11 results on '"Farkouh, Ala'A"'
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2. Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations.
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Agarwal, Ashok, Farkouh, Ala’a, Saleh, Ramadan, Abdel-Meguid Hamoda, Taha Abo-Almagd, Salvio, Gianmaria, Boitrelle, Florence, Harraz, Ahmed M., Ghayda, Ramy Abou, Kavoussi, Parviz, Gül, Murat, Toprak, Tuncay, Russo, Giorgio Ivan, Durairajanayagam, Damayanthi, Rambhatla, Amarnath, Birowo, Ponco, Cannarella, Rossella, Nguyen Ho Vinh Phuoc, Zini, Armand, Arafa, Mohamed, and Wyns, Christine
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MALE infertility , *SEMEN analysis , *DELPHI method , *INTERNET surveys , *SPERMATOZOA - Abstract
Purpose: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. Materials and Methods: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. Results: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). Conclusions: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Controversy and consensus on indications for sperm DNA fragmentation testing in male infertility: A global survey, current guidelines, and expert recommendations
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Agarwal, Ashok, Farkouh, Ala'a, Saleh, Ramadan, Hamoda, Taha Abo-Almagd Abdel-Meguid, Harraz, Ahmed M., Kavoussi, Parviz, Arafa, Mohamed, and Palani, Ayad
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Delphi Method ,Male Infertility ,DNA Fragmentation ,Practice Guidelines ,Survey ,Sperm - Abstract
Purpose: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. Materials and Methods: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. Results: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. Conclusions: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians.
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- 2023
4. Sperm DNA fragmentation in male infertility: From bench to bedside.
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Farkouh, Ala'a, Saleh, Ramadan, Shah, Rupin, and Agarwal, Ashok
- Abstract
Sperm DNA fragmentation (SDF) is a molecular marker of sperm chromatin health. Elevated SDF is associated with male infertility, recurrent pregnancy loss, and failure of assisted reproductive technologies (ART). In 2021, the sixth edition of the World Health Organization (WHO) Manual for the Laboratory Examination and Processing of Human Semen has listed SDF as an extended test of semen that can be ordered under certain circumstances. However, the manual neither explained the indications for testing nor provided clear guidance on diagnostic thresholds. This article summarizes the current body of knowledge regarding clinical applications of SDF, including the appropriate population to test, methods of testing, and management strategies. Several etiologic factors and pathophysiologic mechanisms for SDF have been described including poor lifestyle habits, noxious exposures, and varicocele. Four SDF assays are included in the WHO manual and may be utilized based on resources and expertise. Strategies to lower SDF levels in infertile men include addressing underlying causes, supplementation with antioxidants, shorter abstinence periods, and use of testicular sperm for intracytoplasmic sperm injection. SDF testing can be implemented in the evaluation of infertile men and couples experiencing ART failure and appropriate management strategies can be offered to improve reproductive outcomes. There is vast potential for future research regarding the clinical utility of SDF in the evaluation and treatment of infertile couples. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Controversy and Consensus on the Management of Elevated Sperm DNA Fragmentation in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations.
