Pituitary-testicular axis in men with beta-thalassaemia major

Delayed puberty and hypogonadism are frequently observed in patients with homozygous beta-thalassaemia. We evaluated the pituitary-testicular axis in 30 thalassaemic men, aged from 17 to 35 years who were regularly transfused and underwent chelation therapy, while emphasis was given to pituitary reserves of gonadotrophins and the correlation of hormones with serum ferritin (SF). The investigation included endocrinological examination, evaluation of serum basal levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), free testosterone and gonadotrophin-releasing hormone (GnRH) test and also spermiograms. According to the results, patients were divided into three groups: group A, which included 18 eugonadal patients with moderately elevated SF, group B which included six patients who had hypogonadotrophic hypogonadism and excessive elevation of SF, and group C, which included six patients characterized as intermediate, with regard to sexual maturation and SF levels. In conclusion, beta-thalassaemia major leads to variable pituitary iron overload and thus hypophyseal damage. This endocrine disturbance is becoming less frequent nowadays with early and intensive chelation therapy.

Conjunctiva is an estrogen-sensitive epithelium

BACKGROUND

To investigate whether the conjunctival epithelium shows cyclical maturation changes during the ovarian cycle and to study the cytological appearance of the conjunctiva in postmenopausal and pregnant women.

PATIENTS

Fifteen menstruating women with ovulatory cycles, ten postmenopausal women, and twelve pregnant women in the second or the third trimester of their pregnancy.

INTERVENTIONS

Conjunctival and vaginal smears were taken on a near-daily basis.

MAIN OUTCOME MEASURES

The percentage of the parabasal, the intermediate and the superficial cells (Maturation Index) in each specimen was determined.

RESULTS

In the conjunctival smears of the menstruating women cyclical maturation changes were noted. These changes were parallel to those of the vaginal smears, but to a minor degree. No cyclical changes were found in either the postmenopausal women or in the pregnant women, showing an extreme shift to the left in the Maturation Index.

CONCLUSION

Conjunctiva appears to be a relatively estrogen-sensitive epithelium.

The prognostic value of basal luteinizing hormone:follicle-stimulating hormone ratio in the treatment of patients with polycystic ovarian syndrome by assisted reproduction techniques

One of the main endocrinological disturbances in patients with polycystic ovarian syndrome (PCOS) is the increased baseline concentrations of luteinizing hormone (LH) and consequently a high LH:follicle-stimulating hormone (FSH) ratio. The aim of this study was to assess the relationship between the baseline LH:FSH ratio with the stimulation response and the miscarriage risk in PCOS women stimulated for assisted reproduction techniques (ART) with and without gonadotrophin-releasing hormone analogue (GnRHa). Two groups of PCOS patients were analysed retrospectively. Group A (n = 20, 20 cycles) consisted of women stimulated with human menopausal gonadotrophin (HMG), and group B (n = 128, 162 cycles) comprised women stimulated with buserelin-long/HMG. LH and FSH concentrations were measured during the early follicular phase (days 4-6) in a preceding spontaneous or progestin-induced cycle. The following parameters were assessed: number of follicles developed, number of oocytes obtained and percentage of mature oocytes, as well as number of abortions and live births. In group A, the baseline LH:FSH ratio was correlated inversely with the number of follicles developed (P < 0.05), the number of oocytes obtained (P < 0.05) and the percentage of mature oocytes (P < 0.05). In group B, no correlation was found between the LH:FSH ratio and the number of follicles and oocytes, because their numbers were relatively constant irrespective of the baseline LH:FSH ratio, but a significant inverse correlation was noted with the percentage of mature oocytes (P < 0.001). However, a comparison of the slopes of the curve indicated a better correlation between the LH:FSH ratio and the percentage of mature oocytes in group A than in group B (P < 0.05). These findings were also confirmed when patients were subdivided according to the LH:FSH ratio (< 3 or > or = 3). Furthermore, in women who miscarried, the mean LH:FSH ratio was significantly higher than in women having a live birth. In conclusion, in PCOS patients stimulated with HMG, a high basal LH:FSH ratio appears to have an adverse effect on the number of follicles and oocytes, as well as on oocyte maturity. On the other hand, the administration of GnRHa in the long protocol seems to reverse this detrimental effect on follicle and oocyte development. Furthermore, a higher LH:FSH ratio seems to predict a greater possibility for miscarriage, despite the use of GnRHa.

