Dear Dr. Al-Rshoud,

ICSI may or may not work. Again I will say that one has to know the real etiology of the disease that you have diagnosed. Necrozoospermia has an etiology you must follow that. To start out, please review the paper I published that is registered here too in my profile about the infertility among men. 

The etiology is reversible, we have been able to enable the men for natural fertility by eliminating the etiology among men and women.

We will be happy to train your doctors with the breakthrough treatment, if so desired.

Thanks.

Prof. Dr. Shahid H. Sheikh

MBBS, PhD.

92-300-481-6677

Dear Prof. Shahid

Thank you for the answer, i have reviewed your article ,but i haven't found any thing about necrozzospermia. Moreover, i completely understand that there is some hidden aetiology in the testis that kills the sperm. but till now nobody have proved what was that!

Many thanks!

The paper about the CMV & HSV being positive in the sample of the sperm is a very authentic evidence that causes the anatomical anomaly in the spermatoneogenesis,

including but not limited to the necrozoospermia. If you simply check your patients for the antibodies (IgG) present in the blood over the cut off value, that will lead you to determine the root cause of the aspermia, oligospermia, etc.

What we traced was as following.

1. The Neurons responsible of secreting the "Neuro Secretory Enzymes" (NSE) are inflicted with the CMV RNA proliferation, therefore, secreted with the NSE to stimulate the Pituitary. The molecular integrity of the NSE is compromised.

2. The pituitary stimulation by the compromised NSE in turn gives rise to the compromised stimulating hormones, including FSH and others.

3. Comes the arrival of the Neuro viral RNA into the testes along with the stimulating hormone.

4. A variety of sperm reproductive anomalies take place. 

Best Regards.

Prof. Shahid H. Sheikh,

Thanks Professor for this explanation, so do you recommend to screen all male factor infertility for CMV and HSV?

Appreciated!

Dear Firas,

We have experience with necrozoospermic patients without previous diagnosis, and in these cases, we use TESA with very successful results. We recovery motile sperm from testis even if we don´t get it in ejaculate, probably because something is wrong during the pass through the accesory glands.

Best regards

Rocio Nuñez

Thanks Dr.Rocio for the answer.

Plz. do you suggest any medical treatment or adding some materials for the culture medical such as ca++ inophors to improve fertilization rate?

Thanks

We used pentoxifilyne for to improve motiltily, but I don´t like at all. Moreover, in the case of necrozoospermic patients it´s not usefull. Using testicular spermatozoa do not need any treatment as ca++ ionophors. You only need to culture the sperm several hours before ICSI.

Rocío

Many Thanks Dr.Rocio

Regards,

I respectfully disagree with the protocol Dr. Rocio Calonge has suggested. Because the presence of the Neuroinvasive viral RNA's present in the chromosomal DNA will definitely contribute the to the fetal congenial developmental disorders.

One has to look at the Neuroinvasive viral involvement to leave no stone unturned for the possible Anomalies. The objective shouldn't be "Pregnancy By Force".

Good morning!

attached, please find our case-report on the use of laser during ICSI to identify viable sperm.

Good luck and best regards

Jan Krüssel

Article: Pregnancy after laser-assisted selection of viable spermatozoa before intracytoplasmatic sperm injection in a couple with male primary cilia dyskinesia.

Peter Arne Gerber, Roland Kruse, Jens Hirchenhain, Jan-Steffen Krüssel, Norbert J Neumann

[Show abstract] [Hide abstract]

ABSTRACT: To report an intracytoplasmatic sperm injection (ICSI) pregnancy achieved in a couple with male primary cilia dyskinesia (PCD) with viable sperm that were detected using a 1.48 microm wavelength diode laser. Case report. University hospital. A 37-year-old man with infertility due to primary cilia dyskinesia; semen analysis revealed a severe oligoasthenoteratozoospermia with absence of motile spermatozoa. A 34-year-old healthy woman with a 10-year history of primary infertility. Selection of viable spermatozoa using the hypo-osmotic swelling (HOS) test or a 1.48 microm wavelength diode laser and subsequent ICSI. Sperm analysis. Fertilization and cleavage rates and pregnancy. Semen samples showed no motile spermatozoa and high percentages of spermatozoa with curled flagella resembling HOS-reactive spermatozoa. To identify viable spermatozoa we used the HOS test or a 1.48 microm diode laser. The ICSI using HOS-selected spermatozoa resulted in two fertilized out of four oocytes (50%), and injection of laser-selected spermatozoa resulted in four fertilized out of seven oocytes (57%). The transfer of two frozen/thawed oocytes of the laser group led to a singleton pregnancy. Use of a noncontact diode laser for sperm viability assessment may be a useful alternative, especially in cases where the HOS test is not informative.

Fertility and sterility 07/2008; 89(6):1826.e9-12. · 3.97 Impact Factor

Dear Jan

Manky thanks for sending me the case report, plz. can you provide me with the laser protocol( how to use it?)

Regards,

Necrozoospermia and 100% immotile are not the same. 100% immotile: some sperm maybe viable. Perform eosin-negrosin stain for % viability.

One possible cause is antisperm antibodies. Perform an indirect test e.g. MAR test for IgG in serum.

If positive give oral antioxidants, let the man ejaculate in medium with 3% human serum albumin then density gradient centrifugation. Antisperm antibodies come in the ejaculate via the prostate.

You use hypoosmotic medium (1:1 sperm wash media with distile water) to get tail curling, select those sperms ,put into again to the normal media and use for ICSI

best regards

Prof.Dr.Tulay Irez

Thx. Dr. Tulay for the answer

Agree with Prof. Tulay Irez:

Use HOS Test to identify sperm with intact normal DNA.

Those sperm exhibiting tail curling can be used for ICSI, we believe.

However, such a study should be reported.

Ref: Stanger et al, 2010. RBM Online 21, 474-484.

Best wishes and do report your experience.

John Yovich