Background: We developed a simplified IVF culture system (SCS) which has proven to be effective a... more Background: We developed a simplified IVF culture system (SCS) which has proven to be effective and safe in a selected IVF cohort. Methods: Preterm birth (PTB) and low birth weight (LBW) of 175 singletons born after using the SCS, 104 after fresh embryo transfer (ET), and 71 after frozen embryo transfer, were compared with all singletons born in Flanders between 2012 and 2020 conceived after natural conception, ovarian stimulation (OS), and assisted reproduction (IVF/ICSI). Findings: The proportion of preterm (<37 weeks) births was significantly higher in the case of IVF or ICSI, followed by hormonal treatment, compared to spontaneous pregnancies. There was no significant difference in PTB between SCS and any of the other groups. Concerning the average birth weight we found no significant difference between singletons born after natural conception and SCS. However, a significant difference in average birth weight was found between SCS singletons and singletons born after IVF, ICS...
Background: Assisted reproductive techniques services are often not accessible to the majority of... more Background: Assisted reproductive techniques services are often not accessible to the majority of infertile couples in Low and Middle Income Countries (LMIC) due to high costs. Lowering IVF laboratory costs is a crucial step to make IVF affordable for a larger part of the world population. We developed a simplified culture system (SCS) which has proven to be effective, and the next step is to prove its safety.Methods: Preterm birth (PTB) and low birthweight (LBW) of 176 singletons born after using the SCS, 105 after fresh embryo transfer (fresh ET), and 71 after frozen embryo transfer (frozen ET) were compared with all IVF/ICSI singletons born in Belgium between 2013 and 2018. When comparing our 105 SCS babies born after fresh ET with all Belgian babies born after conventional IVF only, we also adjusted for 7 risk factors known to influence perinatal outcome, namelythe mother’s age, day of transfer, pituitary inhibition protocol, rank of cycles, number of oocytes retrieved, number o...
Introduction: A higher pregnancy rate after slow-release insemination instead of bolus injection ... more Introduction: A higher pregnancy rate after slow-release insemination instead of bolus injection was described in previous studies. Besides an effective medical treatment most patients wish to receive a patient-centred approach with sufficient emotional support. Study question: Does a patient-friendly approach with slow-release insemination (SRI) increase the clinical pregnancy rate (CPR) after intrauterine insemination (IUI) with donor semen? Study design, size, duration: The data of an ongoing prospective cohort study were analysed investigating the results of 1995 donor inseminations in 606 women from July 2011 until December 2018. As from January 2016 the insemination procedure was performed by midwives instead of medical doctors. Instead of bolus injection of sperm a slow-release IUI was done together with a more patient-centred approach. Materials and Methods: The data of 1995 donor inseminations were analysed to study the importance of different covariates influencing IUI suc...
Background: Manual semen assessment (MSA) is a key component in a male’s fertility assessment. Cl... more Background: Manual semen assessment (MSA) is a key component in a male’s fertility assessment. Clinicians rely on it to make diagnostic and treatment decisions. When performed manually, this routine laboratory test is prone to variability due to human intervention which can lead to misdiagnosis and consequently over- or under-treatment. For standardization, continuous training, quality control (QC) programs and pricy Computer-Assisted Sperm Analysis (CASA) systems have been proposed, yet, without resolving intra- and inter-laboratory variability. In response, promising simplified sperm testing devices, able to provide cost-effective point-of-care male infertility diagnosis are prospected as a plausible solution to resolve variability and increase access to sperm testing. Materials and methods: A throughout literature research for semen testing, sperm analysis, smart-phone assisted semen analysis, ‘at-home’ semen testing, male infertility, infertility in developing countries, inferti...
