Sperm Vitality and Necrozoospermia: Diagnosis, Management, and Results of a Global Survey of Clinical Practice

Agarwal, Ashok; Sharma, Rakesh K.; Gupta, Sajal; Boitrelle, Florence; Finelli, Renata; Parekh, Neel; Durairajanayagam, Damayanthi; Saleh, Ramadan; Arafa, Mohamed; Cho, Chak Lam; Farkouh, Ala’a; Rambhatla, Amarnath; Henkel, Ralf; Vogiatzi, Paraskevi; Tadros, Nicholas; Kavoussi, Parviz; Ko, Edmund; Leisegang, Kristian; Kandil, Hussein; Palani, Ayad; Salvio, Gianmaria; Mostafa, Taymour; Rajmil, Osvaldo; Banihani, Saleem Ali; Schon, Samantha; Le, Tan V.; Birowo, Ponco; Çeker, Gökhan; Alvarez, Juan; Corral Molina, Juan Manuel; Ho, Christopher C.K.; Calogero, Aldo E.; Khalafalla, Kareim; Duran, Mesut Berkan; Kuroda, Shinnosuke; Colpi, Giovanni M.; Zini, Armand; Anagnostopoulou, Christina; Pescatori, Edoardo; Chung, Eric; Caroppo, Ettore; Dimitriadis, Fotios; Pinggera, Germar-Michael; Busetto, Gian Maria; Balercia, Giancarlo; Elbardisi, Haitham; Taniguchi, Hisanori; Park, Hyun Jun; Rosas, Israel Maldonado; Rosette, Jean de la; Ramsay, Jonathan; Bowa, Kasonde; Simopoulou, Mara; Rodriguez, Marcelo Gabriel; Sabbaghian, Marjan; Martinez, Marlon; Sadighi Gilani, Mohamed Ali; Al-Marhoon, Mohamed S.; Kosgi, Raghavender; Cannarella, Rossella; Micic, Sava; Fukuhara, Shinichiro; Parekattil, Sijo; Jindal, Sunil; Abdel-Meguid, Taha Abo-Almagd; Morimoto, Yoshiharu; Shah, Rupin

World J Mens Health. 2022 Apr;40(2):228-242. 10.5534/wjmh.210149.

Sperm Vitality and Necrozoospermia: Diagnosis, Management, and Results of a Global Survey of Clinical Practice

Agarwal A ¹
Sharma RK ¹
Gupta S ¹
Boitrelle F ^2,3
Finelli R ¹
Parekh N ⁴
Durairajanayagam D ⁵
Saleh R ⁶
Arafa M ^1,7,8
Cho CL ⁹
Farkouh A ¹
Rambhatla A ¹⁰
Henkel R ^1,11,12,13
Vogiatzi P ¹⁴
Tadros N ¹⁵
Kavoussi P ¹⁶
Ko E ¹⁷
Leisegang K ¹⁸
Kandil H ¹⁹
Palani A ²⁰
Salvio G ²¹
Mostafa T ²²
Rajmil O ²³
Banihani SA ²⁴
Schon S ²⁵
Le TV ^26,27
Birowo P ²⁸
Çeker G ²⁹
Alvarez J ³⁰
Corral Molina JM ³¹
Ho CC ³²
Calogero AE ³³
Khalafalla K ⁷
Duran MB ³⁴
Kuroda S ¹
Colpi GM ³⁵
Zini A ³⁶
Anagnostopoulou C ³⁷
Pescatori E ³⁸
Chung E ^39,40
Caroppo E ⁴¹
Dimitriadis F ⁴²
Pinggera GM ⁴³
Busetto GM ⁴⁴
Balercia G ²¹
Elbardisi H ^7,8
Taniguchi H ⁴⁵
Park HJ ^46,47
Rosas IM ⁴⁸
Rosette Jdl ⁴⁹
Ramsay J ⁵⁰
Bowa K ⁵¹
Simopoulou M ⁵²
Rodriguez MG ⁵³
Sabbaghian M ⁵⁴
Martinez M ⁵⁵
Sadighi Gilani MA ⁵⁴
Al-Marhoon MS ⁵⁶
Kosgi R ⁵⁷
Cannarella R ³³
Micic S ⁵⁸
Fukuhara S ⁵⁹
Parekattil S ⁶⁰
Jindal S ⁶¹
Abdel-Meguid TAA ^62,63
Morimoto Y ⁶⁴
Shah R ⁶⁵

