Publications by authors named "Pinggera Germar-Michael"

Purpose: In this systematic review and meta-analysis, we investigated assisted reproductive technology (ART) success in infertile men with clinical varicocele and abnormal semen parameters who underwent varicocele repair (VR) before the ART procedure as compared to those who did not.

Materials And Methods: A comprehensive search of the Scopus, PubMed, Embase, and Cochrane Library databases was conducted using a specific query string to identify studies examining the impact of VR on ART outcomes, including fertilization rate, clinical pregnancy, pregnancy loss, and live-birth rate, until October 2023. Outcomes were analyzed based on the type of ART.

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Nonobstructive azoospermia (NOA) is considered the most challenging clinical scenario for infertile men and current treatments leave many men unsuccessful at being able to achieve a pregnancy with their partner using their own sperm. Microdissection testicular sperm extraction (micro-TESE) is the choice for men with NOA desiring to father children with their own gametes. Micro-TESE results in the highest numbers of sperm cells retrieved for use with in vitro fertilization/intracytoplasmic sperm injection.

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Article Synopsis
  • Non-obstructive azoospermia (NOA) is a prevalent and complex issue with varied treatment options and no definitive guidelines, leading to differing management practices internationally.
  • A comprehensive survey with 336 responses from specialists in 49 countries explored current medical and surgical strategies for NOA, analyzing results against existing guidelines and offering expert recommendations.
  • Key findings included diverse approaches to hormonal therapy, significant variation in sperm retrieval success rates, and differing protocols around varicocele repair and follicle-stimulating hormone cutoff levels for sperm retrieval.
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  • * Conducted from July to September 2022, a questionnaire gathered responses from 367 doctors in 49 countries, focusing on how they diagnose NOA through methods like hormone tests and genetic analyses.
  • * The survey identified that while many practices align with guidelines, significant differences in approaches were found, underscoring the need for standardized, evidence-based international guidelines for NOA evaluation.
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Purpose: Varicocele has been associated with high seminal oxidative stress (OS), impaired semen quality, and reduced male fertility potential. However, the exact mechanism(s) underlying the development of varicocele-mediated infertility and the cause-effect relationship between varicocele and testicular dysfunction are not fully understood. The aim of this systematic review and meta-analysis (SRMA) is to investigate the impact of varicocele on testicular OS markers and sperm parameters in experimental animals with varicocele as compared to animals without varicocele.

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  • This systematic review and meta-analysis investigates whether varicocele repair (VR) can lower sperm DNA fragmentation (SDF) and seminal oxidative stress (measured by malondialdehyde or MDA) in infertile men.
  • An analysis of 29 studies involving 1,491 men shows a significant reduction in SDF post-VR, regardless of the surgical technique used and the method of SDF testing.
  • The findings also indicate a notable decrease in seminal MDA levels following VR, supporting the effectiveness of varicocele repair in improving reproductive parameters in affected men.
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Preoperative homeostasis of sex hormones in testicular germ cell tumor (TGCT) patients is scarcely characterized. We aimed to explore regulation of sex hormones and their implications for histopathological parameters and prognosis in TGCT using a data-driven explorative approach. Pre-surgery serum concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), estradiol (E2) and prolactin were measured in a retrospective multicenter TGCT cohort (n = 518).

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Article Synopsis
  • The study investigates global practices and challenges in using sperm DNA fragmentation (SDF) assays, which can affect male reproductive potential, as outlined in the latest WHO manual.
  • A survey of 436 reproductive clinicians revealed that the most popular SDF assay is TUNEL, with a significant influence from availability on their choices.
  • Clinicians see the value of SDF testing in understanding infertility but face barriers like insufficient professional guidelines and a lack of accepted reference values for interpreting SDF results.
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  • The meta-analysis investigates the effects of varicocele repair on semen parameters in infertile males, combining data from diverse studies without language restrictions.
  • A total of 351 studies were analyzed, revealing significant improvements in several semen parameters post-repair, including semen volume, sperm concentration, total sperm count, motility, and morphology, while sperm vitality showed no improvement.
  • This research is the largest of its kind and highlights the benefits of varicocele repair for male infertility, contributing valuable insights for clinical practice.
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  • AI has rapidly advanced in medicine, particularly benefiting fields like andrology and reproductive medicine through technologies like machine learning and neural networks.
  • AI tools can enhance the diagnosis and treatment of male infertility, improve patient care accuracy, and increase efficiency in clinical management and research.
  • Future advancements in AI integration are expected to lead to significant breakthroughs and improvements in evidence-based practices within andrology and reproductive medicine.
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  • The study investigates global practices for managing sperm DNA fragmentation (SDF) in infertile men, highlighting its impact on fertility and assisted reproductive technology (ART).
  • A survey collecting data from 436 reproductive experts across 55 countries revealed a common recommendation for lifestyle changes and antioxidants, with varying durations for treatment and differing management approaches for specific infertility cases.
  • The findings indicate a lack of uniformity in practices, emphasizing the need for standardized guidelines and expert consensus for treating men with elevated SDF.
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  • The study explores global practices for sperm DNA fragmentation (SDF) testing in infertile men, following its inclusion in the WHO laboratory manual.
  • A survey conducted among 436 infertility clinicians across 55 countries reveals varied testing practices, with many testing SDF in cases of unexplained infertility, recurrent pregnancy loss, and among smokers.
  • The findings highlight the need for clearer professional guidelines on SDF testing, given the diversity in current practices and the potential benefits for certain patient populations.
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Purpose: Seminal oxidative stress (OS) is a recognized factor potentially associated with male infertility, but the efficacy of antioxidant (AOX) therapy is controversial and there is no consensus on its utility. Primary outcomes of this study were to investigate the effect of AOX on spontaneous clinical pregnancy, live birth and miscarriage rates in male infertile patients. Secondary outcomes were conventional semen parameters, sperm DNA fragmentation (SDF) and seminal OS.