Background: Pregnancy rates after in vitro fertilisation (IVF) treatment continue to improve, whi... more Background: Pregnancy rates after in vitro fertilisation (IVF) treatment continue to improve, while intrauterine insemination (IUI) programmes show no such trend. There is a need to improve success rates with IUI to retain it as a viable option for couples who prefer avoiding IVF as a first line treatment. Objective: To investigate if a modified slow-release insemination (SRI) increases the clinical pregnancy rate (CPR) after intrauterine insemination (IUI) with partner semen. Materials and Methods: This was a prospective cohort study in a Belgian tertiary fertility centre. Between July 2011 and December 2018, we studied data from an ongoing prospective cohort study including 989 women undergoing 2565 IUI procedures for unexplained or mild/moderate male infertility. These data were analysed in order to study the importance of different covariates influencing IUI success. Generalised estimating equations (GEEs) were used for statistical analysis. Results of two periods (2011-2015, pe...
We wanted to determine the sperm DNA fragmentation index (DFI) cutoff for clinical pregnancies in... more We wanted to determine the sperm DNA fragmentation index (DFI) cutoff for clinical pregnancies in women receiving intra-uterine insemination (IUI) with this sperm and to assess the contribution of Human Papillomavirus (HPV) infection on sperm DNA damage and its impact on clinical pregnancies. Prospective non-interventional multi-center study with 161 infertile couples going through 209 cycles of IUI in hospital fertility centers in Flanders, Belgium. Measurement of DFI and HPV DNA with type specific quantitative PCRs (HPV 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68) in sperm before its use in IUI. Clinical pregnancy (CP) rate was used as the outcome to analyze the impact on fertility outcome and to calculated the clinical cutoff value for DFI. A DFI criterion value of 26% was obtained by receiver operating characteristic (ROC) curve analysis. Couples with a male DFI > 26% had significantly less CPs than couples with DFI below 26% (OR 0.0326; 95% CI 0.0019...
Intrauterine inseminations (IUI) are easier to perform, less invasive and less expensive than oth... more Intrauterine inseminations (IUI) are easier to perform, less invasive and less expensive than other methods of assisted reproduction. The rationale for the use of artificial insemination is to increase gamete density at the site of fertilisation. It is generally accepted that IUI with homologous semen should be preferred as a first choice treatment above more invasive and expensive techniques of assisted reproduction in case of cervical, unexplained and moderate male factor subfertility. Scientific validation of this strategy is difficult because the literature is rather
Artificial insemination with homologous (AIH) or donor semen (AID) is nowadays a very popular tre... more Artificial insemination with homologous (AIH) or donor semen (AID) is nowadays a very popular treatment procedure used for many subfertile women worldwide. The rationale behind artificial insemination is to increase gamete density at the site of fertilisation. The sequence of events leading to today’s common use of artificial insemination traces back to scientific studies and experimentation many centuries ago. Modern techniques used in human artificial insemination programmes are mostly adapted from the work on cattle by dairy farmers wishing to improve milk production by using artificial insemination with sperm of selected bulls with well chosen genetic traits. The main reason for the renewed interest in artificial insemination in human was associated with the refinement of techniques for the preparation of washed motile spermatozoa in the early years of IVF. The history of artificial insemination is reviewed with particular interest to the most important hurdles and milestones.
The Walking Egg non-profit organization (npo) was founded in 2010 by scientists and an artist. Fr... more The Walking Egg non-profit organization (npo) was founded in 2010 by scientists and an artist. From this unusual blend, a unique objective came forth: to implement accessible infertility programmes in resource-poor countries. Our project aims to raise universal awareness about the issue of childlessness and to make, in all its aspects, infertility care including assisted reproductive technologies (ART), available and accessible worldwide. This can only be achieved when good quality but affordable infertility care is associated with effective family planning and safe motherhood programmes. To be successful, a global project to tackle the socio-cultural, ethical, economical and political differences hindering access to fertility care must happen.
