Azoospermia Clinical Trial
Official title:
The Effect of Low Electrical Current on Testicular Spermatocyte Count
Oligozoospermia, refers to a low concentration of sperm. A low sperm count or poor sperm
quality is the cause of infertility in about 20% of couples with fertility problems, and a
contributory factor in a further 25% of couples. In the majority of cases, no cause can be
found. For mild male infertility, intra uterine insemination (IUI) is the procedure of
choice with a pregnancy rate of 6.5%. In IUI, sperm is inserted using a thin, flexible
catheter directly into a woman's uterus.
Azoospermia affects 1% of the male population and 20% of male infertility situations. Over
50% of azoospermic cases are due to testicular failure, including absence or failed
production as well as low production and maturation arrest during the process of
spermatogenesis. ICSI allows successful fertilization even with immature sperm obtained
directly from testicular tissue. This is done through TESA (Testicular sperm aspiration) or
TESE (Testicular sperm extraction). In cases of TESE small strips of testicular tissue are
extracted with the intention of finding few viable sperm cells to be used for IVF or ICSI.
Men with non-obstructive azoospermia have 0 to 3 mature spermatids per seminiferous tubule
in contrast to 17-35 mature spermatids in men with normal spermatogenesis. TESE success
rates are approximately 50% but differ according to etiology. Unfortunately, there is no
method of pointing out where sperm may be found. TESE is accompanied with pain, tissue loss,
reduced success in future TESE due to tissue scaring and testosterone deficiency.
The complex process of spermatogenesis includes maturation of young spermatids into
spermatozoas, a process which takes approximately 74 days. During spermatogenesis,
spermatogonial stem cells are transformed into spermatids and released from the seminiferous
tubule epithelium into its lumen. Non-motile spermatozoa are transported through the
seminifreous tubules to the epididymis by testicular fluid secreted from the Sertoli cells
with the aid of peristaltic contraction. During transport through the epididymis, sperm
cells develop the ability to progress forward, undergo capacitation and attach and penetrate
the egg.
The electric charge of the spermatic cell has been termed zeta potential (electrokinetic
potential) and is defined as the electric potential in the slip plane between the sperm
membrane and its surroundings. Mature sperm possess an electric charge of −16 to −20 mV.
In the animal study conducted, positive electrical current with a low amplitude bellow
sensation level was situated around the scrotum of four normospermic and one oligospermic
male pigs. At the end of the research the concentration of spermatocytes in the epididymis
obtained in surgery was found to be 200 to 1600 percent above the baseline.
Our intention is to evaluate if positive electrical current with a low amplitude bellow
sensation level situated on the scrotum will increase the concentration of spermatocytes in
the ejaculate.
If our hypothesis is confirmed this may become a method for treating male infertility. The
period of improvement is still unclear.
Status | Not yet recruiting |
Enrollment | 10 |
Est. completion date | January 2017 |
Est. primary completion date | December 2016 |
Accepts healthy volunteers | No |
Gender | Male |
Age group | 21 Years to 45 Years |
Eligibility |
Inclusion Criteria: - Men with primary infertility defined as a state of Azoospermia. - Men with pathological sperm tests indices as defined by the WHO. Exclusion Criteria: - Men with genetic syndromes, and states of Azoospermia secondary to chemotherapy, bone marrow transplantation or radiation. |
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
Israel | Male Fertility Clinic, Sheba Medical Center | Ramat Gan |
Lead Sponsor | Collaborator |
---|---|
Sheba Medical Center |
Israel,
Chan PJ, Jacobson JD, Corselli JU, Patton WC. A simple zeta method for sperm selection based on membrane charge. Fertil Steril. 2006 Feb;85(2):481-6. — View Citation
Ishijima SA, Okuno M, Mohri H. Zeta potential of human X- and Y-bearing sperm. Int J Androl. 1991 Oct;14(5):340-7. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Spermatomcyte count in the ejaculate. | To evaluate if positive electrical current with a low amplitude below sensation level situated on the scrotum will increase the concentration of spermatocytes in the ejaculate. | One year. | No |
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