No abstract available.
Humans ; Sperm Banks* ; Spermatozoa*

Sperm banking from recruited donors is an important way to help infertile couples who want to achieve pregnancy by therapeutic artificial insemination, even in the era of in vitro fertilization. Korea has the lowest population density of newborns among all Organization for Economic Co-operation and Development countries, with a total fertility rate of 1.17 and an annual birth rate of 300,000 or less as of 2017. This situation emerged due to various causes, including late marriage, fecundity problems, and air pollution. Nevertheless, we have imposed strict limits on basic research and clinical activities, including the operation of sperm banks, in the field of human reproduction under the 2005 Bioethics and Safety Act. Therefore, cryopreserved sperm for artificial insemination is almost absent in the sperm banks of major human reproduction centers. To resolve this difficult situation, as well as to increase the operation of sperm banks in Korea to the global standard level, the author evaluates the underlying reasons for donor sperm use by azoospermic patients from medical, ethical, legal, religious, and cultural perspectives, and then proposes a plan to resolve this situation including highly regulated standard operating procedures to ensure comprehensive safety practices for voluntary sperm donors and infertile couples, as well as to build an ideal sperm donation program.
Air Pollution ; Bioethics ; Birth Rate ; Family Characteristics ; Fertility ; Fertilization in Vitro ; Humans ; Infant, Newborn ; Insemination, Artificial ; Korea ; Marriage ; Population Density ; Pregnancy ; Reproduction ; Sperm Banks ; Spermatozoa ; Tissue Donors

Approximately 15% of couples hoping to conceive are infertile. Male factor infertility is the only cause in 40% of those couples. Approximately 20% of men with infertility have azoospermia. Of these patients, roughly 40% are experience obstruction or absence of sperm passage. However, the other 60% of patients must seek out adoption or conceive using a sperm bank. Currently, recommendations regarding legal issues are needed for sperm banks to be operated safely and effectively, and this paper provides a set of such recommendations.
Azoospermia ; Family Characteristics ; Hope ; Humans ; Infertility ; Male ; Sperm Banks ; Spermatozoa

This study aimed to ascertain the current status of Japanese sperm banking for young cancer patients. During 2015, we mailed the directors of 695 institutes where sperm cryopreservation might be performed with questionnaires requesting information on the number of patients, age, precryopreservation chemotherapy, semen analyses results and diagnoses, cryopreservation success rate, and causes of unsuccessful cryopreservation. Of these 695 institutes, 92 had cryopreserved sperm before chemotherapy within the study period. In all, 820 cancer patients (237 testicular, 383 hematological, 46 bone and soft tissue, 20 brain, and 134 other malignancy) consulted the responding institutes for sperm cryopreservation. Except for testicular tumor, the number of patients whose sperm was preserved before cancer treatment was low compared to that of young cancer patients. Approximately 20% of patients with malignancies other than testicular tumor underwent chemotherapy before cryopreservation. The success rate of cryopreservation in hematological malignancy was 82.5%, significantly lower than that of both the testicular cancer (93.6%) and other malignancy groups (95.6%) (P < 0.05). The primary reasons for preservation failure were azoospermia and poor semen quality. Patients with hematological malignancies had a higher rate of unsuccessful cryopreservation compared to those in other groups, possibly due to the large number of patients requesting sperm cryopreservation after chemotherapy induction. In Japan, information regarding sperm banking prior to cancer treatment appears to be lacking. Information regarding sperm preservation before chemotherapy should be provided to all Japanese oncologists.
Adolescent ; Adult ; Age Factors ; Azoospermia ; Cryopreservation ; Drug Therapy ; Humans ; Japan/epidemiology* ; Male ; Middle Aged ; Neoplasms/epidemiology* ; Semen Analysis ; Semen Preservation/methods* ; Sperm Banks/statistics & numerical data* ; Surveys and Questionnaires ; Testicular Neoplasms/epidemiology* ; Treatment Outcome ; Young Adult

