Computer‐aided sperm analysis,the new key player in routine sperm assessment

For sperm analysis, important inter‐laboratory variations have been observed in manual analyses. In this study, a computer‐aided sperm analysis (CASA) system was assessed versus manual technique, and specific software modifications were operated to fit the David's classification already used in the laboratory. Four parameters were studied (concentration, motility, vitality and morphology), and at least 30 semen samples from 30 different patients have been tested. Manual and automated analyses were compared using a least‐squares regression line analysis, Student's t test, Bland–Altman plots and Passing–Bablok regressions. Repeatability was also assessed, and coefficients of variation (CV) were calculated. Both manual and automated methods gave similar results for sperm concentration (n = 150), motility (n = 30), vitality (n = 90) and morphology (n = 90). Repeatability always showed a decrease in the CV with automated analysis; for example in normal range of sperm values, CV for manual and CASA analyses were, respectively, 9.0% versus 4.4% for sperm concentration, 5.2% versus 4.1% for motility, 7.3% versus 4.2% for vitality and 11.4% versus 4.1% for morphology. All parameters were comparable between automated and manual analysis, and repeatability measures confirm the more reliable values of the SCA compared to those of manual analysis.     

Comparison of the Sperm Quality Analyzer IIC variables with the computer-aided sperm analysis estimates

Sperm Quality Analyzer (SQA) IIC, an upgrade version, is an inexpensive device and provides a quantitative estimation of sperm motility, whereas the use of computer-aided sperm analysis (CASA) provides high precision and provision of quantitative data on sperm kinetics. The aim of the present study was to evaluate if the SQA IIC variables correlated with the CASA estimates. Semen quality analysis of 71 fresh semen samples was performed using SQA IIC and CASA. Total sperm concentration, percentage of progressively motile sperm, percentage of normal morphology, motile sperm concentration, sperm motility index (SMI) and functional sperm count (FSC) determinations were performed using SQA IIC. Sperm concentration, sperm motility, and sperm motion variables including amplitude of lateral head displacement (ALH), beat cross frequency (BCF), curvilinear velocity (VCL), straight line velocity (VSL), average path velocity (VAP), linearity (LIN=VSL/VCL), and straightness (STR=VSL/VAP) were evaluated simultaneously on the same semen samples using CASA. The sperm characteristics were compared between SQA IIC and CASA. There were significant correlations of sperm concentration (r=0.634, p < 0.0001), sperm motility (r=0.697, p < 0.0001), and motile sperm concentration (r=0.757, p < 0.0001) between the two devices. Both SMI and FSC significantly correlated with eight CASA estimates, including sperm concentration, sperm motility, motile sperm concentration, ALH, VCL, VSL, VAP, and Rapid. SQA IIC is simple and easy to use. Moreover, the SQA IIC variables well correlated with the CASA estimates. As a screening test for semen quality, SQA IIC is considered as useful in the management of male infertility.     

Semen quality in adult male survivors 5 years after the 2008 Wenchuan earthquake

The influence of the Wenchuan earthquake on semen quality of adult male survivors is unclear. We investigated the semen quality included 673 male survivors from the worse‐affected counties in the earthquake between Aug 2008 and July 2013. Semen parameters including pH, volume, concentration, motility and morphology were measured according to the World Health Organization (WHO) criteria. Kruskal–Wallis analysis of variance was used to examine the statistical differences between years, and a logistic regression was used to analyse the impacts caused by earthquake on the changes of semen quality. We found the medians (5th and 95th) were 2.5 ml (0.6–5.5) for semen volume, 59.0 × 10⁶ ml^?1 [(13.0–133.0)] × 10⁶ ml^?1 for semen concentration, 46% (13–64%) for sperm progressive motility and 3.0% (0–17.5%) for normal morphology for adult male survivors. Semen concentration, the percentage of sperm progressive motility, total motility and sperm normal morphology were all decreased in the first 3 years, and the differences among years 1, 2 and 3 were significant except the percentage of sperm progressive motility (P < 0.05). The casualties and heavy housing damage caused by earthquake had a negative effect on semen quality. The main findings will provide further diagnosis and therapy basis of male fertility by data, for affected populations in the earthquake.     