Background Although the increased risk for perinatal morbidity and mortality of babies born after... more Background Although the increased risk for perinatal morbidity and mortality of babies born after ART is largely attributed to a higher rate of multiple gestations, a significantly worse perinatal outcome for singleton pregnancies following ART compared to pregnancies after natural conception has been reported as well. Most studies only include IVF/ICSI pregnancies; studies describing the perinatal outcome of pregnancies after non-IVF assisted reproduction are scarce. Methods and Materials Population-based cohort study with three exposure groups: a study group of pregnancies (1) after ovarian stimulation (OS), with or without artificial insemination (AI), (2) after IFV or ICSI and (3) a naturally conceived (NC) comparison group. Data from the regional registry of all hospital deliveries in the Dutch-speaking part of Belgium during an 18-years period from January 1993 until December 2010 were used. The perinatal outcome parameters were prematurity, low birth weight, perinatal mortali...
Infertility is a universal problem with the highest prevalence in low-resource countries, particu... more Infertility is a universal problem with the highest prevalence in low-resource countries, particularly in sub-Saharan Africa where infection-related tubal damage is the commonest cause. It is estimated that more than 180 million couples in developing countries suffer from primary or secondary infertility. In most African countries, the social stigma of childlessness still leads to isolation and abandonment. Differences between the developed and developing world are emerging because of the different availability in infertility care and the different socio-cultural value surrounding procreation and childlessness. Although reproductive health education and prevention of infertility are number one priorities, the need for accessible diagnostic procedures and affordable assisted reproductive technologies (ART) is very high. The success and sustainability of ART in resource-poor settings will depend, to a large extend, on our ability to optimise these techniques in terms of availability, ...
According to a number of high quality studies intrauterine insemination (IUI) with homologous sem... more According to a number of high quality studies intrauterine insemination (IUI) with homologous semen should be the first choice treatment in case of unexplained and moderate male factor subfertility. IVF and ICSI are clearly over-used in this selected group of infertile couples. The limited value of IUI in infertility treatment as mentioned in the 2013 NICE guidelines was surely a premature statement and should be adapted to the actual literature. More evidence-based data are becoming available on different variables influencing the success rates after IUI. It can be expected that these findings may lead to a better understanding and use of IUI in the near future.
Objective: To study the influence of human papillomavirus (HPV) virions present in different sper... more Objective: To study the influence of human papillomavirus (HPV) virions present in different sperm fractions of male partners of women undergoing IUI on fertility outcome. Design: Prospective noninterventional multicenter study. Setting: Inpatient hospital fertility centers. Patient(s): Seven hundred thirty-two infertile couples undergoing 1,753 IUI cycles with capacitated sperm. Intervention(s): None. Main Outcome Measure(s): Biochemical and clinical pregnancy rate in IUI cycles with HPV-positive or HPV-negative semen. Result(s): Five hundred seventy-three infertile couples undergoing 1,362 IUI cycles were enrolled. Work-up of the 1,362 sperm samples that were used for IUI generated 3,444 separate sperm fractions. Each of the sperm fractions was tested with quantitative polymerase chain reaction for 18 different HPV types (
In the current approach to male fertility testing, basic semen analysis has limitations as a pred... more In the current approach to male fertility testing, basic semen analysis has limitations as a predictor of fertility status, and the technology is fraught with variability. Nonetheless, it remains the cornerstone of the evaluation of the male infertility, and we recommend adherence to most recent World Health Organization guidelines. Although the current sperm function tests (bioassays) have important drawbacks, they are still valuable as research tools. Sperm quality assays with analysis of sperm DNA fragmentation need further investigation before they can be recommended for routine clinical use. The answer to the many current challenging questions relies on identifying spermatogenesis pathologies and the resulting sperm dysfunctions at the cellular and molecular levels. New discoveries may bring answers or new avenues to explore. (Fertil Steril Ò 2019;111:835-41. Ó2019 by American Society for Reproductive Medicine.