BACKGROUND: Artificial insemination by donor (AID) is important to chance the pregnancy in male infertile couples by requiring appropriate medical, legal and ethical reviews. The purpose of this study was to investigate the perception changes of AID to collect the basic information for establishing the sperm donation, cryopreservation and artificial insemination management system. METHODS: We evaluated the people's thought of sperm donation, cryopreservation, and artificial insemination by donor by means of national inquiry survey from 247 infertile couples for 4 weeks from October 2016. The questionnaires were composed of 4 areas, and each questionnaire consisted of 15 items. Changes in the perception of AID by year were investigated after review of domestic journals. RESULTS: 67.6% of respondents knew the growth of couples with difficulty getting pregnant due to male infertility. 82.2% of respondents replied the necessary of sperm bank as a treatment option for infertility and 40.5% knew the donation and receipt system of sperm. In the survey of change perception of AID according to year, 37.5% and 39.5% of respondents were got information about AID from doctor in 2003 and 2004, but 49.6% from broadcasting in 2016. As a child grows up, 4.0% (2003), 9.0% (2014), and 42.8% (2016) of respondents answered to tell the child about AID. CONCLUSIONS: Infertile couple's thought of AID about the extension of opportunities for male infertility treatment is changed. In conclusion, it is necessary to establish institutional system of sperm donation, cryopreservation and artificial insemination prior to public sperm bank operation.
Child ; Cryopreservation ; Ethical Review ; Family Characteristics* ; Humans ; Infertility ; Infertility, Male ; Insemination, Artificial* ; Male ; Pregnancy ; Sperm Banks ; Spermatozoa* ; Surveys and Questionnaires ; Tissue Donors*

Sperm banking is an important option to maintain the male fertilization capacity or induce pregnancy even though under the era of in vitro fertilization. The medical indications for sperm banking are generally consisted of 3 categories. There are cases on planning the permanent contraception like vasectomy or cancer patients to be scheduled the chemotherapy or radiotherapy as first category, male infertile patients with severe oligozoospermia or artificially harvested sperm ie, from microscopic epididymal sperm aspiration or testicular sperm extraction et cetera for the artificial insemination with husband sperm as second category, and the therapeutic donor insemination as third category. Of these three categories, the sperm donation program accompanies various complicated practical, ethical and legal issues. Therefore, highly regulated statements are mandatory in order to secure safety and the complete practices for voluntary sperm donors and infertile couples both. In aspect of administrative structure of sperm bank, there are 3 types that are national based to be established in the most of European countries and China, public based in Japan, and commercially available in the USA. Additionally, each country has different standard guidelines, regulation statements, act and law to control the sperm donation program as well as different cultural or religious background. Nevertheless, we need a consensus document to operate the sperm bank with the standard guidelines to be well revised according to each country's ethical perspectives as well as contemporary scientific evolution. This article will provide what is the Korean model for ideal sperm bank with the history of sperm cryopreservation and banking, background and prerequisite for the public sperm bank operation, and also expected effects.
China ; Consensus ; Contraception ; Cryopreservation ; Drug Therapy ; Family Characteristics ; Fertilization ; Fertilization in Vitro ; Humans ; Insemination ; Insemination, Artificial ; Japan ; Jurisprudence ; Korea* ; Male ; Oligospermia ; Pregnancy ; Radiotherapy ; Sperm Banks* ; Sperm Retrieval ; Spermatozoa* ; Spouses ; Tissue Donors ; Vasectomy

PURPOSE: This study evaluated the demographics and semen parameters of males with cancer who banked their sperm prior to chemotherapy. MATERIALS AND METHODS: This is a retrospective study of 66 cases referred for sperm banking prior to initiation of chemotherapy over a 15-year period (1999~2014). Patients who had previously received cancer treatment including chemotherapy or radiotherapy were not included in this study. RESULTS: We studied a total of 66 cancer patients referred for cryopreservation of sperm prior to chemotherapy. The mean age of the patients at the time of banking was 32.0+/-7.9 years (range, 19~58 years). The types of cancer were testicular cancer (31 cases, 47.0%), non-Hodgkin's disease (10 cases, 15.1%), Hodgkin's disease (5 cases, 7.6%), leukemia (8 cases, 12.1%), gastrointestinal malignancy (5 cases, 7.6%), and musculoskeletal malignancy (5 cases, 7.6%). There were significant differences in sperm concentration and viability among the various types of cancer, but no significant difference in semen volume or sperm motility and morphology. CONCLUSIONS: In this study we found that sperm quality could decrease even before chemotherapy. Because chemotherapy can also negatively affect spermatogenesis, sperm cryopreservation prior to treatment should be strongly recommended for cancer patients of reproductive age.
Cryopreservation* ; Demography ; Drug Therapy* ; Hodgkin Disease ; Humans ; Infertility, Male ; Korea ; Leukemia ; Male ; Radiotherapy ; Retrospective Studies ; Semen ; Semen Analysis* ; Sperm Banks ; Sperm Motility ; Spermatogenesis ; Spermatozoa* ; Testicular Neoplasms