Assessment of sperm quality analyzer II B: comparison with manual semen analysis and CASA

Two hundred and seven patients with male infertility were investigated. Total sperm concentration and percent progressive motility by SQA IIB showed high correlations with those of conventional manual method. Percent of normal morphology showed a significant correlation among these techniques. The sperm motility index (SMI) and total functional sperm concentration (TFSC) demonstrated high correlations with any variables of manual analysis. Only velocity and amplitude of lateral head displacement showed significant correlations with the variables obtained by SQA IIB, especially with SMI and TFSC. It was suggested that SQA IIB could be a useful instrument in the clinical practice of infertility as a screening test for semen quality.     

Comparison of measurements of human sperm motility characteristics by the automated CellSoft system and time-exposure photomicrography

Human sperm motility characteristics in 28 semen samples with sperm concentrations less than 40 x 10(6) ml-1, as determined by the World Health Organization manual analysis (WHO, 1987), were measured by the automated CellSoft semen analyser (Cryo Resources Ltd, New York, NY, USA) using different system parameter settings (Mortimer & Mortimer, 1988a). The results were compared with those obtained by time-exposure photomicrographic (TEP) analysis. It was found that the settings of the minimum video frame rate and the threshold velocity used to distinguish motile from immotile sperm by the automated CellSoft system had a significant influence on measurements of percentage motility but not on linear velocity. At the five different parameter settings used in the present study, the automated CellSoft system gave significantly lower mean values for percentage motility in comparison with the WHO manual and TEP analyses. Measurements for linear velocity between the automated CellSoft system and TEP analyses were found not to be significantly different in these defined semen samples.     

Comparison of three different extenders on Murrah buffaloes (Bubalus bubalis) semen freezability

The use of frozen semen for artificial insemination is the main approach utilised for the genetic improvement of most domesticated species. The advantages include lower transportation costs, continuous availability of semen, fewer occurrences of sexually transmitted diseases and the incorporation of desirable genes in a relatively short amount of time. Nevertheless, the use of frozen semen in buffalo herds remains limited due to the loss of sperm quality when buffalo semen is frozen. So, the goal of this study was to evaluate the pre‐ and post‐cryopreservation quality of buffalo semen diluted in three distinct freezing media: Tris‐egg yolk, Botu‐bov® (BB) and ACP‐111®. Thirty‐two ejaculates from four bulls were analysed in terms of kinetics, morphology and sperm viability by epifluorescence microscope. Thawed samples were also evaluated for capacitation‐like damage, DNA fragmentation and plasma and acrosomal membrane integrity using flow cytometry. The Tris‐egg yolk and BB® extenders yielded better results than the ACP‐111® extender for kinetics parameter (total motility, progressive motility and percentage of rapid cells). However, semen samples were similar for parameters evaluated by flow cytometry. Taken together, the data indicate that in comparison with Tris‐egg yolk and BB extender, ACP‐111® can also be used as an extender for buffalo semen cryopreservation.     

Automation of human semen analysis using a novel artificial intelligence optical microscopic technology

Current semen analysis still commonly depends on a manual microscopy method in clinical laboratories worldwide. However, some of the major disadvantages of this technique are that it is labour‐intensive, subjective, laboratory‐based and time‐consuming. Although computer‐assisted semen analysers (CASAs) have enabled partial automation of routine semen analysis, they lack wider acceptance due to their complicated operation. Therefore, the development of an accessible, rapid and standardised method for semen analysis is urgently needed. Here, we describe the development and clinical testing of a novel, automated, artificial intelligence optical microscopic (AIOM)‐based technology, LensHooke? X1 PRO (X1 PRO), designed for the quantitative measurement of sperm concentration, motility and seminal pH. We observed high degree of correlation in the results of concentration, progressive motility and progressively motile sperm concentration between the X1 PRO semen analyser and manual method using 135 clinical semen samples. In addition, the seminal pH results obtained by X1 PRO and manual methods were comparable (p = .12). In summary, our results showed that new X1 PRO semen analyser is a reliable diagnostic tool for routine semen analysis providing clinically acceptable results based on World Health Organization (WHO) 5th Edition guidelines.     