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Farkouh, Ala’a, Agarwal, Ashok, Abdel-Meguid Hamoda, Taha Abo-Almagd, Kavoussi, Parviz, Saleh, Ramadan, Zini, Armand, Arafa, Mohamed, Harraz, Ahmed M., Gul, Murat, Karthikeyan, Vilvapathy Senguttuvan, Durairajanayagam, Damayanthi, Rambhatla, Amarnath, Boitrelle, Florence, Chung, Eric, Birowo, Ponco, Toprak, Tuncay, Ghayda, Ramy Abou, Cannarella, Rossella, Nguyen Ho Vinh Phuoc, and Dimitriadis, Fotios
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REPRODUCTIVE technology , *MALE infertility , *ANTIOXIDANTS , *MISCARRIAGE , *INTERNET surveys - Abstract
Purpose: Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition. Materials and Methods: An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method. Results: A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4–6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated. Conclusions: This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians. [ABSTRACT FROM AUTHOR]
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- 2023
- Full Text
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6. Consensus and Diversity in the Management of Varicocele for Male Infertility: Results of a Global Practice Survey and Comparison with Guidelines and Recommendations
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Shah, Rupin, Agarwal, Ashok, Kavoussi, Parviz, Rambhatla, Amarnath, Saleh, Ramadan, Cannarella, Rossella, Harraz, Ahmed M., Boitrelle, Florence, Kuroda, Shinnosuke, Hamoda, Taha Abo-Almagd Abdel-Meguid, Zini, Armand, Ko, Edmund, Çalık, Gökhan, Toprak, Tuncay, Kandil, Hussein, Gül, Murat, Bakırcıoğlu, Mustafa Emre, Parekh, Neel, Russo, Giorgio Ivan, Tadros, Nicholas, Kadıoğlu, Ateş, Arafa, Mohamed, Chung, Eric, Rajmil, Osvaldo, Dimitriadis, Fotios, Malhotra, Vineet, Salvio, Gianmaria, Henkel, Ralf, Le, Tan V., Sogutdelen, Emrullah, Vij, Sarah, Alarbid, Abdullah, Güdeloğlu, Ahmet, Tsujimura, Akira, Calogero, Aldo E., El Meliegy, Amr, Crafa, Andrea, Kalkanlı, Arif, Baser, Aykut, Hazır, Berk, Giulioni, Carlo, Cho, Chak-Lam, Ho, Christopher C.K., Salzano, Ciro, Zylbersztejn, Daniel Suslik, Tien, Dung Mai Ba, Pescatori, Edoardo, Borges, Edson, Saïs-Hamza, Eminej, Huyghe, Eric, Ceyhan, Erman, Caroppo, Ettore, Castiglioni, Fabrizio, Bahar, Fahmi, Gökalp, Fatih, Lombardo, Francesco, Gadda, Franco, Duarsa, Gede Wirya Kusuma, Pinggera, Germar-Michael, Busetto, Gian Maria, Balercia, Giancarlo, Cito, Gianmartin, Blecher, Gideon, Franco, Giorgio, Liguori, Giovanni, Elbardisi, Haitham, Keskin, Hakan, Lin, Haocheng, Taniguchi, Hisanori, Park, Hyun Jun, Ziouziou, Imad, de la Rosette, Jean J. M. C. H., Hotaling, Jim, Ramsay, Jonathan, Molina, Juan Manuel Corral, Lo, Ka Lun, Böcü, Kadir, Khalafalla, Kareim, Bowa, Kasonde, Okada, Keisuke, Nagao, Koichi, Chiba, Koji, Hakim, Lukman, Makarounis, Konstantinos, Hehemann, Marah, Peña, Marcelo Rodriguez, Falcone, Marco, Bendayan, Marion, Martinez, Marlon, Timpano, Massimiliano, Altan, Mesut, Fode, Mikkel, Al-Marhoon, Mohamed S., Gilani, Mohammad Ali Sadighi, Soebadi, Mohammad Ayodhia, Gherabi, Nazim, Sofikitis, Nikolaos, Kahraman, Oğuzhan, Birowo, Ponco, Kothari, Priyank, Sindhwani, Puneet, Javed, Qaisar, Ambar, Rafael F., Kosgi, Raghavender, Ghayda, Ramy Abou, Adriansjah, Ricky, Condorelli, Rosita Angela, La Vignera, Sandro, Micic, Sava, Kim, Shannon Hee Kyung, Fukuhara, Shinichiro, Ahn, Sun Tae, Mostafa, Taymour, Ong, Teng Aik, Takeshima, Teppei, Amano, Toshiyasu, Barrett, Trenton, Arslan, Umut, Karthikeyan, Vilvapathy Senguttuvan, Atmoko, Widi, Yumura, Yasushi, Yuan, Yiming, Kato, Yuki, Jezek, Davor, Cheng, Bryan Kwun-Chung, Hatzichristodoulou, Georgios, Dy, Jun, Castañé, Eduard Ruiz, El-Sakka, Ahmed I., Nguyen, Quang, Sarıkaya, Selçuk, Boeri, Luca, Tan, Ronny, Moussa, Mohamad A., El-Assmy, Ahmed, Alali, Hamed, Alhathal, Naif, Osman, Yasser, Perovic, Dragoljub, Sajadi, Hesamoddin, Akhavizadegan, Hamed, Vučinić, Miroslav, Kattan, Said, Kattan, Mohamed S., Mogharabian, Nasser, Phuoc, Nguyen Ho Vinh, Ngoo, Kay Seong, Alkandari, Mohammad H., Alsuhaibani, Shaheed, Sokolakis, Ioannis, Babaei, Mehdi, King, Mak