Annelies Thijssen graduated in July 2012 with a Masters in Biomedical Sciences from the Transnati... more Annelies Thijssen graduated in July 2012 with a Masters in Biomedical Sciences from the Transnational University Limburg, Diepenbeek, Belgium. In September 2012 she began a PhD project, 'Sperm banking in Belgium: medical, ethical and economical aspects', a collaboration between Hasselt University and Ziekenhuis Oost-Limburg with Willem Ombelet as promoter. KEY MESSAGE Clinical pregnancy rates following homologous intrauterine insemination are significantly influenced by female age, male smoking, primary/secondary infertility and inseminating motile count. Based on the results of the final multivariate model, we were able to build a calculation tool for the prediction of clinical pregnancy for a given patient.
Human fertility is linked to sperm quality and therefore the establishment of reference values fo... more Human fertility is linked to sperm quality and therefore the establishment of reference values for normality is mandatory. The first aim was to establish a reference profile of men in the general population by examining the semen of partners of women with chronic anovulation. The second aim was to determine the prevalence of sperm abnormalities in this patient group. Sperm samples of 304 partners of patients with chronic anovulation were analysed prospectively. Semen samples were examined according to WHO guidelines, for sperm morphology Tygerberg strict criteria were used. We compared the results of this study with the cut-off values for normality we obtained in a previous study performed in our centre. The mean value was 3.1 ml for volume, 64.7 mill / ml for concentration, 51.9% for progressive motility (grade a + b motility) and 7.4% for sperm morphology. Single parameter and double parameter abnormalities were observed in 42.7% and 8.2% of cases respectively. A normal sperm samp...
Infertility care is one of the most neglected health care issues in developing countries (DC), af... more Infertility care is one of the most neglected health care issues in developing countries (DC), affecting more than 50 million couples. The social stigma of childlessness still leads to isolation and abandonment. Bilateral tubal occlusion due to sexually transmitted diseases and pregnancy-related infections is the most common cause of infertility in DC. Consequently most cases of infertility are only treatable by using assisted reproductive technologies which are either unavailable or too costly. Lowering the laboratory costs associated with IVF is a crucial step to make IVF affordable for a larger part of the world population. We recently developed and described a new simplified method of IVF culturing, called the (t)WE lab method. Our initial results in fresh IVF cycles showed that IVF methodology can be significantly simplified and result in successful outcomes at levels that compare favourably to those obtained in high resource programs. We report three pregnancies and four live ...
in Denver. His studies have focused on molecular and cellular aspects of early mammalian developm... more in Denver. His studies have focused on molecular and cellular aspects of early mammalian development including human follicles, oocytes and embryos and has published numerous research articles and reviews and coauthored or edited books dealing with early mammalian development, including the human. His current research centres on the role(s) of mitochondria in early development and the molecular organization of the oocyte and embryo plasma membrane as related to developmental competence.
Many variables may influence success rates after intrauterine insemination (IUI), including sperm... more Many variables may influence success rates after intrauterine insemination (IUI), including sperm quality in the native and washed semen sample. A literature search was performed to investigate the threshold levels of sperm parameters above which IUI pregnancy outcome is significantly improved and/or the cutoff values reaching substantial discriminative performance in an IUI programme. A search of MEDLINE, EMBASE and Cochrane Library revealed a total of 983 papers. Only 55 studies (5.6%) fulfilled the inclusion criteria and these papers were analysed. Sperm parameters most frequently examined were: (i) inseminating motile count after washing: cutoff value between 0.8 and 5 million; (ii) sperm morphology using strict criteria: cutoff value !5% normal morphology; (iii) total motile sperm count in the native sperm sample: cutoff value of 5-10 million; and (iv) total motility in the native sperm sample: threshold value of 30%. The results indicate a lack of prospective studies, a lack of standardization in semen testing methodology and a huge heterogeneity of patient groups and IUI treatment strategies. More prospective cohort trials and prospective randomized trials investigating the predictive value of semen parameters on IUI outcome are urgently needed. RBMOnline
Background: We developed a simplified IVF culture system (SCS) which has proven to be effective a... more Background: We developed a simplified IVF culture system (SCS) which has proven to be effective and safe in a selected IVF cohort. Methods: Preterm birth (PTB) and low birth weight (LBW) of 175 singletons born after using the SCS, 104 after fresh embryo transfer (ET), and 71 after frozen embryo transfer, were compared with all singletons born in Flanders between 2012 and 2020 conceived after natural conception, ovarian stimulation (OS), and assisted reproduction (IVF/ICSI). Findings: The proportion of preterm (<37 weeks) births was significantly higher in the case of IVF or ICSI, followed by hormonal treatment, compared to spontaneous pregnancies. There was no significant difference in PTB between SCS and any of the other groups. Concerning the average birth weight we found no significant difference between singletons born after natural conception and SCS. However, a significant difference in average birth weight was found between SCS singletons and singletons born after IVF, ICS...