Standardisation of a novel sperm banking kit – NextGen® – to preserve sperm parameters during shipment

Many male patients diagnosed with cancer are within their reproductive years. These men are advised to freeze their spermatozoa prior to the start of cancer treatment. Very often, sperm banking facilities may not be readily available and patients may be required to travel to distant sperm bank centres. Our objective was to design and standardise a remote home shipping sperm kit that allows patients to collect a semen sample at home and ship it overnight to a sperm bank. A total of 21 semen samples and two transport media (refrigeration media and human tubal fluid) and five different combinations of ice packs were tested for maintaining desired shipping temperature. Ten semen samples were assessed for pre‐ and post‐shipment changes in sperm motility, membrane integrity, total motile spermatozoa and recovery of motile spermatozoa. Even though motility, membrane integrity and total motile spermatozoa declined both in samples examined under simulated shipped conditions and in overnight‐shipped samples, the observed motility and total motile spermatozoa were adequate for use with assisted reproductive techniques. Using refrigeration media, cooling sleeve and ice packs, adequate sperm motility can be maintained utilising NextGen^® kit and these spermatozoa can be used for procreation utilising ART techniques such as intracytoplasmic sperm injection.     

Accuracy of the normal sperm morphology value by Sperm Quality Analyzer IIC: comparison with the strict criteria

The aim of the present study is to investigate the accuracy of the normal sperm morphology value by Sperm Quality Analyzer IIC (SQA IIC), which was developed to provide a rapid and low-cost quantitative evaluation of semen quality. Normal sperm morphology was assessed using SQA IIC in comparison with that by the strict criteria in 62 semen samples. Normal sperm morphology value by SQA IIC was based on the studies of three traditional sperm parameters from over 4000 fresh, untreated semen samples, while the strict criteria was based on the method by Kruger et al. The mean +/- SD of percent normal morphology by SQA IIC and the strict criteria were 37.6 +/- 10.9% (range 15-52) and 19.9 +/- 8.2 (range 1-34), respectively. There was a significant correlation of the sperm morphology assessment between the two methods (r=0.454, p < 0.001). Using the cut-off value of >30% normal morphology by SQA IIC, the positive predictive value and the negative predictive value of the 'normal' strict criteria were 79.6% (39/49) and 46.2% (6/13), respectively. These results indicate that SQA IIC might be used as an initial screening test for the evaluation of sperm morphology. However, sperm morphological assessment by the strict criteria should be performed in order to make decisions in planning strategies for the treatment of infertile couples.     

四种精液检测方法的比较和临床评价

目的 对以色列计数板(IC)、Makler计数板(MC)、精子质量分析仪(SQA)和血细胞计数板(CC)应用于精液常规分析的结果进行比较，并作出评估。方法 用4四种方法对来自有正常生育力的健康男性的64份精液标本进行分析。结果 在计数精子密度方面，IC、MC和SQA的结果有较好的一致性，3者之间无统计学上显著性差异；而CC与IC和SQA之间存在统计学上显著性差异，其P值分别为0．002和0．005。在计数精子活率方面，CC与MC和SQA之间也有统计学上显著性差异，其P值分别为0和0．02。我们使用了IC和MC检测前向运动精子百分率，结果显示两者之间无统计学上显著性差异，两者之间有较好的一致性。结论 在精液常规分析中，IC、MC和SQA这3种方法的结果虽具有较好的一致性，但不如CC准确，在临床应用时，应注明使用何种方法进行测定；也可将IC、MC和SQA等方法与CC进行比较，计算出校正系数予以调整。     

Comparative study of fertility parameters in vitrified human spermatozoa in the presence or absence of EmbryORP®: A novel antioxidant