Siu, Diemer, Thorsten, Gava, Marcelo M., Henrique, Raphael, Spinola e Silva, Rodrigo, Paul, Gustavo Marquesine, Mierzwa, Tiago Cesar, Glina, Sidney, Siddiqi, Kashif, Wu, Han, Wurzacher, Jana, Farkouh, Ala'a, Son, Hwancheol, Minhas, Suks, Lee, Joe, Magsanoc, Nikko, Capogrosso, Paolo, Albano, German Jose, Lewis, Sheena E.M., Jayasena, Channa N., Alvarez, Juan G., Teo, Colin, Smith, Ryan P., Chua, Jo Ben M., Jensen, Christian Fuglesang S., Parekattil, Sijo, Finelli, Renata, Durairajanayagam, Damayanthi, Karna, Keshab Kumar, Ahmed, Abdelkareem, Evenson, Don, Umemoto, Yukihiro, Puigvert, Ana, Çeker, Gökhan, Colpi, Giovanni M., Rolitsky, Sarah, Bouzouita, Abderrazak, Shokeir, Ahmed, Aşçı, Ahmet, Bouker, Amin, Adamyan, Aram, Avoyan, Armen E., Palani, Ayad, Aghamajidi, Azin, Eze, Balantine, Noegroho, Bambang Sasongko, Purnomo, Basuki, Erkan, Bircan Kolbaşı, Zilaitiene, Birute, Kulaksız, Deniz, Kafetzis, Dimitrios, Lee, Dong Sup, Stember, Doron, Evgeni, Evangelini, Alhajeri, Faisal, Finocchi, Federica, Colombo, Fulvio, Tsangaris, George, Sallam, Hassan N., Acosta, Herik, Rosas, Israel Maldonado, Kirkman-Brown, Jackson, Shin, Jae Il, Sonksen, Jens, Dong, Jie, Marmar, Joel, Moreno-Sepulveda, Jose, Seo, Ju Tae, Aydos, Kaan, Kesari, Kavindra Kumar, Trost, Landon, Jenkins, Lawrence, Rocco, Lucia, Darbandi, Mahsa, Simopoulou, Mara, Alves, Marco, Sabbaghian, Marjan, Tavalaee, Marziyeh, Razi, Mazdak, Duran, Mesut Berkan, Nago, Mitsuru, Elkhouly, Mohamed, Khalili, Mohamed, Nasr-Esfahani, Mohammad Hossein, Kamath, Mohan S., Uğur, Muhammet Raşit, Park, Nam Cheol, Cruz, Natalio, Garrido, Nicolas, Sodeifi, Niloofar, Al Khalidi, Noora, Shoshany, Ohad, Satyagraha, Paksi, Drakopoulos, Panagiotos, Vogiatzi, Paraskevi, Dolati, Parisa, Das, Partha, Chiu, Peter Ka-Fung, Tsioulou, Petroula A., Patel, Premal, Singh, Rajender, Kaiyal, Raneen Sawaid, Santos, Ferreira, Dada, Rima, Brodjonegoro, Sakti, Banihani, Saleem Ali, Schon, Samantha, Darbandi, Sara, Güneş, Sezgin, Homa, Sheryl, Mutambirwa, Shingai, Roychoudhury, Shubhadeep, Diaz, Sofia Ines Leonardi, Gopalakrishnan, Sreelatha, Krawetz, Stephen, Jindal, Sunil, Avidor-Reiss, Tomer, Lin, Tsung Yen, Kumar, Vijay, Ibrahim, Wael, Kerkeni, Walid, Woo, Wongi, Morimoto, Yoshiharu, Cheng, Yu-Sheng, Shah, Rupin, Agarwal, Ashok, Kavoussi, Parviz, Rambhatla, Amarnath, Saleh, Ramadan, Cannarella, Rossella, Harraz, Ahmed M., Boitrelle, Florence, Kuroda, Shinnosuke, Hamoda, Taha Abo-Almagd Abdel-Meguid, Zini, Armand, Ko, Edmund, Calik, Gokhan, Toprak, Tuncay, Kandil, Hussein, Gül, Murat, Bakırcıoğlu, Mustafa Emre, Parekh, Neel, Russo, Giorgio Ivan, Tadros, Nichola, Kadioglu, Ate, Arafa, Mohamed, Chung, Eric, Rajmil, Osvaldo, Dimitriadis, Fotio, Malhotra, Vineet, Salvio, Gianmaria, Henkel, Ralf, Le, Tan V., Sogutdelen, Emrullah, Vij, Sarah, Alarbid, Abdullah, Gudeloglu, Ahmet, Tsujimura, Akira, Calogero, Aldo E., Meliegy, Amr El, Crafa, Andrea, Kalkanli, Arif, Baser, Aykut, Hazir, Berk, Giulioni, Carlo, Cho, Chak-Lam, Ho, Christopher C. K., Salzano, Ciro, Zylbersztejn, Daniel Suslik, Tien, Dung Mai Ba, Pescatori, Edoardo, Borges, Edson, Serefoglu, Ege Can, Sas-Hamza, Emine, Huyghe, Eric, Ceyhan, Erman, Caroppo, Ettore, Castiglioni, Fabrizio, Bahar, Fahmi, Gokalp, Fatih, Lombardo, Francesco, Gadda, Franco, Duarsa, Gede Wirya Kusuma, Pinggera, Germar-Michael, Busetto, Gian Maria, Balercia, Giancarlo, Cito, Gianmartin, Blecher, Gideon, Franco, Giorgio, Liguori, Giovanni, Elbardisi, Haitham, Keskin, Hakan, Lin, Haocheng, Taniguchi, Hisanori, Park, Hyun Jun, Ziouziou, Imad, Rosette, Jean de la, Hotaling, Jim, Ramsay, Jonathan, Molina, Juan Manuel Corral, Lo, Ka Lun, Bocu, Kadir, Khalafalla, Kareim, Bowa, Kasonde, Okada, Keisuke, Nagao, Koichi, Chiba, Koji, Hakim, Lukman, Makarounis, Konstantino, Hehemann, Marah, Peña, Marcelo Rodriguez, Falcone, Marco, Bendayan, Marion, Martinez, Marlon, Timpano, Massimiliano, Altan, Mesut, Fode, Mikkel, Al-Marhoon, Mohamed S., Gilani, Mohammad