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Dietary patterns and semen quality in young men
vasectomy reversal – values mostly dependent on the duration of obstruction. Given the recent improvements IVF, we sought to determine pregnancy outcomes of couples undergoing PESA and IVF. DESIGN: Retrospective chart review. MATERIALS AND METHODS: The charts of 68 consecutive couples who underwent 68 cycles of sperm retrieval for OA and had IVF from 2002 to 2010 were analyzed with patients requiring testicular intervention excluded (n ¼ 17). RESULTS: Viable sperm were identified in 100% of men who underwent PESA. Fresh spermatozoa were obtained in 40 patients (78%) simultaneously with female egg retrieval. In this subgroup, males were aged 34 1 years with a partner age of 40 1 years. The average fertilization rate was 77% with 5 embryos not surviving to transfer (12.5%). Of those who had successful embryo transfer, pregnancy was confirmed in 48% (17/35). Twin gestations were produced in 12% (2/17). Frozen-thawed PESA spermatozoa were used in 11 patients (22%). In this subgroup, males were aged 34 1 years with a partner age of 37 1 years. The average fertilization rate was 74% with pregnancy confirmed in 55% (6/11). No multiple gestations were generated using frozen-thawed spermatozoa and no complications were identified in any PESA procedure. CONCLUSION: PESA is an effective means of obtaining spermatozoa for use in IVF given patients with OA. Our results show improvements in the cumulative fertilization (76.2%) and pregnancy (50%) rates compared to previous studies (58-65% and 32-40% respectively). Given the improvements in technology, further research into the preferential use of IVF and PESA over surgical correction in OA is required. O-25 Monday, October 17, 2011 04:30 PM CRYOPRESERVATION WITH PRO-KINETIC AGENTS MAY HAVE AN ADVERSE IMPACT ON SPERM MOTILITYAND RECOVERY IN MEN WITH TESTIS CANCER. J. M. Hotaling, R. Hsi, N. Lopushnyan, C. H. Muller, T. J. Walsh. Urology, University of Washington, Seattle, WA. OBJECTIVE: To identify modifiable, laboratory factors that may improve the yield of motile sperm following cryopreservation of ejaculated samples among men with testis cancer and male infertility. DESIGN: Retrospective review. MATERIALS AND METHODS: We performed retrospective review of deidentified laboratory data from the University of Washington Male Infertility Laboratory from 1994-2009. 1000 semen samples from 423 men that underwent cryopreservation and at least one test thaw were available. Variables analyzed included sperm concentration (106/mL), motility (%), sperm motility enhancement (none, pentoxifylline (PX), pentoxifylline + deoxyadenosine (PX/DOA), preparation medium (HTF, HamsF10) and freezing rate (rapid and slow). Iterative multivariate linear regression models were generated using the predictor variables, age and raw semen total motile count (TMC) or % motility and were stratified based on whether a density gradient (DG) was used. Change in test-thaw motility and TMC from raw samples were assessed as the outcomes of interest. Analyses were clustered to the individual. Men with testis cancer were compared to those with male infertility to determine differences in predictors of sperm recovery between these two groups. RESULTS: Among men with male factor infertility, PX and PX/DOA did not yield significant improvements in %motile sperm or TMC recovery. This is in contrast to men with testis cancer without DG where PX (8.110^6, 95%CI [19.5, 3.2]) and PX/DOA (7.1 10^6, [13.1, 1.1]) resulted in significant reductions in TMC. Likewise, where a DG was used a statistically significant decrease in TMC recovery was seen for PX (11.4 10^6, [20.1, 2.6]) and PX/DOA (20.0 10^6, [32.2,7.9]). CONCLUSION: PX and PX/DOA may decrease recovery of TMC and % motility in men with testis cancer. This suggests the need for tailored sperm cryopreservation protocols based upon an individuals specific disease. Further prospective studies are needed to confirm and elaborate this work. Supported by: Hirschler Award. O-26 Monday, October 17, 2011 04:45 PM COMPARISON OF IVF/ICSI OUTCOMES IN MALE FACTOR INFERTILITY PATIENTS WITH AND WITHOUT SPINAL CORD INJURIES. A. S. Q. Kathiresan, G. R. Attia, S. J. Ory, M. J. Barrionuevo, C. M. Lynne, N. L. Brackett. Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, FL; Department of Urology, University of Miami Miller School of Medicine, Miami, FL; Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL. OBJECTIVE: Semen of men with spinal cord injury (SCI) has normal sperm concentration but abnormally low sperm motility/viability - a pro-
