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Gosalvez J.,Autonomous University of Madrid | Ruiz-Jorro M.,Crea - Tec | Sanchez-Martin P.,GINEMED | Caballero P.,Clinica Tambre
Revista Internacional de Andrologia | Year: 2013

Objective: The study was made to analyze the baseline levels of damage recorded in sperm DNA fragmentation (SDF) and to estimate sperm DNA longevity as observed in donors after thawing. Material and methods: Fifty donors and forty individuals attending a clinic and classified as a normo-zoospermic population were compared. The baseline SDF levels and the increasing rate of SDF (r-SDF) obtained after thawing when the sperm was incubated for a period of 24. h with different sub-sampling performed after 2, 6 and 24. h of incubation were considered as the independent variables and compared. Results: Cryopreserved donor sperm exhibited baseline SDF values approximately 2 times lower than those observed in the control group. DNA stability was 2.5 times higher than that observed in the control cohort. Baseline values of SDF of approximately 8% generates 65% sensitivity and 82% specificity to discriminate between the donors and controls. Values of increase of damage of 1.8% per hour, analyzed during the first hours of incubation, identify the donor characteristics with 77% sensibility and 65% specificity. Neither value show any correlation within the control and donor cohorts group. Conclusion: The establishment of these types of threshold values can be used to identify donors considered as "super-donors" in relation to their low levels of SDF and high chromatin stability. The donors selected from the different clinics participating in this study showed similar characteristics for these parameters. © 2013 Asociación Española de Andrología, Medicina Sexual y Reproductiva. Source


Balda J.A.R.,Hospital Universitario 12 Of Octubre | Carrera M.,Hospital Universitario 12 Of Octubre | Caballero J.L.,Clinica Center | Bruna I.,Hospital de Madrid Monteprincipe | And 13 more authors.
Revista Iberoamericana de Fertilidad y Reproduccion Humana | Year: 2010

The aim of this study was to develop and validate a tool to assess treatment satisfaction with follitropin alpha multi-dose pen injection (Gonal-fTM). The development and validation process included creation of a questionnaire further to guidance by infertility specialists, users of the device as well as experts for design of questionnaires. The questionnaire was used in an observational, cross-over, multicentre, post-marketing study with 101 female patients. After assessing sample adequacy (Kaiser-Meyer-Olkin index and Bartlett's test of sphericity), Rasch analysis (infit and outfit statistics) resulted in a reduced version of the questionnaire. Psychometric properties such as feasibility (omitted response and time to fulfill it), variability (floor and ceiling effects), validity (factor analysis and nonparametric tests) and reliability (Cronbach's alpha) were assessed.). 91.1% of participants completed the questionnaire in 5.04 (SD: 3.3) minutes. A significant correlation between the global treatment satisfaction scores and two dimensions of the questionnaire ('Ease of use and administration' and 'Storage and transportation conditions') was observed, as well as variables such as number of previous treatments, time to the last treatment, and minutes required to get the pen ready. In conclusion, the questionnaire is a feasible, reliable and valid tool to assess patients' satisfaction of treatment with the Gonal-f© follitropin alfa pen device. Source


Nunez-Calonge R.,Clinica Tambre | Cortes S.,Clinica Tambre | Gutierrez Gonzalez L.M.,Complutense University of Madrid | Kireev R.,Complutense University of Madrid | And 6 more authors.
Reproductive BioMedicine Online | Year: 2016

