familiar to most of the people. It is a kind of third party reproduction. People consider it as a new way of adoption. Embryo adoption is meant for people who face trouble in achieving a successful pregnancy. Embryo adoption is done in order to provide an opportunity to assist people who want to conceive. Embryo adoptions are even done on an anonymous basis. In such cases, the donor and the recipient will not be known for each other. Open basis donation is also done, where the donor and the recipient will be known each other. Genetic parents are free to select the adoptive parents if they are undergoing for the process through an agency. The terms and conditions are negotiable within the two families. Before entering to the process, a detailed check-up of the recipient will be done in order to decide whether she is eligible for the process. Once all the formalities are over, the procedure will be performed further. The embryos to be transferred will be created during an IVF cycle. Following the embryo creation, it will be placed in to the uterus of recipient woman to facilitate pregnancy. The recipient woman who gives birth to the child will have the right to own the child thereafter. The principle used for embryo adoption is same as that of egg donation or sperm donation. Embryo adoption and Embryo Reduction in Bangalore can be done as a service of an individual fertility clinic or by any of several organizations.

Egg Donation

A healthy egg is inevitable for successful reproduction to occur. For proper fertilization to occur, the woman produce egg & this is then to be fertilized by the sperm. In some cases, the egg might either be absent or must be of inferior quality. These conditions can decrease the chances of a successful fertilization. Methods like egg donation can be a boon in this regard. This is critical in process like IVF (In Vitro Fertilization). In egg donation process, one or more eggs are donated by a healthy female. Egg donation might also be required in cases where the woman experiences menopause at a younger age. For those females who do not have reproductive organs like ovaries, these can be a beneficial method for having their own children. Necessity for this method can also arise due to the various damages to the reproductive organs. Egg donors can be broadly classified into 3.
  • Designated donors: These donors are either the acquaintances or relatives of the recipients.
  • Anonymous donors: These donors are not known by the recipients. These individuals are mostly recruited by agencies & programs.
  • Shared oocyte programmes: These programmes become relevant during IVF procedures. In such procedures, it is common to have unused eggs. These eggs may be used for 3rd party fertilization. This can also be helpful in balancing the expense incurred in IVF procedures.
A proper screening is to be done before performing egg donation. An IVF stimulation therapy is performed on the donor. After this, the egg is retrieved. The next step is fertilization. The healthiest embryo is then implanted into the uterus of the recipient. The uterine lining has to be proper in its function in order for embryo transfer to be successful. If this is also ok, the woman can now carry and deliver. The success rate of this procedure varies from 60%-80%. High success rates are encountered if a fresh cycle is followed by a frozen cycle.

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