Background: Assisted reproductive techniques services are often not accessible to the majority of... more Background: Assisted reproductive techniques services are often not accessible to the majority of infertile couples in Low and Middle Income Countries (LMIC) due to high costs. Lowering IVF laboratory costs is a crucial step to make IVF affordable for a larger part of the world population. We developed a simplified culture system (SCS) which has proven to be effective, and the next step is to prove its safety.Methods: Preterm birth (PTB) and low birthweight (LBW) of 176 singletons born after using the SCS, 105 after fresh embryo transfer (fresh ET), and 71 after frozen embryo transfer (frozen ET) were compared with all IVF/ICSI singletons born in Belgium between 2013 and 2018. When comparing our 105 SCS babies born after fresh ET with all Belgian babies born after conventional IVF only, we also adjusted for 7 risk factors known to influence perinatal outcome, namelythe mother’s age, day of transfer, pituitary inhibition protocol, rank of cycles, number of oocytes retrieved, number o...
Introduction: A higher pregnancy rate after slow-release insemination instead of bolus injection ... more Introduction: A higher pregnancy rate after slow-release insemination instead of bolus injection was described in previous studies. Besides an effective medical treatment most patients wish to receive a patient-centred approach with sufficient emotional support. Study question: Does a patient-friendly approach with slow-release insemination (SRI) increase the clinical pregnancy rate (CPR) after intrauterine insemination (IUI) with donor semen? Study design, size, duration: The data of an ongoing prospective cohort study were analysed investigating the results of 1995 donor inseminations in 606 women from July 2011 until December 2018. As from January 2016 the insemination procedure was performed by midwives instead of medical doctors. Instead of bolus injection of sperm a slow-release IUI was done together with a more patient-centred approach. Materials and Methods: The data of 1995 donor inseminations were analysed to study the importance of different covariates influencing IUI suc...
Background: Manual semen assessment (MSA) is a key component in a male’s fertility assessment. Cl... more Background: Manual semen assessment (MSA) is a key component in a male’s fertility assessment. Clinicians rely on it to make diagnostic and treatment decisions. When performed manually, this routine laboratory test is prone to variability due to human intervention which can lead to misdiagnosis and consequently over- or under-treatment. For standardization, continuous training, quality control (QC) programs and pricy Computer-Assisted Sperm Analysis (CASA) systems have been proposed, yet, without resolving intra- and inter-laboratory variability. In response, promising simplified sperm testing devices, able to provide cost-effective point-of-care male infertility diagnosis are prospected as a plausible solution to resolve variability and increase access to sperm testing. Materials and methods: A throughout literature research for semen testing, sperm analysis, smart-phone assisted semen analysis, ‘at-home’ semen testing, male infertility, infertility in developing countries, inferti...