The cryopreservation of spermatozoa has the main purpose of preserving male fertility. However, current preservation techniques have shown to produce lesions in the structure and alter sperm functions, probably due to the production of reactive oxygen species (ROS) during cryopreservation. To overcome the damage provoked by ROS, we introduced a novel antioxidant called EmbryORP^® in a vitrification protocol and compared eight fertility parameters: motility, viability, morphology, concentration, the semen pH, the oxidation-reduction potential (ORP), the spontaneous acrosomal reaction (AR) and the mitochondrial membrane potential (MMP), in the presence or absence of EmbryORP^®. We analysed 20 samples from healthy human sperm donors and observed that the antioxidant significantly decreased the semen pH as well as the MMP and the ORP affecting the balance of ROS. The antioxidant also lowered the motility and viability of the cells, but preserved the acrosome and sperm morphology in general. We concluded that EmbryORP^® lowered the ORP, but to a suboptimal level that may be harmful to spermatozoa. Despite these results, our work opens new perspectives on how to improve cryopreservation media. Therefore, we recommend exploring the EmbryORP^® potential benefit by reducing its concentration or changing the exposure time during the cryopreservation protocol.     

Semen quality evaluation in a cohort of 28213 adult males from Sichuan area of south‐west China

The trends in semen quality are conflicting. Although many previous surveys on semen quality indicated a decline, the trends in semen quality in Sichuan area of south‐west China are not clear. We analysed the semen parameters in a cohort of 28 213 adult males close to general population in Sichuan between July 2007 and June 2012, and investigated the changes on semen quality. The semen parameters including pH, volume, concentration, motility, morphology were measured according to the World Health Organization (WHO) criteria. Kruskal–Wallis analysis of variance was used to examine the statistical differences of semen quality between groups. We found that the medians (5th and 95th percentiles) were 2.4 ml (1.0–5.0) for semen volume, 62.0 × 10⁶ ml^?1 (15.0–142.0) for semen concentration, 39% (18–60%) for sperm progressive motility and 10.5% (1.0–34.5%) for normal morphology. In these 5 years, sperm concentration and the percentage of sperm normal morphology were decreased from 66.0 × 10⁶ ml^?1 to 49.0 × 10⁶ ml^?1 and from 13.5% to 4.5%, respectively; among different reproductive history groups, sperm concentration and the percentage of sperm normal morphology were also decreased in these 5 years. And the incidence of azoospermia was increasing. These may imply that there is a decline in semen quality of adult males in Sichuan area.     

Short‐term storage of salmonids semen in a sodium alginate‐based extender

Short‐term storage of semen is a useful strategy for preservation of fish spermatozoa. However, there is a significantly decrease on sperm function mainly due to oxidative stress. In this way, sodium alginate plays an important role as free radical scavenger compound. Accordingly, the aim of our study was to analyse the effect of a sodium alginate‐based extender on sperm function in the short‐term storage of salmonids semen. Samples of Salmo salar, Oncorhynchus kisutch, and Oncorhynchus mykiss were stored in Storfish^® (Ext‐C) and Storfish^® supplemented with sodium alginate (Ext‐A) during 10 days at 4°C. After storage, motility, viability, mitochondrial membrane potential (ΔΨmit), superoxide anion (O₂^?) level and DNA fragmentation (DNA Frag) were assessed. Ext‐A had positive effect in preservation of sperm motility, viability, ΔΨmit, O₂^? level and DNA integrity in the three species analysed compared to control samples. In Ext‐A, the spermatozoa of S. salar and O. mykiss showed significantly higher motility, viability and ΔΨmit than O. kisutch. However, O. kisutch and O. mykiss had significantly lower O₂^? level than S. salar, and DNA fragmentation in O. kisutch and S. salar was significantly lower than in samples of O. mykiss (p < 0.05). Dilution of salmonids semen in a sodium alginate‐based extender is effective for protecting sperm quality during 10 days of short‐term storage.     

Gradient sperm selection for reproductive techniques in cattle: Is Isolate a suitable replacement for Percoll?

