Male infertility, two studies undertaken by IVI for debate in the ESHRE congress

Azoospermia (absence of sperm in semen samples) requires a testicular biopsy to determine if the testicle generates sperm. It would therefore be a great step forward to discover an alternative non-invasive method, such as an algorithm, that would allow us to know the presence of sperm in the testicle to avoid an invasive procedure.  Dr. ​Marga Esbert, at IVI Barcelona, has based her study on the determination of the predictive capacity of certain factors to indicate the existence, or not, of sperm in the testicle.

In the study, data was collected from all the azoospermic patients at IVI Barcelona who had undergone testicular biopsies between 2004 and 2017. From a total sample of 96 men, different parameters were analysed, such as age, the length/duration of sterility, FSH level, body mass, size of the testicles and type of pathology and its association with success in biopsy.

According to Dr Esbert, "in patients with obstructive azoospermia we were able to recover sperm up to 100% in these cases.  However, in men with secretory azoospermia the percentage dropped to 29% and they (these men) would have most benefited if we could have obtained a diagnosis using a non-invasive method.

Different types of markers are being researched but, at the moment, there is no scientific consensus. For our part, we discovered in this study that, depending on the testicular volume, we can estimate to quite a reliable degree, the presence of sperm in the testicle. We are working to obtain other types of markers, and the next phase of our research will be focused on finding proteins and micro RNA from the samples of azoospermic patients to allow us to predict if the testicle is functional."

On the other hand, Dr. Rocío Rivera, at IVI Valencia, studied the variations in the protein profile of the samples of different patients comparing those, thanks to fertilisation by ICSI, it was possible to obtain a pregnancy with those who had previously failed.  Therefore, after analysing the proteins that make up the sperm, we could identify which ones were related to the reproductive success or failure. In order to standardise the female factor as much as possible and that the outcome of pregnancy depended, to a greater extent, on the male factor, all patients opted for oocyte donation treatments.

Dr. Rivera confirmed that "with this study we have known and described the protein profile of the samples, both for those patients who became pregnant and those who did not. We have verified that there are differences in terms of proteins and that these can serve as markers that will allow us to separate sperm that are susceptible to pregnancy from those that are not. Furthermore, using the MACS technique, it can be considered to enrich a sample with sperm that contains the optimal proteins to be used in a reproduction treatment. However, this does not stop it being a hypothesis to continue investigating in the future."

Obstructive azoospermia

Azoospermia consists of the absence of sperm in the ejaculated semen, the obstructive semen is the least severe. It consists of a defect in the seminiferous tubes or the vas deferens that prevents the exit of sperm during ejaculation only if there is sperm production in the testicle.

Secretory azoospermia

Secretory azoospermia is the most serious as it involves a defect in spermatogenesis (the process of formation of male sex cells) that causes sperm not to be generated.

MACS technique

MACS is a technique that allows the selection of sperm with the best characteristics to be used in assisted reproduction treatments.