Evaluation of different ovarian stimulation protocols for in vitro fertilization

In this study we evaluated retrospectively the efficacy of five different ovarian stimulation protocols in an in vitro fertilization program, in which 512 women were involved. Ovulation was induced by the following protocols: group I (271 cycles): buserelin short protocol (1 mg/day, intranasally) with human menopausal gonadotropin/human chorionic gonadotropin (hMG/hCG); group II (45 cycles): buserelin (short protocol) with pure follicle stimulating hormone (p-FSH)/hMG/hCG; group III (24 cycles): clomiphene citrate (100 mg/day) with hMG/hCG; group IV (122 cycles): hMG (3 ampules/day) and hCG; group V (113 cycles): hMG/hCG and prednisolone (7.5 mg/day) after cycle programming with oral contraceptives. The lowest cancellation rate (3.3%) was noted in group I, followed by group V (9.7%). The highest number of follicles was observed in groups I (8.3 +/- 0.3; mean +/- SEM) and V (7.8 +/- 0.5). Also, more oocytes were retrieved in group I (7.2 +/- 0.3, p < 0.001), which were of good quality based on oocyte maturity as well as on the fertilization rate, and more embryos (4.5 +/- 0.3, p < 0.05) were developed. The correlation between estradiol and the total follicular volume on the day of hCG administration was also examined in the five groups. The best correlation (r = 0.6502) was found in group I, followed by group V (r = 0.5810). Significant differences were observed in the five groups with regard to the number of hMG ampules administered (p < 0.0001, F = 15.393) and the stimulation days (p < 0.0001, F = 35.32). Sixty-six clinical pregnancies were achieved: 37 (17.5%) in group I, seven (25.9%) in group II, one (10%) in group III, ten (15.6%) in group IV and 11 (15.5%) in group V (differences were not statistically significant). In conclusion, all five protocols were satisfactory in ovarian stimulation for in vitro fertilization, and gonadotropin releasing hormone (GnRH) analogs seemed to be more advantageous by reducing the cancellation rate, enhancing the number of oocytes retrieved and embryos developed and by improving the pregnancy rates.

Maternal plasma level of thrombomodulin is increased in mild preeclampsia

The purpose of this study was to determine if plasma thrombomodulin levels, a glycoprotein found on the surface of the endothelial cell, are elevated in pregnant women with mild preeclampsia and if these levels correlated with other features of disease severity. Parameters were compared in three groups of women: (I) 30 pregnant women with mild preeclampsia, (II) 30 normotensive pregnant women of similar lengths of gestation, and (III) 30 normotensive healthy young women. Thrombomodulin levels were significantly elevated in women with preeclampsia as compared with those of gestation-matched pregnant and non-pregnant controls. There was no correlation between plasma thrombomodulin levels and creatinine and uric acid blood levels. It is thus suggested that plasma thrombomodulin levels are elevated in preeclampsia, even in its mild stage, reflecting a vascular endothelial damage.

Ovarian stimulation and ovarian tumours: a critical reappraisal

Increased interest has arisen recently about the possible association between ovarian stimulation and ovarian tumours. In this article, the current knowledge on the epidemiology, pathogenesis and aetiology of ovarian tumours is extensively reviewed in relation to the existing literature on the relationship between ovulation induction and ovarian neoplasia. The available data from epidemiological studies and case reports do not support a direct causal relationship between ovarian stimulation and ovarian cancer. However, it is possible that ovarian stimulants may have an augmenting role for special categories of tumours, e.g. sex-cord stromal tumours. A definite answer to this important issue may be reached through large prospective epidemiological studies or large retrospective well-designed case-control studies.

