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| |  Test Determines If Sperm Are Alive or Dead SAN FRANCISCO -- June 27, 1997 -- A healthy baby born two weeks ago to a Bay Area couple now gives hope to thousands of men who have been ruled out as potential fathers because they were told they possessed "dead" sperm. The birth is the first reported success nationwide resulting from a new test developed by fertility specialists at University of California San Francisco (UCSF). The test determines if a non-moving sperm is "alive" rather than "dead" and capable of initiating pregnancy through "in vitro fertilization" (IVF). Until now, all non-moving sperm were considered ineffective for IVF procedures, the medical name for fertilization that takes place outside the human body. "The birth of my son is quite honestly the happiest moment of my life," said Mike Parks, 47, who is a medical pioneer. "After trying for so long, to become a father and to see my wife Marie transformed into a mother, holding our perfect little boy -- it's just so amazing and wonderful." David Franklin Parks, named after both of his grandfathers, was born on June 10 in an East Bay hospital. He weighed 6 pounds, 4 ounces and was 20 inches long. Mike and Marie, 37, had been trying to have a baby for more than 10 years, and they were told by many doctors that they had no hope of ever having a child. "Traditionally, sperm motility has been the most widely accepted measure of sperm health," said UCSF male fertility specialist Paul Turek, MD, assistant professor of urology. "This belief until now has excluded sperm that may be alive and healthy but not moving." About 15 percent of American couples have trouble conceiving a child, Turek said, and of this group, about 40 percent have a problem that is male related. About half of these men have abnormalities of sperm, including low counts, abnormal shape and poor movement. Turek, who is the director of the UCSF Male Infertility Clinic and Laboratory, used a physiologic principle called hypo-osmotic swelling (HOS) to develop a test to find living sperm among those thought to be dead. A research article about the effectiveness of Turek's HOS test is published in the June 1997 issue of the scientific journal Molecular Reproduction and Development. Co-author of the study is Colin Smikle, M.D., a fellow in reproductive endocrinology at the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences. In the past, men with non-moving sperm were left out of fertility treatments because "there was no way to tell whether the sperm were alive or dead," Turek said. Applying the HOS test, Turek exposed non-moving testicular sperm to a diluted sugar solution and was able to determine which sperm were alive. The living sperm absorbed water and swelled, while dead or damaged sperm did not. As a result, UCSF specialists were able to select an individual, living, non-moving sperm and inject it directly into the center of a human egg -- a method known as intracytoplasmic sperm injection (ICSI). Though fertility specialists have used ICSI since 1992, until now the procedure has focused on moving sperm, and men whose sperm showed "no sign of life" were excluded, Turek said. "HOS can accurately detect living ejaculated and testicular sperm in a population of non-moving, but not necessarily dead, sperm," he added. The ICSI procedure is used along with the process of IVF. IVF begins with the female partner, who undergoes daily administration of fertility drugs to stimulate eggs to mature. These eggs are then removed from the ovaries and incubated under very precise conditions in an IVF laboratory. Fertilization is attempted in more than one egg, and successful fertilization usually occurs in 12 to 16 hours. In most cases, two or more fertilized eggs are returned to the woman's uterus as a method of increasing the odds that at least one will implant in the uterine lining and pregnancy will occur. After nearly giving up on parenting, the Parks came to UCSF three years ago for fertility treatment on the recommendation of Mike's long-time personal doctor. Their IVF attempt resulted in the recovery of 11 eggs, seven of which were fertilized by ICSI using Mike's non-moving, healthy sperm identified by the HOS test. Two of these embryos were returned to Marie's uterus, and five were frozen for future use. Neither embryo implanted, however, so there was a second try using three more embryos, which also failed. The third time was the charm -- out of the two remaining embryos, one successfully implanted and Marie became pregnant. "We have been on an emotional rollercoaster for the past 10 years," Marie said. "To succeed at anything you must also face failure and disappointment, which we did so often. But we never gave up, and now we have a happy, healthy baby." David was born at full-term, and there were no complications during the pregnancy or the birth. "The ongoing research at UCSF and elsewhere of new techniques to achieve pregnancy provides new opportunities to infertile couples who previously had no hope of bearing a child," said Eldon Schriock, M.D., UCSF associate professor of ob/gyn & reproductive sciences and director of the UCSF IVF Program. Like other IVF-related procedures at UCSF, the ICSI technique involves team members who specialize in each step of the process. Members of the UCSF fertility team are Schriock and Carolyn Givens, MD, UCSF assistant professor of ob/gyn and reproductive sciences, who oversee treatment of the female partner, and Turek, who specializes in male infertility. Roger Pedersen, Ph.D., professor of anatomy and ob/gyn, heads the UCSF IVF Laboratory along with Joseph Conaghan, Ph.D. They oversee the fertilization procedure in the laboratory and perform the ICSI technique. The UCSF IVF Program has delivered more than 450 babies since it became the Bay Area's first such clinic in 1983. Today, the program ranks as one of the top in the country.
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