Ali Sadighi, Soebadi, Mohammad Ayodhia, Gherabi, Nazim, Sofikitis, Nikolao, Kahraman, Oğuzhan, Birowo, Ponco, Kothari, Priyank, Sindhwani, Puneet, Javed, Qaisar, Ambar, Rafael F., Kosgi, Raghavender, Ghayda, Ramy Abou, Adriansjah, Ricky, Condorelli, Rosita Angela, Vignera, Sandro La, Micic, Sava, Kim, Shannon Hee Kyung, Fukuhara, Shinichiro, Ahn, Sun Tae, Mostafa, Taymour, Ong, Teng Aik, Takeshima, Teppei, Amano, Toshiyasu, Barrett, Trenton, Arslan, Umut, Karthikeyan, Vilvapathy Senguttuvan, Atmoko, Widi, Yumura, Yasushi, Yuan, Yiming, Kato, Yuki, Jezek, Davor, Cheng, Bryan Kwun-Chung, Hatzichristodoulou, Georgio, Dy, Jun, Castañé, Eduard Ruiz, El-Sakka, Ahmed I., Nguyen, Quang, Sarikaya, Selcuk, Boeri, Luca, Tan, Ronny, Moussa, Mohamad A., El-Assmy, Ahmed, Alali, Hamed, Alhathal, Naif, Osman, Yasser, Perovic, Dragoljub, Sajadi, Hesamoddin, Akhavizadegan, Hamed, Vučinić, Miroslav, Kattan, Said, Kattan, Mohamed S., Mogharabian, Nasser, Phuoc, Nguyen Ho Vinh, Ngoo, Kay Seong, Alkandari, Mohammad H., Alsuhaibani, Shaheed, Sokolakis, Ioanni, Babaei, Mehdi, King, Mak Siu, Diemer, Thorsten, Gava, Marcelo M., Henrique, Raphael, Silva, Rodrigo Spinola e, Paul, Gustavo Marquesine, Mierzwa, Tiago Cesar, Glina, Sidney, Siddiqi, Kashif, Wu, Han, Wurzacher, Jana, Farkouh, Ala’A, Son, Hwancheol, Minhas, Suk, Lee, Joe, Magsanoc, Nikko, Capogrosso, Paolo, Albano, German Jose, Lewis, Sheena E. M., Jayasena, Channa N., Alvarez, Juan G., Teo, Colin, Smith, Ryan P., Chua, Jo Ben M., Jensen, Christian Fuglesang S., Parekattil, Sijo, Finelli, Renata, Durairajanayagam, Damayanthi, Karna, Keshab Kumar, Ahmed, Abdelkareem, Evenson, Don, Umemoto, Yukihiro, Puigvert, Ana, Çeker, Gökhan, Forum, Giovanni M Colpi, Shah, R., Agarwal, A., Kavoussi, P., Rambhatla, A., Saleh, R., Cannarella, R., Harraz, A. M., Boitrelle, F., Kuroda, S., Hamoda, T. A. -A. A. -M., Zini, A., Ko, E., Calik, G., Toprak, T., Kandil, H., Gul, M., Bakircioglu, M. E., Parekh, N., Russo, G. I., Tadros, N., Kadioglu, A., Arafa, M., Chung, E., Rajmil, O., Dimitriadis, F., Malhotra, V., Salvio, G., Henkel, R., Le, T. V., Sogutdelen, E., Vij, S., Alarbid, A., Gudeloglu, A., Tsujimura, A., Calogero, A. E., El Meliegy, A., Crafa, A., Kalkanli, A., Baser, A., Hazir, B., Giulioni, C., Cho, C. -L., Ho, C. C. K., Salzano, C., Zylbersztejn, D. S., Tien, D. M. B., Pescatori, E., Borges, E., Serefoglu, E. C., Sais-Hamza, E., Huyghe, E., Ceyhan, E., Caroppo, E., Castiglioni, F., Bahar, F., Gokalp, F., Lombardo, F., Gadda, F., Duarsa, G. W. K., Pinggera, G. -M., Busetto, G. M., Balercia, G., Cito, G., Blecher, G., Franco, G., Liguori, G., Elbardisi, H., Keskin, H., Lin, H., Taniguchi, H., Park, H. J., Ziouziou, I., de la Rosette, J., Hotaling, J., Ramsay, J., Molina, J. M. C., Lo, K. L., Bocu, K., Khalafalla, K., Bowa, K., Okada, K., Nagao, K., Chiba, K., Hakim, L., Makarounis, K., Hehemann, M., Pena, M. R., Falcone, M., Bendayan, M., Martinez, M., Timpano, M., Altan, M., Fode, M., Al-Marhoon, M. S., Gilani, M. A. S., Soebadi, M. A., Gherabi, N., Sofikitis, N., Kahraman, O., Birowo, P., Kothari, P., Sindhwani, P., Javed, Q., Ambar, R. F., Kosgi, R., Ghayda, R. A., Adriansjah, R., Condorelli, R. A., La Vignera, S., Micic, S., Kim, S. H. K., Fukuhara, S., Ahn, S. T., Mostafa, T., Ong, T. A., Takeshima, T., Amano, T., Barrett, T., Arslan, U., Karthikeyan, V. S., Atmoko, W., Yumura, Y., Yuan, Y., Kato, Y., Jezek, D., Cheng, B. K. -C., Hatzichristodoulou, G., Dy, J., Castane, E. R., El-Sakka, A. I., Nguyen, Q., Sarikaya, S., Boeri, L., Tan, R., Moussa, M. A., El-Assmy, A., Alali, H., Alhathal, N., Osman, Y., Perovic, D., Sajadi, H., Akhavizadegan, H., Vucinic, M., Kattan, S., Kattan, M. S., Mogharabian, N., Phuoc, N. H. V., Ngoo, K. S., Alkandari, M. H., Alsuhaibani, S., Sokolakis, I., Babaei, M., King, M. S., Diemer, T., Gava, M. M., Henrique, R., Spinola e