Epidemiology of human papillomavirus infection in Greek asymptomatic women

In an attempt to estimate the prevalence of human papilloma virus (HPV) positivity among asymptomatic, cytologically normal Greek women, and the possible associations between HPV infection and other demographic, sexual, behavioural and sociological parameters, we undertook an epidemiological study of 226 clinically normal women from an outpatient gynaecological clinic in Northern Greece. The polymerase chain reaction was used for detection of HPV DNA and dot blot hybridization analysis for HPV typing (only for the high-risk types 16 and 18). Eighty-two of the 226 women examined (36.3%) were positive for HPV DNA, 6.6% (15/226) were positive for HPV-16 DNA and only 1.3% (3/226) were positive for HPV-18 DNA. From all epidemiological correlates, age and residence showed a negative correlation with risk of HPV infection, whereas use of contraceptive intrauterine device, class II or III result of the last Papanicolaou cytological examination, history of painful inflammatory disease of inner genitals and frequent washing of the genital area, particularly during the menstrual period, were positively correlated with increased risk of HPV infection. No association was found between HPV DNA positivity and other well-known risk factors for cervical cancer, confirming the observations of other authors that sexual behaviour, a significant risk factor for cervical cancer, is not inevitably correlated with risk of HPV infection.

Two cases of ovarian tumours in women who had undergone multiple ovarian stimulation attempts

Concerns have been raised recently about the possible association between superovulation and ovarian cancer. In order to contribute to the limited literature on this important issue, two cases of ovarian tumours in women who had undergone multiple ovulation inductions are presented. In the first case, the patient had secondary anovulatory infertility. She was treated with human menopausal gonadotrophin (HMG) alone and in combination with clomiphene citrate or buserelin for six cycles. She then underwent ovarian stimulation with buserelin/HMG in the long protocol for in-vitro fertilization (IVF) and embryo transfer. In preparation for a new IVF/embryo transfer attempt, 8 months later, the screening ultrasound revealed a cystic formation of the left ovary and an enlargement of the right. During laparotomy, both ovaries were found to bear large tumours (approximately 6 x 5 x 4 cm) which were removed. Histological examination showed that they were epithelial tumours (serous-papillary cystadenomas) of borderline malignancy. The patient conceived spontaneously 1.5 years after the operation. In the second case, the patient presented with secondary anovulatory infertility. She underwent ovulation induction with clomiphene/HMG and with buserelin/HMG in the long protocol, and intra-uterine insemination with husband's spermatozoa and conceived (singleton pregnancy). She was delivered by Caesarean section, during which a cystic tumour of the left ovary was removed. Histological examination revealed a benign mucous cystadenoma of the ovary.(ABSTRACT TRUNCATED AT 250 WORDS)

Postmenopausal virilization due to ovarian hyperthecosis

A case of a 66-year-old obese woman with type II diabetes mellitus and a 4 year history of virilism is presented. After removal of the ovaries the raised testosterone levels returned to normal and signs of virilism gradually receded. The histological finding of nodular hyperthecosis of the ovaries is discussed in relation to hyperinsulinaemia.

Effect of pentoxifylline on human sperm motility and fertilizing capacity

The effect of pentoxifylline (PF) treatment on human sperm motility and fertilizing capacity was assessed in 43 couples undergoing IVF/ET, as well as in 84 couples treated with AIH/IUI. Sperm motility increased following PF treatment in asthenospermic samples (n = 12) from 39.2 +/- 1.5 to 45.5% +/- 2% (p = .05), in oligoasthenospermic (n = 40) from 38.1 +/- 1.6 to 43.6 +/- 1.7% (p = .001), and in total (n = 127) from 50 +/- 1 to 52.5 +/- 1% (p < .001). In addition, PF incubation of sperm samples resulted in higher sperm motility values compared to swim-up in all categories of sperm samples. Furthermore, progressive motility increased in all sperm groups following PF treatment (astheno-spermic: +16.7%; oligoasthenospermic: +14%, p < .001; oligozoospermic: +23.5%, p < .001; normozoospermic: +15.3%, p < .05; total +19.2%, p < .001). Sperm preparation with PF resulted in higher fertilization rates in all categories of sperm samples compared to swim-up (total: 46.6 vs. 29.1%, respectively; p < .05). Moreover, PF treatment of human sperm resulted in 9 viable pregnancies (IVF/ET: 5, AIH/IUI: 4) and one biochemical (IVF/ET). PF improving sperm motility and fertilizing capacity appears to be a promising motility stimulant.