Background: Pregnancy rates after in vitro fertilisation (IVF) treatment continue to improve, whi... more Background: Pregnancy rates after in vitro fertilisation (IVF) treatment continue to improve, while intrauterine insemination (IUI) programmes show no such trend. There is a need to improve success rates with IUI to retain it as a viable option for couples who prefer avoiding IVF as a first line treatment. Objective: To investigate if a modified slow-release insemination (SRI) increases the clinical pregnancy rate (CPR) after intrauterine insemination (IUI) with partner semen. Materials and Methods: This was a prospective cohort study in a Belgian tertiary fertility centre. Between July 2011 and December 2018, we studied data from an ongoing prospective cohort study including 989 women undergoing 2565 IUI procedures for unexplained or mild/moderate male infertility. These data were analysed in order to study the importance of different covariates influencing IUI success. Generalised estimating equations (GEEs) were used for statistical analysis. Results of two periods (2011-2015, pe...
We wanted to determine the sperm DNA fragmentation index (DFI) cutoff for clinical pregnancies in... more We wanted to determine the sperm DNA fragmentation index (DFI) cutoff for clinical pregnancies in women receiving intra-uterine insemination (IUI) with this sperm and to assess the contribution of Human Papillomavirus (HPV) infection on sperm DNA damage and its impact on clinical pregnancies. Prospective non-interventional multi-center study with 161 infertile couples going through 209 cycles of IUI in hospital fertility centers in Flanders, Belgium. Measurement of DFI and HPV DNA with type specific quantitative PCRs (HPV 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68) in sperm before its use in IUI. Clinical pregnancy (CP) rate was used as the outcome to analyze the impact on fertility outcome and to calculated the clinical cutoff value for DFI. A DFI criterion value of 26% was obtained by receiver operating characteristic (ROC) curve analysis. Couples with a male DFI > 26% had significantly less CPs than couples with DFI below 26% (OR 0.0326; 95% CI 0.0019...
Intrauterine inseminations (IUI) are easier to perform, less invasive and less expensive than oth... more Intrauterine inseminations (IUI) are easier to perform, less invasive and less expensive than other methods of assisted reproduction. The rationale for the use of artificial insemination is to increase gamete density at the site of fertilisation. It is generally accepted that IUI with homologous semen should be preferred as a first choice treatment above more invasive and expensive techniques of assisted reproduction in case of cervical, unexplained and moderate male factor subfertility. Scientific validation of this strategy is difficult because the literature is rather
Artificial insemination with homologous (AIH) or donor semen (AID) is nowadays a very popular tre... more Artificial insemination with homologous (AIH) or donor semen (AID) is nowadays a very popular treatment procedure used for many subfertile women worldwide. The rationale behind artificial insemination is to increase gamete density at the site of fertilisation. The sequence of events leading to today’s common use of artificial insemination traces back to scientific studies and experimentation many centuries ago. Modern techniques used in human artificial insemination programmes are mostly adapted from the work on cattle by dairy farmers wishing to improve milk production by using artificial insemination with sperm of selected bulls with well chosen genetic traits. The main reason for the renewed interest in artificial insemination in human was associated with the refinement of techniques for the preparation of washed motile spermatozoa in the early years of IVF. The history of artificial insemination is reviewed with particular interest to the most important hurdles and milestones.
The Walking Egg non-profit organization (npo) was founded in 2010 by scientists and an artist. Fr... more The Walking Egg non-profit organization (npo) was founded in 2010 by scientists and an artist. From this unusual blend, a unique objective came forth: to implement accessible infertility programmes in resource-poor countries. Our project aims to raise universal awareness about the issue of childlessness and to make, in all its aspects, infertility care including assisted reproductive technologies (ART), available and accessible worldwide. This can only be achieved when good quality but affordable infertility care is associated with effective family planning and safe motherhood programmes. To be successful, a global project to tackle the socio-cultural, ethical, economical and political differences hindering access to fertility care must happen.