PURPOSE: Infertile couples interested in nonspouse artificial insemination by donor (AID) not only require a thorough understanding of the medical procedure but also must scrutinize the effects it will have on family relationships, including those on the infant to be born. We conducted a series of surveys in couples with male infertility to collect information necessary for AID counseling. MATERIALS AND METHODS: A total of 384 cases with noncurable male infertility were enrolled in this inquiry survey. The questionnaire consisted of 18 items that assessed demographic characteristics, background information concerning the choice to use AID, subjective experiences, long-term effects, and an overall evaluation. RESULTS: A total of 126 surveys were returned (32.8%). AID was first suggested by the husband in about half of the cases. The major reason for considering the procedure was to form a complete family. Two-thirds of the couples were anxious about the procedure, most often about possible congenital or acquired deformities in the infant. After the birth of the child, most couples were positive about their decision to have used AID. About half of the couples felt that the child was their own and expected not to tell the child about AID. Overall, about 50% of the couples were satisfied with the procedure. CONCLUSIONS: Those who underwent AID experienced various psychological effects, including anxiety about the child to be born. To overcome these problems, sufficient medical information and consultation about the process of selecting the donor and about AID procedures should be provided before the procedure is used.
Anxiety ; Child ; Congenital Abnormalities ; Counseling ; Family Characteristics ; Family Relations ; Humans ; Infant ; Infertility, Male ; Insemination, Artificial* ; Male* ; Parturition ; Questionnaires ; Sperm Banks ; Spouses ; Tissue Donors*

OBJECTIVETo investigate sperm function indexes that can be used to effectively evaluate the sperm donors' fertility so as to select healthy post-thaw semen samples and improve the success rate of assisted reproductive technology.

METHODSAccording to the pregnancy outcomes, we divided 40 donor semen samples into a high-fertility group (n = 20) and a low-fertility group (n = 20). We measured and compared the concentration, progressive motility, morphology, acrosome intactness, DNA integrity and mitochondrial membrane potential (MMP) of the post-thaw sperm between the two groups.

RESULTSThere were statistically significant differences between the high- and low-fertility groups in the percentages of morphologically normal sperm ([18.50 +/- 6.10]% vs [14.42 +/- 6.44]%, P < 0.01), acrosome intactness ([86.17 +/- 4.49]% vs [80.04 +/- 7.52]%, P < 0.05) and DNA fragmentation index ([9.21 +/- 3.22]% vs [15.72 +/- 8.20]%, P < 0.05), but not in MMP ([56.75 +/- 18.80]% vs [52.23 +/- 18.86]%, P > 0.05). A significantly positive correlation was found between MMP and sperm motility (r = 0.760, P < 0.05), but not between other sperm functions and sperm concentration and motility.

CONCLUSIONSperm concentration, motility, morphology, acrosome intactness rate and DNA integrity contribute effectively to the evaluation of the fertilization capacity of post-thaw donor semen samples.

Adult ; Cryopreservation ; Female ; Fertilization ; Humans ; Male ; Pregnancy ; Semen Preservation ; Sperm Banks ; Sperm Count ; Sperm Motility ; Spermatozoa ; physiology

OBJECTIVETo improve the reception and recruitment of sperm donors in sperm banks in China, and solve the problem of insufficiency in sperm donation.

METHODSWe reviewed the recruitment of 1 145 men for sperm donation in the Human Sperm Bank of Hubei Province from September 2011 to April 2012, analyzed the reasons for those not included, and interviewed those included but unwilling to donate sperm.

RESULTSAmong the 1 145 recruits, 551 (48.12%) were students and 594 (51.88%) were other individuals. After the first semen screening, 503 (43.93%) quitted, including 202 students (36.66% of the students recruited) and 301 others (50.67% of the other individuals recruited). After the second semen screening, 432 (37.73%) were excluded, and another 45 (3.93%) excluded after laboratory examination, including 16 cases of mycoplasma positive. Totally, 165 recruits (14.41%) passed the semen screening and laboratory examination, but only 144 of them (87.27%) completed, while the other 21 (12.73%) failed to complete the whole donation process.

CONCLUSIONLow rates of screening qualification and donation process completion are common problems in human sperm banks. The rate of qualified sperm donors can be increased and the operational cost of the human sperm bank can be reduced by enabling the recruits to accomplish the whole donation process. Explanation at the reception, later interview with the recruits, and donors' trust in the sperm bank play important roles in raising the completion rate of sperm donation process.

Adult ; Humans ; Male ; Semen ; Sperm Banks ; Tissue Donors ; psychology ; Tissue and Organ Procurement