In assisted reproductive techniques, it is essential to perform a sperm selection to obtain spermatozoa with high motility and membrane integrity for in vitro fertilisation (IVF) and high‐DNA integrity for intracytoplasmic sperm injection (ICSI). In this study, we evaluated whether Isolate ^® was a suitable substitute for Percoll ^® for assisted reproductive techniques. Commercial cryopreserved bovine semen was used after selection in both gradients, and plasma and acrosome membrane integrity, reactive oxygen species (ROS) levels, DNA integrity and mitochondrial membrane potential (ΔΨm) were assessed by flow cytometry. Motility parameters were also evaluated by CASA system. A similar percentage of spermatozoa with intact plasma membrane, acrosome integrity and high ΔΨm was observed in both sperm selection methods, but only Percoll ^® showed higher percentage of spermatozoa with intact plasma and acrosome membrane compared to the post‐thawing group. No differences were observed in the motility, ROS, DNA fragmentation and on the in vitro embryo production in all experimental groups. In conclusion, the selection of bovine spermatozoa with Isolate ^® generates spermatozoa with similar quality parameters and embryonic development compared to Percoll ^® providing a suitable alternative sperm selection method for assisted reproductive techniques in this species.     

Utilisation of sperm‐binding assay combined with computer‐assisted sperm analysis to evaluate frozen‐thawed bull semen

Due to homologies between the chicken egg perivitelline membrane with mammalian zona pellucida proteins, spermatozoa of several species are able to bind to this membrane. However, adequate standardisation is required to attest possible applications of this technique for semen evaluation of a given species. Therefore, we thawed and divided cryopreserved semen samples into two aliquotes, one kept in water bath at 37 °C (thawed) and the other submitted to snap‐freezing to damage sperm cells (dead spermatozoa). Aliquotes were mixed into different ratios of thawed:dead cells and analysed for motility, membrane and acrosomal integrity, and mitochondrial activity. In parallel, chicken egg perivitelline membranes were inseminated with these ratios, and the number of spermatozoa bound per mm² of membrane was assessed by conventional microscopy (CM) and computer‐assisted sperm analysis (CASA). Linear regression showed high correlation between thawed:dead sperm ratio and number of spermatozoa bound to the membrane (CM: r² = 0.91 and CASA: r² = 0.92 respectively). Additionally, positive correlations were found between the number of spermatozoa bound to the membrane and acrosomal integrity, membrane integrity, mitochondrial activity and motility. These findings indicate that sperm‐egg‐binding assay associated with CASA is a reliable, practical and inexpensive method for examining the fertilising capacity of cryopreserved bull semen.     

Seminal plasma proteins and their relationship with sperm motility and morphology in boars

The identification of biomarkers associated with seminal traits could aid in the selection of higher quality ejaculates and benefit the swine industry. The objective of this study was to identify boar seminal plasma proteins associated with sperm motility and morphology. Twenty ejaculates from fifteen adult boars from a commercial boar stud were used for this work. After routine semen collection and analysis, ejaculates were classified into two groups: high‐quality semen (HQS) and low‐quality semen (LQS), based on sperm motility and morphology. Semen samples were processed for seminal plasma separation and analysis by 2D SDS‐PAGE. Total and progressive sperm motility differed between groups (p < 0.001), as well sperm morphology (p < 0.05). The intensity of spots identified as Major seminal plasma PSP‐I (PSP‐I) and cathepsin B (CTSB) was higher in LQS as compared to HQS samples (p < 0.05). Also, PSP‐I was positively associated with major and sperm cauda defects. Sperm motility was negatively correlated with both PSP‐I and cathepsin B. We conclude that high concentrations of Major seminal plasma PSP‐I and cathepsin B in boar seminal plasma are associated with reduced total and progressive sperm motility and low sperm morphology and might be used as biomarkers for semen quality.     

