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Thread: Male genetic infertility problem: HRSS and/or MESA??

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    Male genetic infertility problem: HRSS and/or MESA??



    Hello,

    My partner has a male genetic infertility problem: most of his sperm do not carry DNA. Some sperm carry half of DNA and very few sperm carry normal DNA. His sperm has normal morphology values.
    In 2003, with his ex-wife, they tried several insemination and in-vitro fertilization through ICSI (with testicular open biopsy and sperm hand-selected at about a magnification of 500x based upon Motility and Morphology). All trials were unsuccessful because no egg fertilized.
    We want to know whether we should try:
    - HIGH-RESOLUTION SPERM SELECTION (HRSS)
    - and/or Microsurgical Epididymal Sperm Aspiration (MESA)?
    We understand the above will then be followed by intra-cytoplasmic sperm injection (ICSI).

    In addition, we have one question: Is Flow Cytometry only used for differentiating chromosomes X and Y (because FISH uses DNA probes that specifically attach to either the X or Y chromosome in sperm) or can this technique be used in our case (to measure quantity of DNA present in the sperm)?

    Thank you

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    Sorry to hear that. If I was your husband I would forget about using my sperm to have children. Waste of time and energy, and there is too big risk of having kids with health problems, if at all. I would let my wife get a sperm donor from healthy, smart, good looking male, and love babies as my own. Nothing is sure of course, but most likely or not kids would be healthy and smart, and would bring you a lot of joy.
    I probably will get you angry with this post, but believe me my intentions are to help the best I can.
    Good luck axelleb.

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    What is the basis for your answer?

    Dear Lebrok, Thank you for your answer. I want to do the smart thing so just need rational/scientific elements to base my decision on. Why did you reply that? I mean, do you know about these techniques and what are your reasons for advising to give up on that?
    Please give me any references to articles I should read.

    Thank you

    axelleb

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    Dear Axelleb, I'm begging you don't look at me as a person that is trying to mess up your future, malice, or simply sob. I know, this issue is a life or death situation, highly emotionally charged, and you’re reaching to strangers for breath of hope.
    I'm not schooled in HRSS or MESA, and I'm not even a scientist with doctorate or one in any standard sense. I'm a father, husband, man that loves science, breathes and thinks science all the time, and my brain is pretty good with estimating and probabilities. What can I say, I should be walking all day in white frock, but my life ways decided that I'm not.
    Thanks to you I've read up a bit about fertility measures that you would like to engage in. It's surely a new frontier with not much statistics and history behind.

    I'm guessing/estimating that your husband is between age of 30 and 40. He's likely tried about 1 000 times to impregnate you and his ex-wife. That means at least one sperm in a thousand might be a good one. Probably it's more like 1 in 10 thousand as usually an egg is covered with tens if not hundreds of sperms trying to get in.
    Now, did you ask the guys that do HRSS, how many sperm they check to select the “good” one, the one that at least look normal? One hundred, one thousand, 100 thousand? How many sperms, one guy with a microscope, can eyeball a day? And he has to work fast, sperm doesn’t live too long, unless he’s sitting in a fridge. The better the magnification the fewer sperm he can see at once.

    MESA is basically for man with obstructed sperm ducts or extremely low sperm count. If sperm count is normal, but all sperm DNA is deformed, it won’t do a thing.
    The bottom line is. If your husband’s sperm normality is less than one in then thousandth, there is a very slim chance finding a fully develop one. It might not exist at all in your husband case. Even after spending 100 000 dollars on experimental techniques, 10 years later they find a sperm that looks normal under 500 magnifications and your egg will get fertilized. What’s a chance of having a healthy baby from a sperm just looking normal? I‘ve never been to any of these clinics but I’m 100% sure that you would need to sign long papers of waivers and no guaranty, especially if it comes to quality or health of your baby.

    I know that my thinking won’t sway you from going into these experimental techniques, and your mind is set. I don’t even expect you to answer my post again. I wouldn’t mind though, if in 5 or 10 years, if you return here and tell us how it went. Even if I’m wrong I would appreciate your life story, and a life lessen. I always find life more interesting than fiction.
    I wish you all the luck.
    Regards

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    Dear Le Brok,
    Thank you for your answer. My mind is not set, as you say. That's why I am posting this. I would like to collect info and advice.
    My partner is 35 and his sperm count is low. I now understand a bit better HRSS and MESA from what you wrote so thank you.
    I should get more info about HRSS. and also about Flow Cytometry (do you know about the latter?) I know it is used to choose the sex but can it be used to select sperm with normal DNA?
    We have nothing against getting a sperm donor and we will do it. We just want to make sure before that we have realistically no chance to have a biological child together despite the recent advances of science. That's why I am searching around. My partner and his ex-wife tried 7 years ago and I want to check whether there have been any advances in the last years that would make a difference for us.
    Thank you

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    I was wondering what they can see in HRSS with 500x magnification. I managed to find one link showing this.

    http://www.ivf.net/ivf/sperm_head_de...tion-o642.html

    I was hoping they can see chromosomes, at least to see if there are all of them. As you see with 500 magnification one can only check for Motility and Morphology. It's hard to put much hope in this technique. As you said, the morphology is normal, but still DNA is missing in your partner case.

    Can they, or some other lab do better magnification to make sure they can pick a sperm with all chromosomes? Or even better to see if chromosomes are a proper length, as the number might be right, it doesn't mean the genome is complete. This would give you much better chance.

    Beyond this point there is nothing more to increase the odds. To check for complete DNA it would take 10 grants per one sperm and destroying (possibly) the only good one in the process.

    Knowing the quality of your husband sperm my biggest concern is that even if a good enough sperm is found to give you a baby, will his genome be complete enough to give you a healthy one?
    It's probably a drama that I couldn't live every day with. That's why my advice was for a donor.

    Take care axelleb.

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    Thanks. I have been searching more info. We sould probably try IMSI that magnify from 6000x to 12000x.
    I am looking where to do in the USA, DC State (where we live).
    Thanks for your advice

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