Background Although the increased risk for perinatal morbidity and mortality of babies born after... more Background Although the increased risk for perinatal morbidity and mortality of babies born after ART is largely attributed to a higher rate of multiple gestations, a significantly worse perinatal outcome for singleton pregnancies following ART compared to pregnancies after natural conception has been reported as well. Most studies only include IVF/ICSI pregnancies; studies describing the perinatal outcome of pregnancies after non-IVF assisted reproduction are scarce. Methods and Materials Population-based cohort study with three exposure groups: a study group of pregnancies (1) after ovarian stimulation (OS), with or without artificial insemination (AI), (2) after IFV or ICSI and (3) a naturally conceived (NC) comparison group. Data from the regional registry of all hospital deliveries in the Dutch-speaking part of Belgium during an 18-years period from January 1993 until December 2010 were used. The perinatal outcome parameters were prematurity, low birth weight, perinatal mortali...
Infertility is a universal problem with the highest prevalence in low-resource countries, particu... more Infertility is a universal problem with the highest prevalence in low-resource countries, particularly in sub-Saharan Africa where infection-related tubal damage is the commonest cause. It is estimated that more than 180 million couples in developing countries suffer from primary or secondary infertility. In most African countries, the social stigma of childlessness still leads to isolation and abandonment. Differences between the developed and developing world are emerging because of the different availability in infertility care and the different socio-cultural value surrounding procreation and childlessness. Although reproductive health education and prevention of infertility are number one priorities, the need for accessible diagnostic procedures and affordable assisted reproductive technologies (ART) is very high. The success and sustainability of ART in resource-poor settings will depend, to a large extend, on our ability to optimise these techniques in terms of availability, ...
According to a number of high quality studies intrauterine insemination (IUI) with homologous sem... more According to a number of high quality studies intrauterine insemination (IUI) with homologous semen should be the first choice treatment in case of unexplained and moderate male factor subfertility. IVF and ICSI are clearly over-used in this selected group of infertile couples. The limited value of IUI in infertility treatment as mentioned in the 2013 NICE guidelines was surely a premature statement and should be adapted to the actual literature. More evidence-based data are becoming available on different variables influencing the success rates after IUI. It can be expected that these findings may lead to a better understanding and use of IUI in the near future.
Objective: To study the influence of human papillomavirus (HPV) virions present in different sper... more Objective: To study the influence of human papillomavirus (HPV) virions present in different sperm fractions of male partners of women undergoing IUI on fertility outcome. Design: Prospective noninterventional multicenter study. Setting: Inpatient hospital fertility centers. Patient(s): Seven hundred thirty-two infertile couples undergoing 1,753 IUI cycles with capacitated sperm. Intervention(s): None. Main Outcome Measure(s): Biochemical and clinical pregnancy rate in IUI cycles with HPV-positive or HPV-negative semen. Result(s): Five hundred seventy-three infertile couples undergoing 1,362 IUI cycles were enrolled. Work-up of the 1,362 sperm samples that were used for IUI generated 3,444 separate sperm fractions. Each of the sperm fractions was tested with quantitative polymerase chain reaction for 18 different HPV types (
In the current approach to male fertility testing, basic semen analysis has limitations as a pred... more In the current approach to male fertility testing, basic semen analysis has limitations as a predictor of fertility status, and the technology is fraught with variability. Nonetheless, it remains the cornerstone of the evaluation of the male infertility, and we recommend adherence to most recent World Health Organization guidelines. Although the current sperm function tests (bioassays) have important drawbacks, they are still valuable as research tools. Sperm quality assays with analysis of sperm DNA fragmentation need further investigation before they can be recommended for routine clinical use. The answer to the many current challenging questions relies on identifying spermatogenesis pathologies and the resulting sperm dysfunctions at the cellular and molecular levels. New discoveries may bring answers or new avenues to explore. (Fertil Steril Ò 2019;111:835-41. Ó2019 by American Society for Reproductive Medicine.