Silva, R., Paul, G. M., Mierzwa, T. C., Glina, S., Siddiqi, K., Wu, H., Wurzacher, J., Farkouh, A., Son, H., Minhas, S., Lee, J., Magsanoc, N., Capogrosso, P., Albano, G. J., Lewis, S. E. M., Jayasena, C. N., Alvarez, J. G., Teo, C., Smith, R. P., Chua, J. B. M., Jensen, C. F. S., Parekattil, S., Finelli, R., Durairajanayagam, D., Karna, K. K., Ahmed, A., Evenson, D., Umemoto, Y., Puigvert, A., Ceker, G., Colpi, G. M., Rolitsky, S., Bouzouita, A., Shokeir, A., Asci, A., Bouker, A., Adamyan, A., Avoyan, A. E., Palani, A., Aghamajidi, A., Eze, B., Noegroho, B. S., Purnomo, B., Erkan, B. K., Zilaitiene, B., Kulaksiz, D., Kafetzis, D., Lee, D. S., Stember, D., Evgeni, E., Alhajeri, F., Finocchi, F., Colombo, F., Tsangaris, G., Sallam, H. N., Acosta, H., Rosas, I. M., Kirkman-Brown, J., Shin, J. I., Sonksen, J., Dong, J., Marmar, J., Moreno-Sepulveda, J., Seo, J. T., Aydos, K., Kesari, K. K., Trost, L., Jenkins, L., Rocco, L., Darbandi, M., Simopoulou, M., Alves, M., Sabbaghian, M., Tavalaee, M., Razi, M., Duran, M. B., Nago, M., Elkhouly, M., Khalili, M., Nasr-Esfahani, M. H., Kamath, M. S., Ugur, M. R., Park, N. C., Cruz, N., Garrido, N., Sodeifi, N., Al Khalidi, N., Shoshany, O., Satyagraha, P., Drakopoulos, P., Vogiatzi, P., Dolati, P., Das, P., Chiu, P. K. -F., Tsioulou, P. A., Patel, P., Singh, R., Kaiyal, R. S., Santos, F., Dada, R., Brodjonegoro, S., Banihani, S. A., Schon, S., Darbandi, S., Gunes, S., Homa, S., Mutambirwa, S., Roychoudhury, S., Diaz, S. I. L., Gopalakrishnan, S., Krawetz, S., Jindal, S., Avidor-Reiss, T., Lin, T. Y., Kumar, V., Ibrahim, W., Kerkeni, W., Woo, W., Morimoto, Y., Cheng, Y. -S., and Tıp Fakültesi
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Aging ,Consensus ,Urology ,INGUINAL VARICOCELECTOMY ,Disease management ,Male infertility ,Survey ,Varicocele ,Consensu ,Global Andrology Forum ,Endocrinology & Metabolism ,NONOBSTRUCTIVE AZOOSPERMIA ,ASSISTED REPRODUCTIVE TECHNOLOGY ,Male Infertility ,Pharmacology (medical) ,Andrology ,IMPAIRED SEMEN QUALITY ,EUROPEAN ASSOCIATION ,Science & Technology ,UROLOGY GUIDELINES ,Health Policy ,Public Health, Environmental and Occupational Health ,Disease Management ,Urology & Nephrology ,SUBCLINICAL VARICOCELE ,Psychiatry and Mental health ,Health Care Sciences & Services ,MICROSURGICAL SUBINGUINAL VARICOCELECTOMY ,Reproductive Medicine ,SPERM MORPHOLOGY ,UNTREATED VARICOCELE ,Life Sciences & Biomedicine - Abstract
Purpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varicocele in the context of male infertility. Materials and Methods: Sixty practicing urologists/andrologists from 23 countries contributed 382 multiple-choice-questions pertaining to varicocele management. These were condensed into an online questionnaire that was forwarded to clinicians involved in male infertility management through direct invitation. The results were analyzed for disagreement and agreement in practice patterns and, compared with the latest guidelines of international professional societies (American Urological As- sociation [AUA], American Society for Reproductive Medicine [ASRM], and European Association of Urology [EAU]), and with evidence emerging from recent systematic reviews and meta-analyses. Additionally, an expert opinion on each topic was provided based on the consensus of 16 experts in the field. Results: The questionnaire was answered by 574 clinicians from 59 countries. The majority of respondents were urologists/ uro-andrologists. A wide diversity of opinion was seen in every aspect of varicocele diagnosis, indications for repair, choice of technique, management of sub-clinical varicocele and the role of VR in azoospermia. A significant proportion of the re- sponses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identi- fied where no guidelines are available. Conclusions: This study is the largest global survey performed to date on the clinical management of varicocele for male in- fertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical prac- tice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men.
