Muhammad Fadhli Abdullah

Introduction: Cryopreservation of spermatozoa is a vital fertility preservation strategy for men with severe oligozoospermia, who face a substantial risk of azoospermia on the day of ovum pick-up. As a consensus on the optimal micro-volume carrier for these challenging cases remains elusive, this study was designed to compare the efficacy of two carriers, the tip-micro and the micro-straw, for cryopreserving severely oligozoospermic samples. Methods: In this experimental study, semen samples from 12 men with severe oligozoospermia were collected. All the samples were cryopreserved using a vapor fast-freezing method and divided between tip-micro and micro-straw carriers. Key sperm parameters motility, viability, and morphology were meticulously analyzed before freezing and after thawing to determine postthaw quality and survival rates. Results: Comparative analysis revealed no statistically significant differences in postthaw survival rate (54.33% ± 9.87% for tip-micro vs. 48.83% ± 9.95% for micro-straw), total motility (18.83% ± 4.68% vs. 17.33% ± 4.65%), or normal morphology (median 0% for both; all P > 0.05). However, a significant advantage was observed for the tip-micro in preserving sperm viability, which was markedly higher than in the micro-straw group (22.67% ± 4.73% vs. 19.92% ± 4.66%; P = 0.011). Conclusions: Both tip-micro and micro-straw carriers are effective for cryopreserving severely oligozoospermic samples. However, the tip-micro demonstrates superiority in maintaining sperm viability, likely due to a reduction in procedural mechanical stress. Given this advantage and its operational simplicity, the tip-micro represents a preferable clinical option for these cases.

Objective: Various factors, such as obstructive azoospermia, cause infertility in men. Biochemical examination of ejaculate, especially measurement of fructose, can be an additional investigation that can be used for this diagnosis in reproductive health. Examination of fructose is carried out after routine ejaculate analysis, resulting in prolonging the examination time so that it will affect the measurement of fructose level in the ejaculate and the accuracy of the diagnosis. This study aims to determine the best timing and procedure for measurement of fructose using a semiautomatic method. Methods: This research is an analytic observational study conducted at Dr. Soetomo General Hospital, Surabaya. A total of 13 ejaculate samples from infertile male patients who met the inclusion criteria were evaluated. Each ejaculate was divided into eight aliquots that were examined for fructose using a semiautomated method after different intervals of time and centrifugation modalities. Results: This study showed a significant difference in fructose levels when aliquots were centrifuged and examined immediately or after different interval of time (p = 0.036). In addition, aliquots left standing for more than 60 minutes (p = 0.012) and 120 minutes (p < 0.001) before centrifugation, showed significantly lower levels compared to aliquots that were centrifuged and then immediately examined. Conclusions: We suggest that measuring fructose immediately after centrifugation is more reliable than measuring fructose left standing before or after centrifugation. Leaving the ejaculate standing will reduce the fructose level so that it does not resemble its real level.

Erectile dysfunction (ED) impacts millions of men, especially older men, and current treatment options, including tadalafil, phosphodiesterase type 5 inhibitors, and short-acting testosterone, are ineffective. This necessitates the immediate development of effective alternative ED treatments. In recent years, attention has been drawn to the secretome of umbilical cord-derived mesenchymal stem cells (UC-MSCs) due to its anti-inflammatory and immunomodulatory properties, which can reduce inflammation and promote tissue repair. The UC-MSCs secretome contains numerous growth factors, such as vascular endothelial growth factor, insulin-like growth factor 1 (IGF-1), and basic fibroblast growth factor (bFGF), which are essential for promoting endothelial cell proliferation and penile blood flow. This review seeks to examine the existing evidence on the use of stem cells, with a focus on UC-MSCs secretome, as a potential treatment modality for erectile dysfunction (ED). By reviewing the PubMed, Google Scholar, and Scopus databases, a comprehensive narrative review was conducted. Included among the search queries were "erectile dysfunction," "stem cells," "mesenchymal stem cells," "umbilical cord," and "secretome." Only research published in English within the past decade was included in the analysis. The findings indicate that the secretome of UC-MSCs has promise for treating ED. The secretome is composed of growth factors, cytokines, and other bioactive compounds that promote tissue repair and regeneration via paracrine effects on adjacent cells. The administration of UC-MSCs improved erectile function, penile blood flow, and smooth muscle content. In addition, discarded UC-MSCs serve as a cost-effective and copious source of ethically acceptable and immunogenic UC-MSCs with low immunogenicity. The secretome of UC-MSCs offers a potential therapeutic strategy for treating erectile dysfunction. However, further preclinical and clinical research must be done to determine the safety and efficacy of stem cell-based treatments for erectile dysfunction.