IVF News

Semen samples can now be accurately analysed up to 52 hours after production using a new mail-in sperm testing kit.

Scientists at the University of Southern California have reported that the accuracy of mail-in semen analysis on that is produced at home is comparable to a traditional semen analysis, which is typically performed within one hour of sperm production. 

'This is a game changer for men because it means they no longer have to come into a lab or clinic to provide a sample, an experience some find unnerving and challenging', said lead investigator Dr Mary Samplaski. 'This allows men to secure highly accurate male fertility results while providing the specimen from the comfort of their own home'.

A semen analysis is one of first fertility investigations offered to couples who are struggling to conceive and can identify sperm quality issues, such as a low sperm count or poor sperm motility, which may reduce the likelihood of achieving a pregnancy naturally. 

The quality of a semen sample begins to diminish one hour after production. As a result, fertility clinics typically ask their patients to produce a semen sample on-site or deliver the sample to the laboratory within one hour of production. 

The recent study, published in the journal Fertility and Sterility, describes a unique preservation solution which can be added to semen samples to control the rate of sperm degradation. This creates a predictable rate of decline in specimen quality, which allowed the researchers to develop an algorithm to calculate the initial quality of the semen sample.

During the validation arm of the study, a traditional, one-hour semen analysis was performed on 104 semen samples. The samples were then mixed with the preservation solution and four further semen analyses were performed for each sample over a 52-hour period. These samples were exposed to a range of temperatures over the analysis period to mimic the temperature fluctuations that can occur during transportation.

The research team found that the results of the four delayed semen analyses could each be used to accurately calculate the initial quality of the semen sample. They concluded that the mail-in sperm testing kit could be used as a viable alternative to the traditional, one-hour semen analysis.

'Essentially, there was no difference in the results' said Dr Samplaski. 'While this study was limited in scope, the findings make the mail-in system a reliable option to consider for routine clinical use in evaluating sperm'.

Dr Samplaski also believes that the mail-in sperm testing kit could improve patient access to diagnostic sperm testing. This is particularly relevant for patients who want to investigate their fertility during the COVID-19 pandemic. 

'The more options a couple has in their fertility care, the better' she said. 'Making evaluative tests easier keeps couples moving forward and ultimately improves their chances of conception'.

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A genetic factor helps some sperm outcompete others to reach the egg cell first. 

Researchers from the Max Planck Institute for Molecular Genetics in Berlin, Germany have discovered that the protein RAC1, which plays a role in the movement of cells, controls the motility and competitiveness of sperm cells in mice. 

'The competitiveness of individual sperm seems to depend on an optimal level of active RAC1; both reduced or excessive RAC1 activity interferes with effective forward movement,' said Dr Alexandra Amaral, first author of the study.

Classical Mendelian genetics predicts that sperm cells have an equal chance in the 'fertilisation race'; however, the t-haplotype is a genetic variant that breaks these rules of inheritance by increasing the fertilisation success rate of sperm cells that carry it. 

The results of the study, published in PLOS Genetics, show that sperm from mice carrying the t-haplotype variant swam faster and in straight lines directly towards the egg cell, whereas the movement of normal sperm cells without the variant was directionless and slow. 

The scientists discovered that the differences in motility were due to the levels of RAC1. RAC1 activity was elevated in sterile mice, where all the sperm cells carry the t-haplotype variant, while RAC1 levels were low in mice that only carry normal sperm cells. In mice that produce a mixture of normal and t-haplotype sperm cells they observed that some sperm cells showed progressive movement and others were less progressive. They reported that it was the normal sperm cells that made little progress. They then treated this mixed population of sperm cells with a compound that inhibits RAC1 activity and showed that this enabled the normal sperm cells to swim progressively. 

The team also found that the t-haplotype variant contains certain genetic factors called distorters that inhibit the progressive movement of sperm cells by interfering with the cell signalling molecules required for motility.