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- 2022
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7. Impact of Antioxidant Therapy on Natural Pregnancy Outcomes and Semen Parameters in Infertile Men: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
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Agarwal, Ashok, Cannarella, Rossella, Saleh, Ramadan, Harraz, Ahmed M., Kandil, Hussein, Salvio, Gianmaria, Boitrelle, Florence, Kuroda, Shinnosuke, Farkouh, Ala’a, Rambhatla, Amarnath, Zini, Armand, Colpi, Giovanni, Gül, Murat, Kavoussi, Parviz, Abdel-Meguid Hamoda, Taha Abo-Almagd, Ko, Edmund, Calik, Gokhan, Toprak, Tuncay, Pinggera, Germar-Michael, and Park, Hyun Jun
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THERAPEUTIC use of antioxidants ,SEMEN analysis ,MALE infertility ,PREGNANCY complications ,MISCARRIAGE - Abstract
Purpose: Seminal oxidative stress (OS) is a recognized factor potentially associated with male infertility, but the efficacy of antioxidant (AOX) therapy is controversial and there is no consensus on its utility. Primary outcomes of this study were to investigate the effect of AOX on spontaneous clinical pregnancy, live birth and miscarriage rates in male infertile patients. Secondary outcomes were conventional semen parameters, sperm DNA fragmentation (SDF) and seminal OS. Materials and Methods: Literature search was performed using Scopus, PubMed, Ovid, Embase, and Cochrane databases. Only randomized controlled trials (RCTs) were included and the meta-analysis was conducted according to PRISMA guidelines. Results: We assessed for eligibility 1,307 abstracts, and 45 RCTs were finally included, for a total of 4,332 infertile patients. We found a significantly higher pregnancy rate in patients treated with AOX compared to placebo-treated or untreated controls, without significant inter-study heterogeneity. No effects on live-birth or miscarriage rates were observed in four studies. A significantly higher sperm concentration, sperm progressive motility, sperm total motility, and normal sperm morphology was found in patients compared to controls. We found no effect on SDF in analysis of three eligible studies. Seminal levels of total antioxidant capacity were significantly higher, while seminal malondialdehyde acid was significantly lower in patients than controls. These results did not change after exclusion of studies performed following varicocele repair. Conclusions: The present analysis upgrades the level of evidence favoring a recommendation for using AOX in male infertility to improve the spontaneous pregnancy rate and the conventional sperm parameters. The failure to demonstrate an increase in live-birth rate, despite an increase in pregnancy rates, is due to the very few RCTs specifically assessing the impact of AOX on live-birth rate. Therefore, further RCTs assessing the impact of AOX on live-birth rate and miscarriage rate, and SDF will be helpful. [ABSTRACT FROM AUTHOR]
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- 2023
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8. Role of Cytocentrifugation Combined with Nuclear Fast Picroindigocarmine Staining in Detecting Cryptozoospermia in Men Diagnosed with Azoospermia.
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Sharma, Rakesh Kumar, Gupta, Sajal, Agarwal, Ashok, Finelli, Renata, Kuroda, Shinnosuke, Saleh, Ramadan, Boitrelle, Florence, Kavoussi, Parviz, Gül, Murat, Tadros, Nicholas, Ko, Edmund, Farkouh, Ala’a, Henkel, Ralf, Arafa, Mohamed, Rambhatla, Amarnath, and Shah, Rupin
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AZOOSPERMIA ,SPERMATOZOA ,SEMEN analysis ,MALE infertility ,SEMEN - Abstract
Purpose: Azoospermia is defined as the absence of spermatozoa in the pellet of a centrifuged semen sample. In fact, when a basic semen analysis fails to detect sperm in the ejaculate, there is still the possibility of detecting rare sperm after centrifugation of the sample and examination of the pellet. In this study, we assessed the role of Cytospin centrifugation in combination with the nuclear fast picroindigocarmine (NF-PIC) staining in identifying sperm in azoospermic samples. Materials and Methods: Semen samples of 251 men diagnosed as having azoospermia after standard examination were further analyzed by Cytospin centrifugation in combination with NF-PIC staining. Results: Sperm were detected in 60 men (23.9%), thus changing their diagnosis to cryptozoospermia. Conclusions: By identifying sperm in the semen of men who were thought to have total azoospermia, the Cytospin NF-PIC test can alter the diagnosis and further treatment of these men. [ABSTRACT FROM AUTHOR]
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- 2022
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9. Antisperm Antibody Testing: A Comprehensive Review of Its Role in the Management of Immunological Male Infertility and Results of a Global Survey of Clinical Practices.
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Gupta, Sajal, Sharma, Rakesh, Agarwal, Ashok, Boitrelle, Florence, Finelli, Renata, Farkouh, Ala’a, Saleh, Ramadan, Abdel-Meguid, Taha Abo-Almagd, Gül, Murat, Zilaitiene, Birute, Ko, Edmund, Rambhatla, Amarnath, Zini, Armand, Leisegang, Kristian, Shinnosuke Kuroda, Henkel, Ralf, Cannarella, Rossella, Palani, Ayad, Chak-Lam Cho, and Ho, Christopher C. K.
