Capacity of objectively assessed sperm motility characteristics in differentiating between semen of fertile and subfertile men

Evaluation of cannabinoid receptors Type 1 and Type 2 mRNA expression in mature versus immature spermatozoa from fertile and infertile males

The expression of the main cannabinoid receptors (CBR1 and CBR2) was investigated to evaluate the possible association with the sperm maturation from fertile and infertile individuals. One hundred subjects were classified into fertile (n = 50) and infertile groups (n = 50). Fresh semen samples were collected. Computer-assisted semen analysis and acrosin activity test were done. RNA was extracted from mature and immature sperm pellets. Reverse transcriptase reaction and real-time PCR were done to assess the levels of both CBR1 and CBR2 genes expression in all samples. Mature spermatozoa from both groups showed significantly higher levels of both CBR1 and CBR2 compared with the immature spermatozoa (p < .05). This increment was significantly more important in the fertile group (p < .05). In mature spermatozoa, CBR1 expression was significantly related to variation in sperm morphology, and CBR2 was significantly related to both sperm morphology and linearity index. In conclusion, CBR1 and CBR2 mRNA expression may closely direct the sperm maturation at different steps of the reproductive process.

Relationship between DYNLT1 and Beclin1 expression and the fertilising potential of human spermatozoa

This study aimed to evaluate dynein light chain type 1 (DYNLT1) mRNA expression in mature spermatozoa and to investigate its association with Beclin1 expression to help in understanding of pathogenesis of male infertility. It included 60 infertile men divided into idiopathic (n = 20), accessory gland inflammation (n = 20), and varicocele (n = 20) groups, and 20 healthy fertile men as a control group. Semen parameters were evaluated according to the 2010 World Health Organization criteria. Mature spermatozoa were isolated by Sil-select gradient. Relative quantification of DYNLT1 and Beclin1 mRNA expression in whole sperm pellet and mature spermatozoa was done using real-time PCR. Beclin1 protein was assessed in whole sperm pellet and mature spermatozoa by ELISA. Beclin1 mRNA and protein were significantly increased in spermatozoa from infertile patients of different aetiologies in comparison to healthy controls (p < .05). However, DYNLT1 mRNA expression was significantly decreased in infertile groups than controls (p < .05). Mature spermatozoa extracted from all studied subjects showed increased DYNLT1 mRNA and decreased Beclin1 mRNA and protein expression compared with the whole sample. It is concluded that decreased Beclin1 and increased DYNLT1 mRNA expression in mature spermatozoa may provide an insight into the biological processes that are activated or suppressed during sperm maturation.

The Role of Protamine 2 Gene Expression and Caspase 9 Activity in Male Infertility

PURPOSE

Approximately 15% of couples are affected by infertility with the man responsible in almost half of the cases. PRMs (protamines) confer a higher order of DNA packaging in sperm than that in somatic cells. Because of the critical roles of PRMs in spermatid differentiation, aberrations in PRM expression or changes in protein structure could be causes of certain types of idiopathic human male infertility. The aim of this study was to give insight into the role of PRM2 gene expression and caspase 9 activity in the pathogenesis of male infertility.

MATERIALS AND METHODS

The current study included 70 men with idiopathic infertility and 64 fertile men who attended the andrology outpatient clinic at Mansoura University Hospital. Semen sample analyses were done according to WHO recommendations. The acrosome reaction of spermatozoa recovered from each sample was assessed. Samples were separated using discontinuous gradient separation. From each semen sample mature sperm were separated from immature sperm. The resulting samples were divided into 2 parts, including one to determine caspase 9 activity and the other for RNA extraction and reverse transcriptase-polymerase chain reaction of PRM2 gene expression. The polymerase chain reaction product was electrophoresed on 2% agarose gel.

RESULTS

PRM2 gene expression was significantly decreased in immature sperm extracted from the fertile and infertile groups. Caspase 9 activity was significantly increased in immature sperm extracted from both groups.

CONCLUSIONS

Low levels of PRM2 may be associated with morphological abnormalities, initiation of the apoptotic pathway and decreasing sperm motility. PRM2 may be an important marker to better understand the key regulatory pathway of spermatogenesis and it may act as a crucial part of fertilization.