Detection of Chlamydia trachomatis in asymptomatic women: relationship to history, contraception, and cervicitis

The presence of Chlamydia trachomatis antigen was examined in 400 endocervical samples collected from an equal number of asymptomatic sexually active women. The overall prevalence was found to be 4%, using the enzyme-linked immunosorbent assay. Chlamydia infection was correlated with younger age (5.8%, p < 0.05), a history of pelvic inflammatory disease (30%, p < 0.0001), and more than four lifetime sexual partners (7.9%, p < 0.01). Women who used oral contraception had more infections (9.7%), than did women who used the intrauterine contraceptive device (4.8%, p > 0.05), condom (0%, p < 0.01) or no contraception (3.1%, p < 0.05). Infection was strongly associated with cervical erythema (8.2%, p < 0.0001), ectopy (7%, p < 0.05), friability (20%, p < 0.0001), and endocervical discharge (100%, p < 0.0001). These results support the view that Chlamydia trachomatis infection is associated with younger age, intense sexual life, and use of oral contraceptives. Given that the majority of infected women revealed cervical pathology, the detection of chlamydia in the high-risk female population with cervical changes seems to be essential.

Follicle cyst formation after administration of different gonadotrophin-releasing hormone analogues for assisted reproduction

The aim of this study was to examine the occurrence of ovarian cysts during the administration of three different gonadotrophin-releasing hormone analogues (GnRHa) in the long protocol as well as their characteristics, management and outcome compared with patients with no cyst formation. A total of 172 in-vitro fertilization (IVF) cycles in which GnRHa was administered at menstruation were analysed. Group B consisted of 72 cycles in which buserelin was used. Of these, 10 (13.9%) were with cysts (group B1) and 62 (86.1%) without cysts (group B2). Group T included 49 cycles in which triptorelin was injected. Of these, seven (14.2%) were with cysts (group T1) and 42 (85.7%) without cysts (group T2). Group L comprised 51 cycles in which leuprolide was administered. Of these, eight (15.7%) were with cysts (group L1) and 43 (84.3%) without cysts (group L2). All women with ovarian cysts had higher serum oestradiol concentrations and all except five underwent cyst aspiration with no complication. No differences were observed in the number of follicles and oocytes between groups B, T and L or between the groups with cysts and those without cysts. The pregnancy rate was similar in all groups. In conclusion, follicle cyst formation does not seem to be related to the use of a specific GnRHa, its short- or long-acting form or to the mode of administration. In addition, follicle cyst aspiration is a safe and successful solution to the problem of functionally active ovarian cysts.

Copper intrauterine contraceptive device and pregnancy rate

Between August 1983 and August 1992, 1995 women aged 20-43 years were fitted with 2736 copper intrauterine contraceptive devices (MLCu250, MLCu375, Nova-T, Gravigard, Anticon). Insertion of the IUD was performed during menstruation by a skilled team of gynecologists. The women were instructed to self-check the IUD tail after each menstrual period. All the women were examined after one month and were followed-up every six months. The 1995 acceptors accumulated a total use of 69,350 months. During this period 39 accidental pregnancies occurred (Pearl Index 0.62, cumulative net pregnancy 1.95 per 100 women). Thirty-six pregnancies were intrauterine and three were ectopic. Most of the accidental pregnancies occurred during the first 12 months of use. The pregnancy rate of IUD users was negatively correlated with age. It is concluded that fitting the Cu-IUD intramenstrually, teaching the user to self-check herself and having frequent re-examinations seems to decrease the pregnancy rate in Cu-IUD users.

Detection of human papillomavirus using the polymerase chain reaction and typing for HPV16 and 18 in the cervical smears of Greek women

The polymerase chain reaction (PCR) was applied for the detection of human papilloma virus (HPV) infection, in samples obtained from the uterine cervices of 202 asymptomatic women with normal cytology in Northern Greece. About 41.8% of the women with microscopically and cytologically normal cervices were found to be infected with HPV. Typing of HPV revealed that 6.9% and 1.5% of the women were infected with HPV16 and HPV18, respectively.