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file uncommon in the general male factor population. This study determined if sperm from men with SCI yield similar outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF/ICSI) as sperm from other etiologies of male factor infertility. In the SCI group, the study further determined if IVF/ICSI outcomes differ when sperm are obtained by penile vibratory stimulation (PVS) versus (v.) electroejaculation (EEJ). DESIGN: Retrospective analysis. MATERIALS AND METHODS: A retrospective analysis identified couples with male factor infertility due to SCI (SCI group) and couples with male factor infertility due to other etiologies (non-SCI group), who underwent IVF/ICSI. A subanalysis was also performed within the SCI group comparing IVF/ICSI outcomes in men whose sperm were collected by PVS v. EEJ. Couples with coexisting female factors for infertility were excluded from analysis. Rates of fertilization (FR), pregnancy (PR), and live birth (LR) were compared between groups. Statistical analysis was performed using the Mann-Whitney U test and chi-square test for continuous and categorical variables, respectively. RESULTS: In the SCI group, 31 couples underwent 48 IVF/ICSI cycles. In the non-SCI group, 358 couples underwent 540 IVF/ICSI cycles. Comparing the SCI group v. the non-SCI group, respectively, FR was 56% v. 68% (P¼0.005), PR per couple was 58% v. 57% (P¼0.931), and LR per couple was 52% v. 52% (P¼0.971). Comparing the PVS group (n ¼ 12) v. the EEJ group (n ¼ 16), respectively, FR was 62% v. 56% (P¼0.564), PR per couple was 58% v. 50% (P¼0.662), and LR per couple was 58% v. 44% (P¼0.445). CONCLUSION: In IVF/ICSI cycles, the rate of fertilization was lower in the SCI group v. the non-SCI group, however, the rates of pregnancy and live birth were similar between the two groups. Sperm collected by PVS v. EEJ in men with SCI appear to result in similar IVF/ICSI success rates.
O-27 Monday, October 17, 2011 05:00 PM DIETARY PATTERNS AND SEMEN QUALITY IN YOUNG MEN. A. J. Gaskins, D. Colaci, J. Mendiola, S. H. Swan, J. Chavarro. Department of Nutrition, Harvard School of Public Health, Boston, MA; School of Medicine, University of Murcia, Espinardo, Murcia, Spain; Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY. OBJECTIVE: To examine the association between dietary patterns and semen parameters in healthy, young adult males. DESIGN: Cross-sectional study. MATERIALS AND METHODS: Men aged 18-22 years were recruited for the Rochester Young Men’s Study in 2009-2010 at the University of Rochester. Diet was assessed using a previously validated food frequency questionnaire. Semen quality was assessed by sperm concentration, motility, and morphology. 188 men with complete semen parameters and diet were included in the analysis. Linear regression was used to analyze diet pattern in quartiles and semen quality parameters adjusting for abstinence time, multivitamin use, race, smoking status, ano-genital distance, body mass index, recruitment period, and exercise. RESULTS: Two dietary patterns were identified by factor analysis, a Western and Prudent diet. The Western diet was characterized by high intakes of red and processed meat, refined grains, pizza, snacks, high energy drinks, and sweets, while the Prudent diet was characterized by high intakes of fish, fruit, vegetables, legumes, and whole grains. Adherence to a Western diet was positively associated with sperm concentration (p-value for trend ¼ 0.03). Men in the highest quartile had 63% higher sperm concentration than men in the lowest quartile (P¼0.02); however, after adjustment for calorie intake the association was nonsignificant. Adherence to a Prudent diet was positively associated with percent motile sperm (p-value for trend ¼ 0.03). Specifically, men in the highest quartile had 7.3% higher motile sperm compared to men in the lowest quartile (P¼0.02). This association remained significant after calorie adjustment. Sperm morphology had no association with either dietary pattern. CONCLUSION: Higher adherence to a Prudent diet was significantly associated with higher sperm motility. Adherence to a Western diet was unrelated to semen parameters after adjustment for total calorie intake. Supported by: NIH grant T32DK007703-16 and P30 DK46200 and European Union DEER Grant 212844.
