What the future holds
Reproductive Andrology Surgery Workshop II
Reproductive Medicine Unit - Jahra Hospital - Kuwait 2014
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Management of Male Infertility What the future holds презентация
Содержание
- 1. Management of Male Infertility What the future holds
- 2. Learning objectives At the completion of this
- 4. Infertility Figures Infertile couples worldwide
- 5. Irvin S, et al 1996, Auger J
- 6. Male reproductive relatively simple anatomy hides an overwhelmingly complex system
- 7. Spermatogenesis Process
- 8. Genetic and epigenetic- regulated process ~2,000 genes,
- 9. Extremely specialized cell type
- 10. Unexplained infertility affects up to 40% of
- 11. Limitations of current management Conventional semen
- 12. Recent Advancements Sperm Function Testing Microsurgery Genetic diagnosis YCMD molecular diagnosis by PCR
- 13. PROSPECTS IN DIAGNOSIS
- 14. Genomics Transcriptomics Proteomics Metabolomics The Era of Biomarkers
- 15. Researchers first to determine entire genetic sequence
- 16. DNA Micro-array Technology Glass or silicon slides
- 18. Potential Clinical Applications of Sperm Molecular
- 19. Seminal Fluid Molecular Genetic Fingerprinting
- 21. Proteins are also critical to understanding disease
- 22. Proteomics
- 24. Sperm & Seminal Plasma Proteomic Profiles
- 25. Sperm Proteomics
- 26. Camargo M et al. Hum. Reprod. 2013;28:33-46
- 27. PROSPECTS IN FERTILITY PRESERVATION
- 32. Spermatogonial stem cell preservation and transplantation Boys
- 33. PROSPECT IN CREATING SPERM FROM IMMATURE AND SOMATIC CELLS
- 34. Nonobstructive azoospermia irreversible condition Esteves et al. Clinics 2011; 66: 691-700
- 35. Current method for identification of sperm production
- 36. Morphometric Evaluation of Seminiferous Tubules Verza Jr
- 37. Novel methods for identification of sperm production
- 38. No residual sperm production in up to 50% of men with NOA
- 39. In mice, transplanted stem cell-derived male gametes resulted in proper spermatogenesis
- 40. In mice, derived gametes generate viable offspring Aponte et al, Clinics 2013
- 41. Biotechnological advancements in the treatment of aspermatogenic men
- 42. Conclusions Novel genomic and proteomic biomarkers could
- 43. Why we should do all that … Courtesy of E.N. & T.A.S. with permission
- 44. THANK YOU شكرا OBRIGADO
Learning objectives At the completion of this presentation, participants will have an overview of: Sperm biomarkers as diagnostic and treatment tools Prospects of male fertility preservation Stem cells as new
Слайд 1Sandro Esteves, MD., PhD.
Medical & Scientific Director, ANDROFERT
Campinas, Brazil
Management of
Male Infertility
What the future holds
What the future holds
Слайд 2Learning objectives
At the completion of this presentation, participants will have an
overview of:
Sperm biomarkers as diagnostic and treatment tools
Prospects of male fertility preservation
Stem cells as new agents for the treatment of male infertility
Sperm biomarkers as diagnostic and treatment tools
Prospects of male fertility preservation
Stem cells as new agents for the treatment of male infertility
Слайд 4Infertility Figures
Infertile couples worldwide
(50-80 million people)
10-15%
male factor infertility
Up to 50%
seek assistance for fertility issues
1 in 8 men
Слайд 5Irvin S, et al 1996, Auger J et al, 1995, Irvine
DS 1994, Jørgensen N et al 2001, Jørgensen N et al 2002, Swan SH 2003, Feki NC et al, 2009
Слайд 8Genetic and epigenetic- regulated process
~2,000 genes, but only 30 in the
Y chromosome
Hamada et al 2012
Слайд 10Unexplained infertility affects up to 40% of infertile men
1 in 100
men have no sperm in ejaculate (azoospermia)
Up to 50% aspermatogenic (absolute sterility)
Up to 50% aspermatogenic (absolute sterility)
Слайд 11Limitations of current management
Conventional semen analysis
Conventional surgeries
Empirical medical treatments
ART overuse
Слайд 12Recent Advancements
Sperm Function Testing
Microsurgery
Genetic diagnosis
YCMD molecular diagnosis by PCR
Слайд 15Researchers first to determine entire genetic sequence of individual sperm
We can
look at a particular individual, make some calls about what they would likely contribute genetically to an embryo and perhaps even diagnose or detect potential problems, and identify healthy sperm for use in IVF
Слайд 16DNA Micro-array Technology
Glass or silicon slides where thousands of features are
arrayed
Gene expression is measured hybridization process
Microarrays are read using laser-based fluorescence scanners
Determine which genes are active and at what levels
Compare with controls, etc.
Gene expression is measured hybridization process
Microarrays are read using laser-based fluorescence scanners
Determine which genes are active and at what levels
Compare with controls, etc.
Слайд 18
Potential Clinical Applications of Sperm Molecular Genetic Fingerprinting
Infertility diagnosis
Assessment of treatment
outcome (medical, surgical)
ART outcome (IUI, IVF, ICSI)
Sperm selection techniques
ART outcome (IUI, IVF, ICSI)
Sperm selection techniques
Слайд 26Camargo M et al. Hum. Reprod. 2013;28:33-46
Change in proteomic profiling in
seminal plasma of adult men before and after varicocelectomy
Слайд 32Spermatogonial stem cell preservation and transplantation
Boys facing gonadotropic treatment
Klinefelter syndrome patients
Cryopreservation
before SSC loss
Extraction: testicular biopsy
Freezing : slow-freezing and storage of testicular tissue or cell suspension in LN
Cryoprotectant: DMSO
Grafting: ectopic or homotopic (mouse)
When to graft: unknown
Fertilizing capacity in humans: unknown
Extraction: testicular biopsy
Freezing : slow-freezing and storage of testicular tissue or cell suspension in LN
Cryoprotectant: DMSO
Grafting: ectopic or homotopic (mouse)
When to graft: unknown
Fertilizing capacity in humans: unknown
Слайд 35Current method for identification of sperm production sites in nonobstructive azoospermia
Esteves
et al Int Braz J Urol 2013; 37: 570-83; Deruyver et al Andrology 2014; 2: 20-4
Слайд 36Morphometric Evaluation of Seminiferous Tubules
Verza Jr S, Esteves SC. Fertil Steril
2012; 98: S242
N=54; Tubule Diameter: KW-H (1;54) = 25.2; P<0.001
Слайд 37Novel methods for identification of sperm production sites in men with
nonobstructive azoospermia
Najari et al, J Urol 2012; Smith et al J Urol 2012; Ramasamy et al., J Pathol Inform 2012
Слайд 42Conclusions
Novel genomic and proteomic biomarkers could add to work-up and clinical
treatment strategies
Advances in immature germ cells cryopreservation/transplantation will expand fertility options for oncological boys
Biotechnological approaches for generating male gametes last frontier to be accomplished