Computer-assisted sperm analysis of canine spermatozoa motility measurements

Computer-assisted sperm analysis (CASA) allows for the determination of specific motion characteristics of sperm cells in vitro. This study was designed to develop a system for the use of CASA to objectively evaluate canine sperm motility, and specifically to determine whether motility characteristics vary between individual dogs. Ejaculates from 10 dogs were collected weekly. Sperm cells were extended in a glucose-free TALP medium, placed on slides and videotaped at 200x. Videotaped samples were then analyzed by the Hamilton-Thorn Motility Analyzer, with 100 cells evaluated per slide. Two slides were made from each ejaculate. Motility characteristics that were evaluated included lateral head displacement, beat cross frequency, path velocity, path linearity, path straightness, percentage of motile cells, and percentage of progressively motile cells. Sperm cell morphology was also evaluated. Canine spermatozoa maintained good overall motility (mean +/- SD, 73 +/- 9%) during the procedure. Mean sperm motility and morphology measurements differed significantly between dogs (P<0.01). There was no difference (P>0.05) between the mean measurements of different ejaculates for an individual dog, or for different slides made from the same ejaculate. Mean motility values for the 10 dogs are reported. There was a significant but not strong correlation (r=0.44) between the percentage of progressively motile sperm cells and the percentage of sperm cells with normal morphology.

Long-term ofloxacin testicular toxicity: an experimental study

The aim of this study was to assess the long-term toxic effect of ofloxacin on the testes and epididymides of 72 adult male albino rats. The rats were divided into group A and group B. Group A, which received ofloxacin for 14 days, was subdivided into two subgroups; LD-14 received low dose 72 mg KBW(-1) daily and HD-14 received high dose 216 mg KBW(-1) daily. Group B, which received ofloxacin for 28 days, was subdivided into two subgroups; LD-28 received 72 mg KBW(-1) and HD-28 received 216 mg KBW(-1) daily. Two matched control groups were followed up for 14 and 28 days respectively. The animals were evaluated for body weight, testicular weight, relative testicular weight, serum testosterone (T), epididymal sperm analysis (sperm count, motility, morphology, curvilinear velocity, linear velocity and linearity index) and testicular histopathology. The adverse effects of ofloxacin were correlated with increased treatment duration and/or dose. It is concluded that long-term ofloxacin has a direct detrimental effect on the testicles of albino rats at the studied doses and durations.

Sperm quality, birth rates and the environment in Flanders (Belgium)

The relationship between fertility and pollution is unclear. We evaluated sperm quality of 562 candidate donors (years 1977-2004), births rates (births), pollutants, and the number of females in reproductive age (NFRA, 20-39 years) in Flanders. Total sperm count did not change significantly with time. Births correlated with sperm morphology (r=0.60, P=0.0027). Continuing decline in sperm morphology with time is confirmed, statistically unrelated to pollutants. Grade A sperm motility declined (1977-1992) with gradual incomplete recovery thereafter. Multiple regression analysis (1995-2002) indicated dioxin (negative association) as the only independent variable for grade A motility (r-adjusted co-efficient of determination "r-adjusted"=0.76, P=0.008). Births and pollution were positively associated but births were only dependent on NFRA (r-adjusted=0.91, P<0.001). Our results suggest a relation between dioxin and sperm motility, partially reversible upon reduction of environmental dioxin. Though significantly correlated with sperm morphology, births are primarily associated with demographic factors.

Testicular Isoform of Angiotensin I-Converting Enzyme (ACE, CD143) on the Surface of Human Spermatozoa: Revelation and Quantification Using Monoclonal Antibodies

PROBLEM

The elucidation of the role of angiotensin-converting enzyme (ACE, CD143) in the male fertility has been hampered by the absence of highly specific antibodies to the native testicular isoform (tACE). The quantification of tACE expression on human-ejaculated spermatozoa was performed using a novel panel of monoclonal antibodies (mAbs).

METHOD OF STUDY

The expression of tACE on the surface of live and fixed human spermatozoa was analyzed by flow cytometry and immunocytochemistry using new mAbs to human tACE.