Affiliations

¹American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
²Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France.
³Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France.
⁴Department of Urology, Cleveland Clinic, Cleveland, OH, USA.
⁵Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia.
⁶Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt.
⁷Department of Urology, Hamad Medical Corporation, Doha, Qatar.
⁸Department of Urology, Weill Cornell Medical-Qatar Doha, Qatar.
⁹SH Ho Urology Center, Department of Surgery, Chinese University of Hong Kong, Hong Kong.
¹⁰Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA.
¹¹Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
¹²Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa.
¹³LogixX Pharma, Theale, Berkshire, UK.
¹⁴Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Greece.
¹⁵Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA.
¹⁶Austin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
¹⁷Department of Urology, Loma Linda University Health, Loma Linda, CA, USA.
¹⁸Department of Physiology, School of Natural Medicine, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa.
¹⁹Fakih IVF Fertility Center, Abu Dhabi, UAE.
²⁰Department of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq.
²¹Department of Endocrinology and Metabolic Diseases, Polytechnic University of Marche, Ancona, Italy.
²²Department of Andrology, Sexology and STIs, Faculty of Medicina, Cairo University, Cairo, Egypt.
²³Department of Andrology, Fundacio Puigvert, Barcelona, Spain.
²⁴Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan.
²⁵Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
²⁶Department of Andrology and Urology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam.
²⁷Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Viet Nam.
²⁸Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
²⁹Department of Urology, Samsun Vezirköprü State Hospital, Samsun, Turkey.
³⁰Centro ANDROGEN, La Coruña, Spain.
³¹Servicio de Urología, Hospital Clínico de Barcelona Barcelona, Spain.
³²Department of Surgery, School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Malaysia.
³³Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
³⁴Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey.
³⁵Andrology and IVF Unit, Procrea Institute, Lugano, Switzerland.
³⁶Department of Surgery, McGill University, Montreal, QC, Canada.
³⁷IVF Clinic “Akeso-Embryo ART”, Athens, Greece.
³⁸Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy.
³⁹Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia.
⁴⁰AndroUrology Centre, Brisbane, QLD, Australia
⁴¹Reproductive and IVF Unit, Andrology Outpatients Clinic, ASL Bari, Conversano (Ba), Italy.
⁴²1st Urology Department, School of Medicine, Aristotle University, Thessaloniki, Greece.
⁴³Department of Urology, Innsbruck Medical University, Innsbruck, Austria.
⁴⁴Department of Urology and Renal Transplantation, University of Foggia, Ospedali Riuniti of Foggia, Foggia, Italy.
⁴⁵Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan.
⁴⁶Department of Urology, Pusan National University School of Medicine, Busan, Korea.
⁴⁷Medical Research Institute of Pusan National University Hospital, Busan, Korea.
⁴⁸Citmer Reproductive Medicine, IVF LAB, Mexico City, Mexico.
⁴⁹Department of Urology, Medipol Mega University Hospital, Istanbul, Turkey.
⁵⁰Department of Andrology, Hammersmith Hospital, London, UK.
⁵¹Department of Urology, Michael Chilufya Sata Copperbelt University School of Medicine, Ndola, Zambia.
⁵²Department of Experimental Physiology, School of Health Sciences, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
⁵³Departamento Docencia e Investigación, Hospital Militar Campo de Mayo, Universidad Barcelo, Buenos Aires, Argentina.
⁵⁴Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
⁵⁵Section of Urology, University of Santo Tomas Hospital, Manila, Philippines.
⁵⁶Department of Surgery, Urology Division, Sultan Qaboos University, Muscat, Oman.
⁵⁷Department of Urology and Andrology, AIG Hospitals, Gachibowli, Hyderabad, India.
⁵⁸Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia.
⁵⁹Department of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan.
⁶⁰Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA.
⁶¹Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India.
⁶²Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt.
⁶³Department of Urology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
⁶⁴HORAC Grand Front Osaka Clinic, Osaka, Japan.
⁶⁵Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India.

KMID: 2527321
DOI: http://doi.org/10.5534/wjmh.210149

Abstract

Sperm vitality testing is a basic semen examination that has been described in the World Health Organization (WHO) Laboratory Manual for the Examination and Processing of Human Semen from its primary edition, 40 years ago. Several methods can be used to test sperm vitality, such as the eosin-nigrosin (E-N) stain or the hypoosmotic swelling (HOS) test. In the 6th (2021) edition of the WHO Laboratory Manual, sperm vitality assessment is mainly recommended if the total motility is less than 40%. Hence, a motile spermatozoon is considered alive, however, in certain conditions an immotile spermatozoon can also be alive. Therefore, the differentiation between asthenozoospermia (pathological decrease in sperm motility) and necrozoospermia (pathological decrease in sperm vitality) is important in directing further investigation and management of infertile patients. The causes leading to necrozoospermia are diverse and can either be local or general, testicular or extra-testicular. The andrological management of necrozoospermia depends on its etiology. However, there is no standardized treatment available presently and practice varies among clinicians. In this study, we report the results of a global survey to understand current practices regarding the physician order of sperm vitality tests as well as the management practices for necrozoospermia. Laboratory and clinical scenarios are presented to guide the reader in the management of necrozoospermia with the overall objective of establishing a benchmark ranging from the diagnosis of necrozoospermia by sperm vitality testing to its clinical management.

Keyword

Asthenozoospermia; Eosine Yellowish-(YS); Infertility; Nigrosin; Spermatozoa; Vitality

Sperm Vitality and Necrozoospermia: Diagnosis, Management, and Results of a Global Survey of Clinical Practice

Abstract

Keyword

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