Annelies Thijssen graduated in July 2012 with a Masters in Biomedical Sciences from the Transnati... more Annelies Thijssen graduated in July 2012 with a Masters in Biomedical Sciences from the Transnational University Limburg, Diepenbeek, Belgium. In September 2012 she began a PhD project, 'Sperm banking in Belgium: medical, ethical and economical aspects', a collaboration between Hasselt University and Ziekenhuis Oost-Limburg with Willem Ombelet as promoter. KEY MESSAGE Clinical pregnancy rates following homologous intrauterine insemination are significantly influenced by female age, male smoking, primary/secondary infertility and inseminating motile count. Based on the results of the final multivariate model, we were able to build a calculation tool for the prediction of clinical pregnancy for a given patient.
Human fertility is linked to sperm quality and therefore the establishment of reference values fo... more Human fertility is linked to sperm quality and therefore the establishment of reference values for normality is mandatory. The first aim was to establish a reference profile of men in the general population by examining the semen of partners of women with chronic anovulation. The second aim was to determine the prevalence of sperm abnormalities in this patient group. Sperm samples of 304 partners of patients with chronic anovulation were analysed prospectively. Semen samples were examined according to WHO guidelines, for sperm morphology Tygerberg strict criteria were used. We compared the results of this study with the cut-off values for normality we obtained in a previous study performed in our centre. The mean value was 3.1 ml for volume, 64.7 mill / ml for concentration, 51.9% for progressive motility (grade a + b motility) and 7.4% for sperm morphology. Single parameter and double parameter abnormalities were observed in 42.7% and 8.2% of cases respectively. A normal sperm samp...
Infertility care is one of the most neglected health care issues in developing countries (DC), af... more Infertility care is one of the most neglected health care issues in developing countries (DC), affecting more than 50 million couples. The social stigma of childlessness still leads to isolation and abandonment. Bilateral tubal occlusion due to sexually transmitted diseases and pregnancy-related infections is the most common cause of infertility in DC. Consequently most cases of infertility are only treatable by using assisted reproductive technologies which are either unavailable or too costly. Lowering the laboratory costs associated with IVF is a crucial step to make IVF affordable for a larger part of the world population. We recently developed and described a new simplified method of IVF culturing, called the (t)WE lab method. Our initial results in fresh IVF cycles showed that IVF methodology can be significantly simplified and result in successful outcomes at levels that compare favourably to those obtained in high resource programs. We report three pregnancies and four live ...
in Denver. His studies have focused on molecular and cellular aspects of early mammalian developm... more in Denver. His studies have focused on molecular and cellular aspects of early mammalian development including human follicles, oocytes and embryos and has published numerous research articles and reviews and coauthored or edited books dealing with early mammalian development, including the human. His current research centres on the role(s) of mitochondria in early development and the molecular organization of the oocyte and embryo plasma membrane as related to developmental competence.
Many variables may influence success rates after intrauterine insemination (IUI), including sperm... more Many variables may influence success rates after intrauterine insemination (IUI), including sperm quality in the native and washed semen sample. A literature search was performed to investigate the threshold levels of sperm parameters above which IUI pregnancy outcome is significantly improved and/or the cutoff values reaching substantial discriminative performance in an IUI programme. A search of MEDLINE, EMBASE and Cochrane Library revealed a total of 983 papers. Only 55 studies (5.6%) fulfilled the inclusion criteria and these papers were analysed. Sperm parameters most frequently examined were: (i) inseminating motile count after washing: cutoff value between 0.8 and 5 million; (ii) sperm morphology using strict criteria: cutoff value !5% normal morphology; (iii) total motile sperm count in the native sperm sample: cutoff value of 5-10 million; and (iv) total motility in the native sperm sample: threshold value of 30%. The results indicate a lack of prospective studies, a lack of standardization in semen testing methodology and a huge heterogeneity of patient groups and IUI treatment strategies. More prospective cohort trials and prospective randomized trials investigating the predictive value of semen parameters on IUI outcome are urgently needed. RBMOnline
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Papers by Willem Ombelet