RESULTS

Monoclonal antibodies 1E10 and 4E3 similarly revealed tACE on the surface of live and fixed spermatozoa. The high percentage of tACE-positive spermatozoa (median 81%) was revealed in the swim-up fraction of sperm. Antibody-induced tACE shedding occurs preferentially from live sperm with defective function and/or morphology. Testicular ACE is located on the plasma membrane of the post-acrosomal region, the neck and midpiece of normal spermatozoa, but showed a variable distribution on the defective cells.

CONCLUSIONS

The new mAbs recognizing the C-terminal domain of human ACE are useful tools for quantification of tACE expression on human live and fixed spermatozoa and further adequate analysis of the tACE role in reproduction.

Prognosis for sperm fertilizability: analysis of different variables in men

An overview of various sperm tests is presented. The standard semen analysis obtained by most clinicians evaluating infertility usually consists of sperm concentration, percent motility, quality of motility, and sperm morphology. Unfortunately, unless the motile density is extremely low, the count and motility are not good prognosticators of fertility potential. Values above the norm for normal fertile couples unfortunately cannot reliably predict normal fertility potential. It is important to find sperm tests that are easy to perform, are relatively inexpensive, and provide an accurate prognosis. Strict morphology was hoped to be such a tool with initial optimism that it was far superior to standard morphology. Unfortunately, this test also failed to be the ideal inexpensive prognostic test after further evaluation. One test that is inexpensive and highly correlates with fertilizability is the presence of antisperm antibodies since their presence frequently does not alter count, motility, or morphology. This test should be performed as part of the routine semen analysis. Other tests highly correlate with the achievement of pregnancy and are simple and inexpensive to perform, but, interestingly, do not correlate with fertilizability. These include the hypoosmotic swelling test (HOST) and the sperm stress test. Abnormalities in these tests imply a different abnormality of sperm that leads to conception failure and that is the transfer of a toxic factor from the sperm to oocyte to embryo that prevents the embryo from implanting. Certainly, the simple, inexpensive HOST should be performed routinely. Other tests of sperm function, e.g., sperm penetration assay, sperm zona pellucida binding assay, and acrosome reaction, have their definite place in the evaluation of the infertile male. However, because they are expensive and difficulty to perform they lend themselves to certain specific circumstances but not to routine testing.

The correlates and alleged biochemical background of the resazurin reduction test in semen

Reduction of the blue dye resazurin to pink resorufin is used to estimate the concentration of metabolically active spermatozoa in semen samples. In order to quantify the reduction of resazurin, a spectrophotometric method was developed measuring the change from blue to pink in the butanol extracted colour. The biochemical mechanisms involved in the reduction of resazurin by motile spermatozoa and seminal plasma were investigated. Addition of NADH + H+ to sperm suspension or seminal plasma increased the reduction of resazurin. The reduction reaction was inhibited by high concentrations of dicoumarol, a specific inhibitor of the diaphorase enzyme, in a dose-dependent manner. It is suggested that the sperm diaphorase enzyme transfers electrons from NADH + H+ to resazurin, reducing it to resorufin. The degree of resazurin reduction was strongly correlated with the concentration of motile spermatozoa recovered from the 90% Percoll fraction (r = 0.98, p < 0.001). A positive correlation was also found between the reducing capacity of seminal plasma (n = 62) on the one hand, and sperm concentration (r = 0.72, p < 0.0001), progressive motility (r = 0.45, p < 0.01), normal morphology (r = 0.50, p < 0.01), and gamma-glutamyltransferase (r = 0.36, p < 0.05) on the other hand. These findings, together with our previous observations that the reduction reaction is inhibited by reactive oxygen species and polymorphonuclear white blood cells, increase our understanding of the biochemical basis of the resazurin test and may provide better insight into the interpretation of this test.

