New focus on adverse effects of male factors in assisted reproductive treatments
The adverse effects of male factors in assisted reproductive treatment were a clear and worrying focus at the 10th Congress of the Asia-Pacific Initiative for Reproduction (ASPIRE)).
The ASPIRE Congress, originally scheduled to take place in the Philippines, is being presented to online attendees in more than 100 countries due to ongoing concerns about COVID-19 in a virtual format (https://aspire2021.cme-congresses.com).
Professor Peter Schlegel from the Center for Reproductive Medicine at New York’s Weill Cornell Medical College, Cast shed new light on sperm quality, the sperm source for assisted conception – either from testicles, epididymis or ejaculate – male obesity and paternal age for fertility treatment success.
He said knowledge about assisted conception was mostly closely related to female factors, but the effects of male infertility had not been considered equally. Globally, one in six couples suffers from infertility, which is defined as the failure to conceive after a year of unprotected sex or the inability to carry pregnancies into a live birth.
With increasing research and experience, it is now recognized that problems with male factors can have a significant impact on assisted reproductive outcomes. “
Peter Schlegel, professor at the Center for Reproductive Medicine at New York’s Weill Cornell Medical College
He said sperm defects, including DNA fragmentation, affected several levels of reproductive function, including fertilization, embryonic development, implantation, and pregnancy maintenance.
“Intracytoplasmic, or single sperm injection into an egg for fertilization, known as ICSI, is widely used in assisted reproduction and has largely overcome sperm count, motility and morphology limitations in many men. However, some sperm factors still affect the chances of Fertilization and pregnancy.
“Sperm DNA fragmentation often occurs after exiting the testicle due to constipation, injury, or medication. A major study in couples who had repeated IVF cycles showed a clinical pregnancy rate of 28 percent for sperm from testicular sources compared to 10 percent for ejaculated sperm. “
In his ASPIRE presentation, Professor Schlegel discussed research on male obesity and paternal age.
“Male obesity – regardless of woman’s weight or other identifiable factors – significantly reduces clinical pregnancy and live birth rates in assisted reproductive technology,” he said.
He said a meta-analysis of the main studies to date has shown that this finding is progressively moving from normal male weight to overweight, obesity and morbid obesity.
Paternal age can have a significant impact on the health of the offspring and can play a role in IVF results. Although finding variability from different studies, Professor Schlegel highlighted one main study that showed a two-fold increased risk of failed conception in assisted reproductive technology when the male partner was over 40 years old.
Increased male age, especially over 40 years of age, has been linked to up to a 40 percent increased risk of miscarriage and other adverse consequences, including birth defects, childhood cancer, autism, and schizophrenia. ”
ASPIRE Congress was also told that reducing the length of abstinence for sperm analysis for IVF treatment actually improves semen quality, clinical pregnancy and live birth rates.
“Longer abstinence is associated with increased sperm DNA fragmentation and lower pregnancy rates after IVF,” said Professor Schlegel.
“Several identifiable male factors, some of which can be treated, can adversely affect the success of assisted reproductive technology. Knowledge of these conditions is critical to effective reproductive care.”
ASPIRE 2021 Virtual Congress