Evaluation of two gonadotropin-releasing hormone (GnRH) analogues (leuprolide and buserelin) in short and long protocols for assisted reproduction techniques

PURPOSE

The administration of two GnRH analogues (buserelin and leuprolide acetate) in long and short protocols was evaluated prospectively. In the long protocol, the analogues were given from day 1 of the cycle for at least 14 days and then hMG administration was started, while in the short protocol the analogues were initiated from cycle day 1, adding hMG from day 3. The patients were divided into four groups according to the protocol used: Group I, buserelin-long; Group II, buserelin-short; Group III, leuprolide-long; and Group IV, leuprolide-short. Serum E2 levels on the day of hCG injection and the number of follicles observed, oocytes retrieved, and embryos obtained, as well as implantation rates, were significantly higher (P < 0.001) in the long protocols than in the short ones.

RESULTS

Pregnancy rates were similar in all groups, although a trend for better results was observed in buserelin-long compared to buserelin-short. There were no differences in the results achieved with buserelin or leuprolide.

CONCLUSION

The administration of GnRH analogues (buserelin and leuprolide acetate) in long protocols induced a more intense ovarian response and was associated with significantly higher implantation rates and also a trend for higher pregnancy rates, although this difference was not statistically significant.

Effect of follicular fluid on the kinetics of human sperm acrosome reaction in vitro

The purpose of the present study was to evaluate the kinetics of human sperm acrosome reaction in vitro using the triple stain technique. Acrosome reaction was studied in sperm samples from 16 fertile men 2, 6, and 9 h after ejaculation, following incubation in culture medium (CM; Ham's F-10), with a mixture of CM and follicular fluid (FF), or with FF only. Incubation of sperm samples without the influence of any medium served as control. The highest proportion of living acrosome-reacted sperm after a 2-h incubation period occurred in samples incubated with FF (18%), followed by samples incubated with the mixture (15.2%), and then with CM (11.8%). The proportion of living sperm that had undergone the acrosome reaction in the control group was significantly lower (5.7%, p < 0.05). After 6 h of incubation, live acrosome-reacted sperm in FF had increased to 39%, in the mixture to 35.5%, and in CM to 30.5%, whereas in the control group the increase was only 6.3% (p < 0.05). After 9 h of incubation, the percentage of living reacted sperm showed a decline compared with the percentage at 6 h. This decline was greater in samples incubated with FF (from 39 to 19.8%) than in samples incubated with the mixture (from 35.5 to 23.6%). Samples incubated in CM only showed a small decrease from 30.5 to 28.4%, while in the control group this percentage decreased from 6.3 to 2.3%. In conclusion, incubation of sperm in suitable media favorably influences the acrosome reaction, inducing an increase in the percentage of live acrosome-reacted sperm.(ABSTRACT TRUNCATED AT 250 WORDS)

Growth hormone, oestradiol, progesterone and testosterone concentrations in follicular fluid after ovarian stimulation with various regimes for assisted reproduction

Follicular fluid samples and oocytes were obtained from 75 women (87 cycles), who participated in an assisted conception programme. Determinations of the concentration of oestradiol, progesterone, testosterone and growth hormone were performed in all follicular fluid samples. Patients were stimulated with the following regimes: group A (24 cycles, 94 samples), human menopausal gonadotrophin (HMG) (three ampoules/day) and human chorionic gonadotrophin (HCG); group B (23 cycles, 53 samples), HMG/HCG with prednisolone (7.5 mg/day) after cycle programming with oral contraceptives; group C (40 cycles, 60 samples), buserelin with HMG/HCG. Oestradiol concentrations (mean +/- SEM) were significantly higher (P < 0.05) in group A (320.1 +/- 27.3 ng/ml) and those of growth hormone in both groups A and C (3.8 +/- 0.2 and 3.2 +/- 0.15 ng/ml, respectively), as compared to the other groups, whereas progesterone and testosterone concentrations were similar in all groups. The mean concentrations of oestradiol, progesterone, testosterone and growth hormone were significantly higher (P < 0.01) in follicular fluid with oocytes of intermediate maturity than with mature oocytes (382.5 ng/ml, 7847.5 ng/ml, 1704.5 ng/dl and 3.7 ng/ml versus 217.8 ng/ml, 5488.4 ng/ml, 1313.6 ng/dl and 2.7 ng/ml, respectively). On the other hand, only oestradiol concentrations were significantly higher in follicular fluid of fertilized compared to non-fertilized oocytes. Concentrations of the other hormones analysed, except growth hormone, were similar in follicular fluid from pregnant and non-pregnant women after assisted reproduction. Growth hormone, on the other hand, was significantly lower (P < 0.05) in follicular fluid from pregnant compared to non-pregnant women (2.8 versus 3.5 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

