A novel microfluidics device for male infertility screening O-076 Meta-analysis of SCSA (cid:2) defined DFI and PG outcomes

Results: Post-orchiectomy TGCC patients did not differ from controls in the proportion of sperm with DNA strand breaks (medians 11 versus 11.5%). XRT resulted in an increase in sperm with defect DNA after 1–2 years (22% versus 11%; p ¼ 0.007), normalizing after 3–5 years. After 3–5 years of treatment with more than two cycles of CT the fraction of sperm with DNA strand breaks was significantly reduced, (7.5 versus 11%, p ¼ 0.044). Conclusions: TGCC patients, prior to XRT or CT, do not differ from controls with regard to the proportion of sperm with DNA breaks. XRT results in an increase in DNA strand breaks, normalizing after 3–5 years. More than two cycles of CT result in a permanent decrease of the fraction of sperm with defect DNA. Our findings indicate that the use of pre-treatment, cryopreserved semen for ICSI is safe, whereas the proportion of sperm with DNA damage is increased up to 2 years after XRT. It needs to be further elucidated whether CT reduces the proportion of sperm with DNA breaks, possibly due to increased apoptosis of germ cells with DNA damage. a hydrostatic microchannel has been constructed which allows for the passage of motile sperm into a target collection chamber. Live sperm were fluorescently labeled with Calcein-AM prior to their placement in the inlet chamber. The microfluidic channelwasintegratedintoa micro-fluorimeter toassess theinten-sity of the fluorescence signal generated by sperm cells accumulating in the target chamber throughout a 50min period. Semen specimens of 21 men sent to a university reproductive endocrinology and infertility center for routine semen analysis were tested 67 times with the microfluidics device. For each sample, 100 m l of semen were used to test the device. Sperm parameters as determined by CASA, includingtotalconcentration, totalmotile concentration and progressive motile concentration, were recorded. These results were then compared with the fluorescence signal reported by the microfluidics device. The sensit-ivity and specificity of the device were assessed in light of reference standards cited by the World Health Organization (WHO) for normal semen analysis. Results: The fluorescence signal recorded by the microfluidics device increased throughout the data collection period for all samples, indicating a time-dependent relationship for the number of live sperm accumulating in the target chamber. Pearson coefficients relating the device signal to total and progressive motile concentration were 0.79 (p<0.001) and 0.80 (p<0.001), respectively. A signal threshold based on the aggregate data was established, correlating to parameters generated from the CASA results. A device value above this threshold indicated that the semen sample exceeded the WHO reference standard, while one below signified a subfertile parameter. Motile concentration of sperm, given the device’s design and intent, was selected as the primary dataset to be evaluated. When considering total and progressive motile concentration, the device was 94% sensitive and 97% specific, and 96% sensitive and 90% specific, respectively. Conclusion: A microfabricated, fully integrated device is presented which an accurate assessment of motile sperm concentration in the human ejaculate when compared with CASA. As motile sperm concentration a key component of the semen analysis, device the clinical at-home setting. Its and of applying lab-on-chip technology to male infertility screening. predictive IVF/ICSI range: NS–0.0001). following meta-analyses conducted the utility of the SCSA (cid:2) sperm fragmentation test for the human infertility clinic. Materials and methods: Three meta-analyses were conducted on sperm DNA fragmentation and pregnancy/delivery rate by means of in vivo, IUI, routine IVF and ICSI ART procedures using the Cochran-Mantel-Haenszel statistic. The Breslow day test (BDT) was used to test the homogeneity of all the odds ratios used in the meta-analyses. Results: A meta-analysis of three studies (n ¼ 1575) was conducted to invest- igate the relationship of %DFI on pregnancy outcome using in vivo and IUI procedures. The meta-analysis indicated that patients were 7.3 · more likely to a pregnancy/delivery if the %DFI ¼ 0.0001). Results from the BDT showed that the odds ratio for all studies was not significantly different (p ¼ 0.96) and showed similar trends. In six other studies (n ¼ 1990) that included routine IVF fertilization as well as in vivo and IUI procedures, the meta-analysis indicated that patients were 3.9 · more likely to achieve a pregnancy/delivery if the %DFI was <30 (p ¼ 0.0001). The odds ratio for all studies tested was not significantly different ( x 2 ¼ 5.7, p ¼ 0.45) and showed similar trends. A meta-analysis of five studies using ICSI and/or IVF (n ¼ 216) showed a non-significant trend where patients were 1.7 · more likely to achieve a pregnancy/ delivery if the %DFI was <30 (p ¼ 0.11). With the BDT, the odds ratio for all studies tested was significantly different ( x 2 ¼ 10.3, p ¼ 0.04). Conclusions: The above meta-analyses show that the SCSA (cid:2) infertility test is significantly predictive for reduced pregnancy success using in vivo, IUI and to a lesser extent routine IVF and ICSI. These data clearly indicate that the SCSA (cid:2) is an important component of the infertility workup and also suggest that if a male partner has a %DFI >30 then the couple should consider moving on to ART procedures, probably skipping IUI, and moving to routine IVF or preferably ICSI. diversityinpoliciesistobevalued,notregretted.Internationallegislationshouldatmostimposeadequatesafetyandqualitystandards. SubstantiveEuropean regulation of personal ethical matters like reproduction should be avoided as much as possible. Reproductive tourism must not be countered by more restrict-iveinternational legislationbutbymaintainingflexibleand‘soft’nationalrules. Conclusions: Allowing reproductive tourism is a form of tolerance that pre-vents the frontal clash between the majority that imposes its view and the minority that claims to have a moral right to some medical service. Reproductive tourism is a safety valve that reduces moral conflict and expresses minimal recognition of the others’ moral autonomy.