Clinical reproduction and fertility最新文献

Photographic slides of 36 sperm were shown to a group of 28 observers with different lengths of experience in assessing sperm morphology. Experienced observers were generally consistent (10 or more of the 17 agreeing) in classifying sperm as normal, amorphous, small heads, lacking acrosomes, and having tail defects or cytoplasmic droplets but categorization was more variable for large, tapering and pyriform heads. This study highlights the need for more widespread agreement about definition of sperm shapes and the development of practical objective methods of assessment.

The ability of human spermatozoa to penetrate zona-free hamster ova in a heterologous ovum penetration (HOP) test was compared with the fertilisation of human oocytes in 54 normospermic couples. Concordant results were seen in 45/54 (83%) cases. However, false-positive HOP test results occurred in 5/45 (11%) couples and false-negative results in 4/9 (44%) couples. The data suggest that a positive HOP test result is a good indication that fertilisation will occur, although a negative HOP test result does not necessarily mean that fertilisation will not take place.

An aetiological role for non-specific genital tract infection (GTI) in male infertility has long been postulated and has led to routine bacteriologic culture of semen in some laboratories. To assess the value of examination of various semen characteristics and conventional culture of semen as diagnostic criteria for GTI, frequencies of bacterial isolation and relationships with leukocytospermia and other abnormalities of semen were determined in 806 samples from 459 men seen over a 2 year period. Combinations of features suggestive of GTI were present in 19.6%. High leucocyte counts were found in 13.5% of specimens and evidence of possible accessory sex organ dysfunction in 57.7%. Significant numbers of bacteria were isolated from 19.5% of samples. Of the few pathogens cultured (46 specimens), 53% were Staphylococcus aureus, a possible contaminant. Furthermore, only one specimen had more than 10(6) pathogenic bacteria per ml, also Staph. aureus. There was a lack of correlation between the presence of bacteriospermia, leukocytospermia and semen changes possibly attributable to accessory sex organ dysfunction, shedding doubt on their relevance to identification of GTI. This was the case even in repeatedly culture-positive specimens. Conventional bacteriological examination of semen specimens is not merited as a routine procedure.

The mouse in vitro fertilisation (IVF) model was used to investigate the effect of porcine relaxin on fertilisation. Porcine relaxin (10 ng/ml) significantly increased the proportion of oocytes fertilised by suboptimal concentrations of mouse spermatozoa. Pronuclear formation was significantly greater in the presence of relaxin. These findings may have clinical importance in the future for improving the success of IVF procedures, and improving pregnancy rates.

Condoms and other rubber products immobilize sperm, but the mechanism is unknown. Sperm motility and eosin Y exclusion were measured following exposure of samples of semen to latex condoms of various types. Sperm motility was markedly reduced by exposure to all latex condoms, but eosin Y exclusion was unchanged. While there appeared to be some variability between semen samples and in time to complete immobilization of all sperm, condoms from one batch were similar. The immobilizing effect was not altered by prewashing the condom with buffer, chelating agent or acid. After immobilization, motility was not recovered by sperm washed in buffer, mixed with normal mid-cycle cervical mucus, or exposed to caffeine or adenosine triphosphate after demembranation with detergent. Studies with components of condoms indicated that raw latex and zinc dimethyl- and dibutyl-dithiocarbamate accelerators immobilized sperm within 30 min. In contrast, silicone rubber had no effect on sperm motility for up to 4 h. Enhancement of the sperm immobilizing effect might improve the contraceptive efficacy of condoms, while a useful non-toxic sperm collecting device for semen analysis, artificial insemination or in vitro fertilisation might be developed by omitting the toxic components from the rubber.

Two hundred and fifty-eight (258) couples requesting in vitro fertilisation (IVF) were interviewed by a social worker prior to commencing treatment. At the time of admission to hospital 147 women and 134 men completed a questionnaire which incorporated the Eysenck Personality Inventory and the Spielberger State-Trait Anxiety Inventory. Forty-three women conceived and 26 couples (14.2%) required extra counselling or support after their involvement in the programme. Couples seeking IVF did not differ significantly from the rest of the population with respect to occupation, education, alcohol, cigarette and medication use. The personality characteristics of couples seeking IVF did not differ significantly from a local comparison group. Personality and psychosocial characteristics did not identify those couples who were more likely to become pregnant by IVF. However, couples who required extra counselling were more likely to have required similar help in the past. Women requiring counselling also scored significantly higher on the Eysenck neuroticism scale and the Spielberger State-Trait anxiety scales compared to those women who did not require extra counselling or support. The male partners scored significantly lower on the Eysenck scale of extroversion compared to male partners of couples who did not require support or counselling. We conclude that these inventories may be of value in identifying certain couples who require extra care during attempted conception by IVF.