The aim of this study was to determine the concentrations of oxidative stress markers, antioxidant enzymes and cytokines in the follicular fluid of young women with low response in ovarian stimulation cycles compared with high responders and fertile oocyte donors of the same age, to assess the impact of oxidative stress on ovarian reserve. The activity of follicular fluid antioxidant enzymes glutathione transferase, glutathione reductase and glutathione peroxidase was significantly lower in young women with reduced ovarian reserve compared with that in high responders and oocyte donors. Follicular fluid concentrations of oxidative stress marker malondialdehyde combined with 4-hydroxyalkenals and nitric oxide were higher in low responders than in high responders and oocyte donors. Significant differences between low responders and donors in concentrations of IL-2, IL-6, IL-8 and vascular endothelial growth factor were observed, with higher concentrations in low responders. However, IL-10 concentration was lower in low responders than in high responders and donors. No significant differences were found in follicular fluid concentrations of tumour necrosis factor alpha between the three groups. These results demonstrate that different concentrations of oxidative stress markers, oxidant enzymes and cytokines in low responders compared with high responders and oocyte donors may negatively impact ovarian response. © 2015 Reproductive Healthcare Ltd. Source


Gosalvez J.,Autonomous University of Madrid | Nunez R.,Clinica Tambre | Fernandez J.L.,Complejo Hospitalario Universitario runa | Fernandez J.L.,Centro Oncologico Of Galicia | And 2 more authors.
Andrologia | Year: 2011

The rate of increase of sperm DNA fragmentation (rsDF) in fresh and frozen-thawed and processed sperm samples after a density gradient for sperm selection was analysed after 0, 0.5, 1.5, 4.5, 6, 24, 48 and 72h of incubation at 37°C, in five donors with proven fertility. The results showed that: (i) sperm DNA fragmentation (sDF) at baseline in fresh samples (14.3±3.3) was lower than that obtained after freeze-thawing and selection (19.4±4.1), significant differences; (ii) After 6h of incubation the mean sDF in fresh samples (24.2±10.2) was significantly lower than that in frozen-thawed samples (45.3±7.1); (iii) Subsequently, the rsDF in fresh semen samples was 1.6% per h after 6h of incubation, while after thawing and selection the rsDF was 4.3% per h; The tendency to increase in sDF showed high R2 values (R2=0.90) for exponential functions in case of fresh samples, whereas R2 values for linear functions were higher after sperm selection (R2=0.97). These results indicate that differences in sperm DNA fragmentation dynamics before and after storage are an important issue that must be considered for storage of sperm to be used for artificial reproduction techniques. © 2011 Blackwell Verlag GmbH. Source


Rodriguez B.,Autonomous University of Madrid | Lopez-Fernandez C.,Autonomous University of Madrid | Nunez-Calonge R.,Clinica Tambre | Caballero P.,Clinica Tambre | And 6 more authors.
Revista Internacional de Andrologia | Year: 2012

Introduction: High levels of oxidative stress can explain the presence of high levels of damage in the DNA molecule. The impact of high levels of oxidative stress in 2 clinical circumstances affecting the male germ line has been well established: leukocytospermia and varicocele. Objective: To assess sperm DNA fragmentation in patients diagnosed with leukocytospermic and varicocele. Material and methods: Leukocytospermic and varicocele patients and external controls (donors with proven fertility and patients with undetermined male factor). Unlike in other studies of sperm DNA fragmentation, in this study both the proportion of damaged sperm after using the sperm chromatin dispersion test (Halosperm), and the proportion of degraded sperm in total fragmented (degradation index [DI]) were taken into consideration. Results: A highly significant increase in sperm DNA fragmentation has been observed in semen samples of patients with varicocele and leukocytospermia. Varicocele patients showed a DI twice as high as that observed in patients with undetermined male factor or in patients with leukocytospermia, and 6 times as high as that observed in the donors. Discussion: The presence of high levels of oxidative stress could be an acceptable explanation for the high levels of damage observed in the spermatozoa of varicocele patients or with leukocytospermia; the level of sperm degradation is higher in the case of varicocele than those observed in leukocytospermia. Conclusions: SDF levels in patients with leukocytospermia and varicocele are significantly higher than those observed in donors or men with undetermined male factor. The DI in sperm samples from patients with varicocele is the highest of all the samples studied in this analysis. The routine determination of the DI may have a practical value, by guiding the patient towards the potential diagnosis of varicocele, even when this is subclinical. © 2012 Sociedad Española de Andrología. Source

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