Ovarian stimulation with buserelin/HMG/HCG: prospective randomized study of short versus long protocol

The combined administration of the gonadotrophin-releasing hormone (GnRH) agonist buserelin and human menopausal gonadotrophin (HMG) was evaluated in 527 cycles (428 patients) of an assisted reproduction programme. All women were randomly allocated according to the ovulation induction protocol into two groups: group I (short protocol; 318 cycles) was given buserelin (1 mg/day) intranasally from cycle day 1 and HMG (2 ampoules/day) from day 3 until human chorionic gonadotrophin (HCG) administration: group II (long protocol; 209 cycles) was given buserelin (1 mg/day) intranasally from cycle day 1 for at least 14 days and then 2 ampoules HMG/day were added, increasing progressively according to the ovarian response. The number (mean +/- SEM) of follicles developed was higher in group II than in group I (9.1 +/- 0.4 versus 7.7 +/- 0.3, respectively; P < 0.05). More oocytes were retrieved in group II (8.4 +/- 0.5) than in group I (6.5 +/- 0.3) (P < 0.001), as well as more embryos (6.3 +/- 0.5 and 4.0 +/- 0.3, respectively; P < 0.001). Moreover, in group II there was a better correlation between oestradiol and the total follicular volume (r = 0.5391) on cycle day 0 compared with group I (r = 0.458), while oestradiol values were similar between the two groups. No differences were observed in the cancellation rate, fertilization rate and maturity of the oocytes between the two groups. The pregnancy rate per transfer was slightly better in group II (25.8%) than in group I (19.4%), but this difference was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Psychosocial impacts of infertility on Greek couples

Psychosocial impacts of infertility were investigated in couples undergoing different treatment procedures in our clinic. Couples were interviewed in a semi-structured way by a psychologist or a psychiatrist and responded to three specially structured questionnaires: the Life Events Scale, the Marlowe-Crowne/Taylor Scale and the Side Effect Checklist. The data were analysed in terms of demographic characteristics as well as treatment procedure. The psychosocial, psychosexual and emotional outcomes of their infertility problem and Greek traditional culture laws are discussed. Stress has been identified in both sexes, depression mostly in women, while men showed a tendency towards repressed anxiety and thus a greater risk of psychosomatic illness, a finding supported by their response to the Side Effect Checklist. Women showed a high defensive anxiety and also reported numerous psychosomatic symptoms. These couples seem to have special needs and fears, both general and treatment specific. Very few of our couples would be considered as severely emotionally disturbed. Women seem to have more difficulties in social adjustment. Sexual dysfunction was reported by almost half of our subjects, although this was associated with a degree of deterioration in their marriage. Guilt feelings, particularly connected with previous abortions, seem to be torturing most women. Finally, both partners seem to have psychological problems irrespective of the one in whom the aetiological problem was found. Moreover, traditional rules seem to impose a special burden on people coming from rural areas. Our results strongly support the belief that infertile couples undergoing different treatments need psychological counselling and supportive psychotherapy.

