International Journal of Fertility最新文献

This study is based on a questionnaire which focused on the possible association between life-style factors and male fertility in a group of 252 men attending our laboratory in connection with a fertility investigation. Their answers were correlated to sperm quality. No association could be documented between sperm quality and smoking habits, coffee drinking, a moderate alcohol intake, exposure to heat (sauna, hot baths, type of underwear, sedentary activities), or physical activities in their leisure time. In contrast, the reported average ejaculation frequency was significantly positively correlated to the motility of the sperm (% progressive), and inversely related to the proportion of sperm with abnormal morphology and semen volume. This indicates that the life style of the subject has little if any impact on semen quality, at least within the limits recorded in the present study.

We studied the possible deleterious effects of Percoll gradient centrifugation processing on spermatozoal integrity in 18 semen samples from patients participating in our IVF program, using optical and electron microscopy. Substantial recovery by sperm count was obtained in the 100% Percoll layer (32%), with greater numbers of motile, alive spermatozoa (P < .01). Whether samples studied were from fertile or infertile men, no significant differences, using nonparametric tests with transmission electron microscopy, appeared in spermatozoal membranes, acrosomes, or nuclei either before or after Percoll treatment. No deleterious effects of Percoll use on spermatozoa were detected during the study.

A group of infertile women who had luteal phase defects (LPD), but in whom follicular maturation was deemed normal, were treated with progesterone until the endometrial biopsy was corrected. At the time the corrected biopsy was obtained, serum was taken and the progestogen-dependent endometrial protein (PEP) concentration was determined. Serum PEP concentration in patients who successfully conceived was 102.5 +/- 62.6% units/mL, while PEP concentrations in patients who failed to conceive were 57.9 +/- 34.4% (P = .003). In patients whose PEP value was more than two standard deviations below the corresponding mean control PEP, pregnancy was achieved in 6/17 (35.3%). The conception rate was significantly greater (25/35, 71.4%) in patients with values higher than this. Thus, the PEP concentration in serum may identify a group of patients with persistent LPD despite apparent normalization of the morphology of late secretory phase endometrium, which might explain some cases of cryptic, unexplained infertility.

The B 10 strain of mice was used to test the effect of the boar seminal vesicle immunosuppressive factor on the female mouse response to the male-specific transplantation antigen. Influence of this factor on human natural killer (NK) cell activity was also studied. No inhibitory effect of the immunosuppressive factor on graft survival was apparent during a time of more than 200 days, nor did the factor suppress NK cell activity.

Sperm hyperactivation motility characterized by wide oscillatory movements of the sperm head, nonlinear directions, and rapid motility with occasional star-shaped pattern of movement was measured during routine semen analyses prior to an in vitro fertilization procedure. The method consisted of diluting liquefied semen 1:20 with Ham's F-10 supplemented with processed human cord sera followed by incubation at 37 degrees C for 30 minutes. At the end of the incubation period, aliquots of semen samples were evaluated by phase contrast microscopy for sperm hyperactivation. The results indicated that (1) sperm samples exhibiting 15% or more hyperactive motility were associated with a significantly higher percent fertilization of oocytes during the IVF procedure; (2) sperm hyperactive motility was correlated to sperm fertilizability during IVF treatment cycles.

Five normally menstruating women were treated in an attempt to induce development of multiple follicles. They were randomly divided into two groups. The first group, consisting of three women, was treated with a combination of follicle stimulating hormone (FSH) and human menopausal gonadotropin (hMG) (combination FSH/hMG). The second group, two women, was treated with hMG only. Following a nonconceptual cycle, the treatments were exchanged. The increment patterns of serum estradiol during the follicular phase and progesterone levels in both groups were identical. Ultrasonographic scanning revealed similar number and size of the growing follicles, which subsequently terminated in the same oocyte recovery rate in both groups (7.6 +/- 3.4 oocytes/procedure in the combination FSH/hMG and 8.0 +/- 2.5 in the hMG-only group). Fertilization and cleavage rates were also similar. These data indicate that high FSH/LH levels in different ratios do not alter ovarian response and oocyte fertilization potential.

In a study of 129 consecutively referred hirsute women, 40% had regular menstrual cycles. About one half of such individuals had elevated levels of one or more androgens (DHEAS, testosterone or free testosterone index), whereas a higher proportion (69%) of hirsute women with oligo-amenorrhea were abnormal. Mean androgen levels in regularly cycling hirsute women were higher than in controls, but lower than or equal to those in oligo-amenorrheic hirsutism. Thus, menstrual status does not predict androgen status in hirsute women.

Patients with complete androgen insensitivity syndrome rarely have Müllerian remnants. A patient with this syndrome found to have a microscopic fallopian tube at the time of gonadectomy is described and possible etiologies for the finding are discussed.

The present study compares the ovarian area and the androgen levels (testosterone, free testosterone, SHBG, testosterone/SHBG ratio) in the two patterns (peripheral cystic pattern, general cystic pattern) of polycystic ovaries diagnosed by transvaginal ultrasound. The results were as follows. (1) The ovarian area of the peripheral cystic pattern group of polycystic ovaries was significantly greater than that of normal controls, but in the general cystic group it was not. (2) Serum levels of testosterone and free testosterone, and the testosterone/SHBG ratio in patients with polycystic ovary syndrome were significantly higher than those of healthy controls; but with ultrasonographic classification, there was no significant difference between the peripheral cystic and general cystic groups. (3) In the polycystic ovary syndrome, elevated levels of testosterone and free testosterone, and of the testosterone/SHBG ratio were observed in approximately half of the patients. Ovarian morphology was different, but androgen status was similar in the two patterns of polycystic ovaries.