Vol. 96., No. 3, Supplement, September 2011
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file uncommon in the general male factor population. This study determined if sperm from men with SCI yield similar outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF/ICSI) as sperm from other etiologies of male factor infertility. In the SCI group, the study further determined if IVF/ICSI outcomes differ when sperm are obtained by penile vibratory stimulation (PVS) versus (v.) electroejaculation (EEJ). DESIGN: Retrospective analysis. MATERIALS AND METHODS: A retrospective analysis identified couples with male factor infertility due to SCI (SCI group) and couples with male factor infertility due to other etiologies (non-SCI group), who underwent IVF/ICSI. A subanalysis was also performed within the SCI group comparing IVF/ICSI outcomes in men whose sperm were collected by PVS v. EEJ. Couples with coexisting female factors for infertility were excluded from analysis. Rates of fertilization (FR), pregnancy (PR), and live birth (LR) were compared between groups. Statistical analysis was performed using the Mann-Whitney U test and chi-square test for continuous and categorical variables, respectively. RESULTS: In the SCI group, 31 couples underwent 48 IVF/ICSI cycles. In the non-SCI group, 358 couples underwent 540 IVF/ICSI cycles. Comparing the SCI group v. the non-SCI group, respectively, FR was 56% v. 68% (P¼0.005), PR per couple was 58% v. 57% (P¼0.931), and LR per couple was 52% v. 52% (P¼0.971). Comparing the PVS group (n ¼ 12) v. the EEJ group (n ¼ 16), respectively, FR was 62% v. 56% (P¼0.564), PR per couple was 58% v. 50% (P¼0.662), and LR per couple was 58% v. 44% (P¼0.445). CONCLUSION: In IVF/ICSI cycles, the rate of fertilization was lower in the SCI group v. the non-SCI group, however, the rates of pregnancy and live birth were similar between the two groups. Sperm collected by PVS v. EEJ in men with SCI appear to result in similar IVF/ICSI success rates.
O-27 Monday, October 17, 2011 05:00 PM DIETARY PATTERNS AND SEMEN QUALITY IN YOUNG MEN. A. J. Gaskins, D. Colaci, J. Mendiola, S. H. Swan, J. Chavarro. Department of Nutrition, Harvard School of Public Health, Boston, MA; School of Medicine, University of Murcia, Espinardo, Murcia, Spain; Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY. OBJECTIVE: To examine the association between dietary patterns and semen parameters in healthy, young adult males. DESIGN: Cross-sectional study. MATERIALS AND METHODS: Men aged 18-22 years were recruited for the Rochester Young Men’s Study in 2009-2010 at the University of Rochester. Diet was assessed using a previously validated food frequency questionnaire. Semen quality was assessed by sperm concentration, motility, and morphology. 188 men with complete semen parameters and diet were included in the analysis. Linear regression was used to analyze diet pattern in quartiles and semen quality parameters adjusting for abstinence time, multivitamin use, race, smoking status, ano-genital distance, body mass index, recruitment period, and exercise. RESULTS: Two dietary patterns were identified by factor analysis, a Western and Prudent diet. The Western diet was characterized by high intakes of red and processed meat, refined grains, pizza, snacks, high energy drinks, and sweets, while the Prudent diet was characterized by high intakes of fish, fruit, vegetables, legumes, and whole grains. Adherence to a Western diet was positively associated with sperm concentration (p-value for trend ¼ 0.03). Men in the highest quartile had 63% higher sperm concentration than men in the lowest quartile (P¼0.02); however, after adjustment for calorie intake the association was nonsignificant. Adherence to a Prudent diet was positively associated with percent motile sperm (p-value for trend ¼ 0.03). Specifically, men in the highest quartile had 7.3% higher motile sperm compared to men in the lowest quartile (P¼0.02). This association remained significant after calorie adjustment. Sperm morphology had no association with either dietary pattern. CONCLUSION: Higher adherence to a Prudent diet was significantly associated with higher sperm motility. Adherence to a Western diet was unrelated to semen parameters after adjustment for total calorie intake. Supported by: NIH grant T32DK007703-16 and P30 DK46200 and European Union DEER Grant 212844.
Vol. 96., No. 3, Supplement, September 2011