Evaluation of Hamilton-Thorn automated semen analysis system

Sperm concentration and percentage motility values generated by the HT M-2030 system (CASA) were compared with those obtained by subjective semen analysis (SSA). Three calibrations arbitrarily designated as A, M, and D for gates and discriminators and three calibrations arbitrarily designated LI, MI, and HI for default pixel count (DPC) and default intensity (DI) were evaluated. The best correlation between CASA and SSA was observed utilizing M calibration (n = 114) with which sperm concentration was +0.3 x 10(6)/mL (r = .96) and motility was -6.3% (r = .89) compared to the values obtained by SSA. It was found that 35.9% of sperm concentration values and 34.2% of sperm motility values were within 10% of the values obtained by SSA. When sperm concentration was between 50 and 100 x 10(6)/mL the difference in motility was reduced (-3.2%) while the difference in sperm concentration was reversed (-2.6 x 10(6)/mL). LI calibration (DPC = 4, DI = 86) gave acceptable results with M calibration for sperm concentration (+2.1 x 10(6)/mL) and motility (-6.9%) compared to the values obtained by SSA. In the presence of sperm clumping, the difference between CASA and SSA was reversed for sperm concentration (+0.56 x 10(6)/mL for normal samples vs. -2.2 x 10(6)/mL for samples with clumping) and was reduced for sperm motility (-7.14% vs. -4.55%, respectively). HT M-2030 under proper calibration can be used as a rapid, objective, and reliable alternative to conventional semen analysis in routine and for research purposes.

Evaluation of intrauterine insemination with washed spermatozoa from the husband in the treatment of infertility

In this study, we examined the efficacy of intrauterine insemination with washed spermatozoa from the husband (AIH/IUI) in the treatment of infertility. A total of 127 treatment cycles were completed (1.95 cycles per patient). The indications for AIH/IUI were male subfertility (group I: 53 couples), cervical factor (group II: four couples), male and cervical factor (group III: six couples) and unexplained infertility (group IV: two couples). Sperm washing caused a reduction of the sperm concentration from 52 x 10(6)/ml to 44 x 10(6)/ml (P less than 0.08) and motility from 49% to 45% (P less than 0.03). Twelve pregnancies were achieved (18.5% per couple and 9.5% per cycle): eight pregnancies in group I (15.1%), one in group II (25%) and three in group III (50%). Of the 12 pregnancies, eight occurred in the first insemination cycle, three in the second and one in the third (1.4 cycles/pregnancy). Sperm motility was significantly higher in the pregnant than in the non-pregnant group (65.5% versus 46.4%, respectively; P less than 0.004), whereas no significant difference was observed in the sperm concentration between these two groups (39 x 10(6)/ml and 54 x 10(6)/ml, respectively). In conclusion, AIH/IUI is a technically easy and non-invasive procedure which offers a satisfactory pregnancy rate in selected couples with male subfertility and/or cervical factor infertility.

LDH isoenzymes in semen of infertile men

LDH isoenzymes (LDH1, LDH2, LDH3, LDH4, LDH5, and LDHx) were evaluated in 68 infertile men and in a control of 10 fertile men. No statistically significant difference was found in the value of the 5 isoenzymes (LDH 1-5) in the different subgroups of infertile men and in the comparison of the infertile men with the control group. LDHx was detected in the infertile men, regardless of the cause of infertility, as long as the sperm concentration was greater than or equal to 16 million/ml, LDHx was not detected not only in all azoospermic men but, also, in those infertile men whose sperm count was less than or equal to 15 million/ml. There is a positive relationship (p less than 0.001) between LDHx and sperm concentration, but there is no such relationship between LDHx and % motility.

Seminal plasma zinc and magnesium in infertile men

Levels of zinc and magnesium were estimated in the seminal plasma of 83 men having various infertility problems. There was a wide overlapping of Zn and Mg mean values among the groups of normal and infertile men, a significant reduction in Mg mean value (but not Zn) only in the group with infection of the accessory genital glands, a very high positive correlation between Zn and Mg mean values in all groups, and a high positive correlation between either Zn or Mg and acid phosphatase (but neither fructose nor sperm count and forward progression) in men with infection, but not in the other groups. Measurement of Mg in seminal plasma can, in combination with other parameters of prostatic function, give useful information regarding male infertility problems, particularly in the case of infection of the accessory genital glands.