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MALE infertility ,SEMEN analysis ,ETIOLOGY of diseases ,AGGLUTINATION ,IMMUNOGLOBULINS - Abstract
Antisperm antibodies (ASA), as a cause of male infertility, have been detected in infertile males as early as 1954. Multiple causes of ASA production have been identified, and they are due to an abnormal exposure of mature germ cells to the immune system. ASA testing (with mixed anti-globulin reaction, and immunobead binding test) was described in the WHO manual 5th edition and is most recently listed among the extended semen tests in the WHO manual 6th edition. The relationship between ASA and infertility is somewhat complex. The presence of sperm agglutination, while insufficient to diagnose immunological infertility, may indicate the presence of ASA. However, ASA can also be present in the absence of any sperm agglutination. The andrological management of ASA depends on the etiology and individual practices of clinicians. In this article, we provide a comprehensive review of the causes of ASA production, its role in immunological male infertility, clinical indications of ASA testing, and the available therapeutic options. We also provide the details of laboratory procedures for assessment of ASA together with important measures for quality control. Additionally, laboratory and clinical scenarios are presented to guide the reader in the management of ASA and immunological male infertility. Furthermore, we report the results of a recent worldwide survey, conducted to gather information about clinical practices in the management of immunological male infertility. [ABSTRACT FROM AUTHOR]
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- 2022
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10. Sperm DNA Fragmentation: A Critical Assessment of Clinical Practice Guidelines.
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Agarwal, Ashok, Farkouh, Ala’a, Parekh, Neel, Zini, Armand, Arafa, Mohamed, Kandil, Hussein, Tadros, Nick, Busetto, Gian Maria, Ambar, Rafael, Parekattil, Sijo, Boitrelle, Florence, Sallam, Hassan, Jindal, Sunil, Ko, Edmund, Simopoulou, Mara, Hyun Jun Park, Sadighi, Mohammad Ali, Saleh, Ramadan, Ramsay, Jonathan, and Martinez, Marlon
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SPERMATOZOA , *DNA , *MALE infertility , *OXIDATIVE stress , *MEN'S health - Abstract
Sperm DNA fragmentation (SDF) is implicated in male infertility and adverse reproductive outcomes. With the publication of many studies regarding the etiologies and contributors to SDF, as well as the effects of SDF, guidelines are necessary to aid clinicians in the application of SDF for male fertility evaluation. Two recent clinical practice guidelines were published by Agarwal et al and Esteves et al. In this article, we have evaluated and compared both guidelines. We have found fairly similar recommendations between the two guidelines and have also highlighted the differences between them. Finally, we have summarized and combined the best practice recommendations from both guidelines. [ABSTRACT FROM AUTHOR]
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- 2022
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11. Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations
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Agarwal, A, Farkouh, A, Saleh, R, Abdel-Meguid Hamoda, TA-A, Harraz, AM, Kavoussi, P, Arafa, M, Salvio, G, Rambhatla, A, Toprak, T, Gül, M, Phuoc, NHV, Boitrelle, F, Birowo, P, Ghayda, RA, Cannarella, R, Kuroda, S, Durairajanayagam, D, Zini, A, Wyns, C, Sarikaya, S, Tremellen, K, Mostafa, T, Sokolakis, I, Evenson, DP, Henkel, R, Zohdy, W, Chung, E, Ziouziou, I, Falcone, M, Russo, GI, Al-Hashimi, M, Calogero, AE, Ko, E, Colpi, G, Lewis, S, Serefoglu, EC, Bahar, F, Martinez, M, Nguyen, Q, Ambar, RF, Bakircioglu, ME, Kandil, H, Mogharabian, N, Sabbaghian, M, Taniguchi, H, Tsujimura, A, Sajadi, H, Ibrahim, W, Atmoko, W, Vogiatzi, P, Gunes, S, Gilani, MAS, Roychoudhury, S, Güngör, ND, Hakim, L, Adriansjah, R, Kothari, P, Jindal, S, Amar, E, Park, HJ, Long, TQT, Homa, S, Karthikeyan, VS, Zilaitiene, B, Rosas, IM, Marino, A