TUNEL assay and SCSA determine different aspects of sperm DNA damage

For the determination of sperm DNA damage, different assays are used. However, no further distinction is made and the literature generally speaks about DNA damage. Thus, this study aimed at comparing the sperm chromatin structure assay (SCSA) and the TUNEL assay. In 79 patients, sperm DNA damage was determined flow cytometrically using the SCSA and the TUNEL assay. Moreover, normal sperm morphology was evaluated according to strict criteria. A statistical comparison of the two methods was performed using standard correlations, Bland and Altman plots, Passing–Bablok regressions and concordance correlation. Results show a significant difference between P‐ and G‐pattern morphology only for the mean channel fluorescence of the SCSA. Spearman’s rank correlations between the different parameters of both assays, SCSA and TUNEL, revealed significant associations between the parameters of the assays. However, when applying Bland and Altman plots, Passing–Bablok regression and concordance correlation results showed that these methods are not comparable. These different techniques determine different aspects of sperm DNA damage, i.e. ‘real’ DNA damage for the TUNEL assay and ‘potential’ DNA damage in terms of susceptibility to DNA denaturation for the SCSA. Thus, one should clearly distinguish between the different assays, not only practically and methodologically but also linguistically.     

Kruger strict morphology and post-thaw progressive motility in cryopreserved human spermatozoa

The purpose of this prospective study was to evaluate Kruger strict morphology and conventional semen analysis in predicting cryosurvival and the progressive motility recovery rate of frozen spermatozoa. Our study included 56 semen samples with >10 million spermatozoa per ejaculate. The main outcome measures were conventional semen analysis, strict morphology analysis by the Kruger method, cryosurvival rate and post-thaw sperm motility. A significant reduction in sperm motility after cryopreservation was demonstrated. The freeze-thawing process caused a 66% reduction in rapid progressive motile spermatozoa, a 45% reduction in slow progressive motile spermatozoa and a 2% reduction in nonprogressive motile spermatozoa. The cryosurvival and progressive motility recovery rates were not correlated with parameters of conventional semen analysis, such as sperm concentration, motility, WHO morphology and total motile count, but the progressive motility recovery rate was significantly correlated with the percentage of spermatozoa exhibiting Kruger normal morphology (P = 0.028). The recovery rate of rapidly progressive motility was profoundly decreased compared with slow progressive motility following the frozen-thaw procedure of semen. Kruger strict morphology assessment was a better predictor of the progressive motility recovery rate following the freezing-thaw procedure than parameters of conventional semen analysis.     

精索静脉曲张患者精液质量及其不育患者手术前后精液变化的观察

目的观察精索静脉曲张（VC）患者的精液质量和精子形态学改变，以及VC不育患者手术前后精液的变化。方法121例VC患者精液按WHO标准常规分析并对精子形态学进行评价，23例健康男性精液检查结果作为对照。并对21例VC不育患者术前及术后的精液进行检测分析。结果121例VC患者的精子密度、（A＋B）级活动力精子（％）、活率、有效精子数、活动精子数、活力指数以及正常形态精子比例较对照组明显降低（P〈0．01）；畸形精子中小头、锥形头和无定形头精子数较对照组增多（P〈0．01）。21例VC不育患者手术后精子质量和精子形态学较术前明显改善。结论VC可以引起精液质量下降导致不育，精子形态学分析是判定VC患者精子受损的一个敏感指标，手术能有效地改善精液质量。     

Semen quality and infertility status can be identified through measures of oxidation–reduction potential

Standard analyses for evaluating semen quality require technical expertise and are interpretive in nature. Oxidative stress (OS) alters many of the semen parameters; thus, a measure of OS could be an indicator of semen quality. Static oxidation‐reduction potential (sORP) is a universal measure of OS traditionally used in environmental applications but is increasingly used in biomedical studies. sORP was measured to determine how well it associates with semen quality and if it differentiates semen from infertile patients and fertile donors. All study participants (Infertile, n = 365 and Fertile, n = 50) underwent standard semen analyses, and sORP was measured in unprocessed semen. In infertile patients, sORP increased with decreased total sperm number, motility and morphology. sORP values were higher in samples with abnormal quality (low number, motility and/or normal morphology) compared with those of normal quality. Infertile patients had higher sOPR values compared to fertile donors. A sORP cut‐off value of 1.38 mV/10⁶ sperm/ml can differentiate normal from abnormal semen samples, while a cut‐off value of 1.41 mV/10⁶ sperm/ml, can differentiate between infertile and fertile semen samples. In conclusion, sORP provides a quick and unbiased indicator of semen quality that can be a beneficial addition to semen analysis to determine semen quality and fertility status.