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Purpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes.

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The swelling ability of kappa-carrageenan (KC) hydrogels was investigated in simulated body fluid (SBF). The SBF mimics the ionic concentrations in the vasa deferentia of human males. The study clarifies if these hydrogels can be adjusted to occlude the vasa deferentia by swelling.

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As the COVID-19 pandemic persists and new vaccines are developed, concerns among the general public are growing that both infection with the SARS-CoV-2 virus and vaccinations against the coronavirus (mRNA vaccines) could lead to infertility or higher miscarriage rates. These fears are voiced particularly often by young adults of reproductive age. This review summarizes the current data on the impact of SARS-CoV-2 infection and corona vaccinations on female and male fertility, based on both animal models and human data.

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Purpose: Both infertility and erectile dysfunction (ED) are known long-term consequences of cancer treatment in young male cancer survivors. In the present study, we aimed to assess whether sperm quality and sexual function in male cancer survivors are associated.

Methods: In this prospective study, n = 244 patients male cancer survivors who underwent sperm analysis and cryopreservation between 2008 and 2018 prior to the initiation of gonadotoxic treatment were invited.

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Purpose: The success of vasectomy is determined by the outcome of a post-vasectomy semen analysis (PVSA). This article describes a step-by-step procedure to perform PVSA accurately, report data from patients who underwent post vasectomy semen analysis between 2015 and 2021 experience, along with results from an international online survey on clinical practice.

Materials And Methods: We present a detailed step-by-step protocol for performing and interpretating PVSA testing, along with recommendations for proficiency testing, competency assessment for performing PVSA, and clinical and laboratory scenarios.

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Antisperm antibodies (ASA), as a cause of male infertility, have been detected in infertile males as early as 1954. Multiple causes of ASA production have been identified, and they are due to an abnormal exposure of mature germ cells to the immune system. ASA testing (with mixed anti-globulin reaction, and immunobead binding test) was described in the WHO manual 5th edition and is most recently listed among the extended semen tests in the WHO manual 6th edition.

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Article Synopsis
  • * Differentiating between asthenozoospermia (low sperm motility) and necrozoospermia (low sperm vitality) is crucial for diagnosing and treating infertility, as their causes can be local or systemic.
  • * A global survey was conducted to assess current practices regarding sperm vitality testing and necrozoospermia management, aiming to create a standard approach for diagnosis and treatment in clinical settings.
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Background: Male sex is related to increased COVID-19 severity and fatality although confirmed infections are similarly distributed between men and women. The aim of this retrospective analysis was to investigate the impact of sex hormones on disease progression and immune activation in men with COVID-19.

Patients And Methods: We studied for effects of sex hormones on disease severity and immune activation in 377 patients (230 men, 147 women) with PCR-confirmed SARS-CoV-2 infections hospitalized at the Innsbruck University Hospital between February and December 2020.

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Gel disintegration via compression is a possible approach for the reversal of the occlusion of male vasa deferentia (VD) by hydrogels. κ -carrageenan (KC) hydrogels can be used for such an application. To determine the required forces for in-vessel compressive disintegration, a gel-tube model, preparing KC gels in different tubes, is studied.

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Supporting and counselling couples with fertility issues prior to starting ART is a multidisciplinary diagnostic and therapeutic challenge. The first German-language interdisciplinary S2k guideline on "Diagnosis and Therapy Before Assisted Reproductive Treatments (ART)" was published in February 2019. The guideline was developed in the context of the guidelines program of the German Society of Gynecology and Obstetrics (DGGG) in cooperation with the Swiss Society of Gynecology and Obstetrics (SGGG) and the Austrian Society of Gynecology and Obstetrics (OEGGG).

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