, Pescatori, E, Ozer, C, Akhavizadegan, H, Garrido, N, Busetto, GM, Adamyan, A, Al-Marhoon, M, Elbardisi, H, Dolati, P, Darbandi, M, Darbandi, S, Balercia, G, Pinggera, G-M, Micic, S, Ho, CCK, Moussa, M, Preto, M, Zenoaga-Barbăroșie, C, Smith, RP, Kosgi, R, Rosette, JDL, El-Sakka, AI, Abumelha, SM, Mierzwa, TC, Ong, TA, Banihani, SA, Bowa, K, Fukuhara, S, Boeri, L, Danacıoğlu, YO, Gokalp, F, Selim, OM, Cho, C-L, Tadros, NN, Ugur, MR, Ozkent, MS, Chiu, P, Kalkanli, A, Khalafalla, K, Vishwakarma, RB, Finocchi, F, Andreadakis, S, Giulioni, C, Çeker, G, Ceyhan, E, Malhotra, V, Yilmaz, M, Timpano, M, Barrett, TL, Kim, SHK, Ahn, S-T, Giacone, F, Palani, A, Duarsa, GWK, Kadioglu, A, Gadda, F, Zylbersztejn, DS, Aydos, K, Kulaksız, D, Gupte, D, Calik, G, Karna, KK, Drakopoulos, P, Baser, A, Kumar, V, Molina, JMC, Rajmil, O, Ferreira, RH, Leonardi, S, Avoyan, A, Sogutdelen, E, Franco, G, Ramsay, J, Ramirez, L, Shah, R, Global Andrology Forum, Agarwal, Ashok, Farkouh, Ala'A, Saleh, Ramadan, Abdel-Meguid Hamoda, Taha Abo-Almagd, Harraz, Ahmed M, Kavoussi, Parviz, Arafa, Mohamed, Salvio, Gianmaria, Rambhatla, Amarnath, Toprak, Tuncay, Gül, Murat, Phuoc, Nguyen Ho Vinh, Boitrelle, Florence, Birowo, Ponco, Ghayda, Ramy Abou, Cannarella, Rossella, Kuroda, Shinnosuke, Durairajanayagam, Damayanthi, Zini, Armand, Wyns, Christine, Sarikaya, Selcuk, Tremellen, Kelton, Mostafa, Taymour, Sokolakis, Ioanni, Evenson, Donald P, Henkel, Ralf, Zohdy, Wael, Chung, Eric, Ziouziou, Imad, Falcone, Marco, Russo, Giorgio I, Al-Hashimi, Manaf, Calogero, Aldo E, Ko, Edmund, Colpi, Giovanni, Lewis, Sheena, Serefoglu, Ege Can, Bahar, Fahmi, Martinez, Marlon, Nguyen, Quang, Ambar, Rafael F, Bakircioglu, Mustafa Emre, Kandil, Hussein, Mogharabian, Nasser, Sabbaghian, Marjan, Taniguchi, Hisanori, Tsujimura, Akira, Sajadi, Hesamoddin, Ibrahim, Wael, Atmoko, Widi, Vogiatzi, Paraskevi, Gunes, Sezgin, Gilani, Mohammad Ali Sadighi, Roychoudhury, Shubhadeep, Güngör, Nur Dokuzeylül, Hakim, Lukman, Adriansjah, Ricky, Kothari, Priyank, Jindal, Sunil, Amar, Edouard, Park, Hyun Jun, Long, Tran Quang Tien, Homa, Sheryl, Karthikeyan, Vilvapathy Senguttuvan, Zilaitiene, Birute, Rosas, Israel Maldonado, Marino, Angelo, Pescatori, Edoardo, Ozer, Cevahir, Akhavizadegan, Hamed, Garrido, Nicola, Busetto, Gian Maria, Adamyan, Aram, Al-Marhoon, Mohamed, Elbardisi, Haitham, Dolati, Parisa, Darbandi, Mahsa, Darbandi, Sara, Balercia, Giancarlo, Pinggera, Germar-Michael, Micic, Sava, Ho, Christopher Chee Kong, Moussa, Mohamad, Preto, Mirko, Zenoaga-Barbăroșie, Cătălina, Smith, Ryan P, Kosgi, Raghavender, Rosette, Jean de la, El-Sakka, Ahmed I, Abumelha, Saad Mohammed, Mierzwa, Tiago Cesar, Ong, Teng Aik, Banihani, Saleem A, Bowa, Kasonde, Fukuhara, Shinichiro, Boeri, Luca, Danacıoğlu, Yavuz Onur, Gokalp, Fatih, Selim, Osama Mohamed, Cho, Chak-Lam, Tadros, Nicholas N, Ugur, Muhammet Rasit, Ozkent, Mehmet Serkan, Chiu, Peter, Kalkanli, Arif, Khalafalla, Kareim, Vishwakarma, Ranjit B, Finocchi, Federica, Andreadakis, Sotiri, Giulioni, Carlo, Çeker, Gökhan, Ceyhan, Erman, Malhotra, Vineet, Yilmaz, Mehmet, Timpano, Massimiliano, Barrett, Trenton L, Kim, Shannon Hee Kyung, Ahn, Sun-Tae, Giacone, Filippo, Palani, Ayad, Duarsa, Gede Wirya Kusuma, Kadioglu, Ate, Gadda, Franco, Zylbersztejn, Daniel Suslik, Aydos, Kaan, Kulaksız, Deniz, Gupte, Deepak, Calik, Gokhan, Karna, Keshab Kumar, Drakopoulos, Panagioti, Baser, Aykut, Kumar, Vijay, Molina, Juan Manuel Corral, Rajmil, Osvaldo, Ferreira, Raphael H, Leonardi, Sofia, Avoyan, Armen, Sogutdelen, Emrullah, Franco, Giorgio, Ramsay, Jonathan, Ramirez, Liliana, Shah, Rupin, and Rocco, Lucia
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Male infertility ,Practice guideline ,Delphi method ,DNA fragmentation ,Survey ,Sperm - Abstract
PURPOSE: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. MATERIALS AND METHODS: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. RESULTS: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. CONCLUSIONS: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians.
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- 2023
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