'Sperm with the t-haplotype manage to disable sperm without it. The trick is that the t‑haplotype 'poisons' all sperm, but at the same time produces an antidote, which acts only in t-sperm and protects them, ' said Professor Bernhard Herrmann, director of the Department of Developmental Genetics at the Max Planck Institute for Molecular Genetics and corresponding author of this study. 

The researchers suggest that abnormal RAC1 activity may underlie certain forms of infertility in men and they are planning to investigate the effect of RAC1 activity on the motility of human sperm. 

'Sperm immotility is a big deal in male infertility. Investigating the levels of this protein in human samples could help to develop treatments for infertility in men,' said Professor Herrmann.

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A new research paper warns that COVID-19 can affect men's sperm, but it may not be that simple.

Researchers from the Justus-Liebig University in Giessen, Germany published a study in Reproduction, showing that the sperm of men who had been diagnosed with COVID-19 showed increased sperm cell death, inflammation and oxidative stress compared to the sperm of men who had not had the virus. 

'These effects on sperm cells are associated with lower sperm quality and reduced fertility potential' said lead researcher Behzad Hajizadeh Maleki. 'Although these effects tended to improve over time, they remained significantly and abnormally higher in the COVID-19 patients, and the magnitude of these changes were also related to disease severity.'

The research looked at sperm samples from 84 men who previously had COVID-19 and 105 who had not. Samples were collected every ten days for 60 days, and were screened for a number of indicators of sperm quality. On average, the samples from men who had been ill with COVID-19 had reduced sperm concentration and mobility, and had four times more misshapen sperm. 

It is known that the cells in the testes have the ACE2 receptor, which the SARS-CoV-2 virus uses to infect cells. This issue was discussed in December at the annual conference of the Progress Educational Trust (PET) – the charity that publishes BioNews. However, it is unknown if this is related to the effect on sperm.

'Being ill from any virus such as flu can temporarily drop your sperm count (sometimes to zero) for a few weeks or months. This makes it difficult to work out how much of the reductions observed in this study were specific to COVID-19 rather than just from being ill' said Dr Channa Jayasena, a reproductive endocrinology and andrology specialist from Imperial College London, who was not involved in the study.

Professor Allan Pacey who spoke at the PET conference pointed out that 'sperm production takes just under three months (roughly) to be completed from start to finish... It would have been more useful to see whether there was a difference at 90 days between the two groups.'

He also added that the men with COVID-19 had been hospitalised and would have been given a number of medications, which the control group were not.

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Targeted invasion of the testes, cellular interference, inflammation and stress are the four key ways by which COVID-19 may affect fertility. 

In a review of COVID-19 studies, researchers discussed how the disease may be affecting men's sexual and reproductive systems. 

'Emerging evidence indicates toward the possibility of testicular damage due to COVID-19, which in turn may compromise the fertility potential of such men along with the disruption of the normal production of sex hormones,' Dr Shubhadeep Roychoudhury, co-author of the review, told Inverse.

The review, published in Open Biology, outlines how testes tissue is rich in ACE2 receptors, the virus' favourite entry-point, making the testes susceptible for targeted invasion by COVID-19 infection. The damage of cells in this tissue could have consequences in reproductive health and sperm production.

Inflammation has also been pinpointed as a potential cause of temporary or permanent damage to reproductive tissues. COVID-19 causes immune system overreactions, which may lead to the inflammation of the testicles, with the potential to disrupt the development of sperm cells. 

The inflammation of the endocrine tissue as a result of viral interference could lead to disruption in men's testosterone and other sex hormone levels.

Finally, COVID-19 is affecting men's mental health. The increase in the levels of stress could indirectly affect men's reproductive health and well-being. Increased oxidative stress can also disrupt the quality of the sperm by affecting its motility, quantity or shape.

The authors of the review stated how the evidence for the conclusions are still 'preliminary in nature', taking into consideration that there is no long-term, large-scale data that enables a clear prediction on the effects of COVID-19 on male fertility.

'Further clinical trials involving male COVID-19 patients of reproductive age as well as longitudinal studies in paediatric patients will help understand the long-term effects of SARS-CoV-2 infection on testicular functions and spermatogenesis.' said Dr Roychoudhury.

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