Effects of resazurin on bovine oocyte fertilization and embryo development in vitro

Resazurin is a redox dye (7-hydroxy-3H-phenoxazin-3-one-10-oxide) used for assessing potential fertility of spermatozoa and functional status of eukaryotic cells. In this study, the fertilizing capacity of spermatozoa treated with resazurin and effects of resazurin on bovine embryo development in vitro was examined. Abattoir-derived bovine oocytes were collected and subjected to in vitro maturation (IVM), fertilization (IVF) and culture (IVC). In Experiment 1, bovine oocytes (n = 2767) were fertilized with spermatozoa exposed to resazurin (17.6 micrograms/ml) for 0, 15, 30, 60 min, respectively. There was no significant (P > 0.05) difference in cleavage rates. However, the proportion of embryos that developed into blastocysts, expanded and hatched blastocysts in those groups in which oocytes/embryos were treated with resazurin during IVC or IVM/IVF/IVC was significantly (P < 0.05) less than those exposed to resazurin during IVM only, or during IVF only. We conclude that resazurin did not have significant adverse effects on fertilizing capability of bovine spermatozoa; however, extended treatment of embryos with resazurin may be detrimental to embryonic development.

Spermatozoa recovered by IxaPrep gradient have improved longevity and better motion characteristics than those by Percoll gradient

To compare the effectiveness of various sperm preparation methods, we examined sperm concentration, percentage of progressive motility, recovery rate, and various motion characteristics in 32 semen samples after Percoll and IxaPrep preparations. Except for sperm concentration, which was much higher after IxaPrep preparation, no statistical differences existed between these two methods in terms of motile sperm concentration (MSC), recovery rate, mean curvilinear velocity (VCL), mean straight-line velocity (VSL) and mean amplitude of lateral head displacement (ALH). Among 22 samples that were allocated in a 37 degrees C, 5% CO2 incubator, the mean MSC after 3 hours was significantly higher following IxaPrep preparation than following Percoll preparation (63.2 x 10(6)/mL vs. 42.8 x 10(6)/mL, p < .03). VCL and VSL were much higher after IxaPrep preparation than after Percoll preparation, both at 3 hours (p < .01) and at 24 hours (p < .03). ALH was also higher after IxaPrep preparation than after Percoll preparation, and it was statistically significant after 3 hours of incubation (p < .03). We conclude that the IxaPrep gradient may be adopted as the preferred method to the Percoll gradient in preparing spermatozoa for assisted reproduction because of the spermatozoa's persistent and better motion activities after incubation.

Performance of the sperm quality analyser in predicting the outcome of assisted reproduction

The present study was undertaken to assess the relationship between the results of conventional semen analysis and the sperm motility index (SMI) as measured by the sperm quality analyser (SQA), and to evaluate these in relation to the fertilization and/or pregnancy outcome of assisted reproduction. SMI determinations and conventional semen analyses were performed on 223 samples from subfertile men in two laboratories in Leuven (n = 136) and Antwerp (n = 87), and on spermatozoa prepared on a Percoll gradient (n = 136) used for treatment of male factor infertility in 57 cycles of intrauterine insemination (IUI), 44 attempts at in vitro fertilization (IVF) and 31 attempts at intracytoplasmic sperm injection (ICSI). SMI values for native semen correlated significantly with sperm concentration, motility and morphology. Multiple regression analysis revealed sperm concentration after preparation, and the concentration of motile spermatozoa with normal morphology and SMI (before preparation) to be the independent determinants for SMI after preparation. SMI values were significantly higher after, than before, preparation (p < 0.0001). In regular IVF (n = 44) the percentage of fertilized oocytes correlated significantly (p < 0.05) with sperm motility (A + B%, r = 0.33), with the percentage of spermatozoa with normal morphology (r = 0.46) before preparation, with the values of SMI both before and after preparation (r = 0.54, r = 0.48), with sperm concentration (r = 0.34) and with the motile sperm concentration (r = 0.29) after preparation. For the occurrence of pregnancy (all treatment methods), comparison of areas under ROC curves (AURC) indicated motile sperm concentration after preparation, as well as SMI both before and after preparation, to have the highest AURC, with no significant difference between these values as far as predictive power was concerned. These results indicate that the SQA allows for rapid evaluation of sperm characteristics and of the effectiveness of sperm preparation techniques. However, it is not superior to conventional semen analysis in predicting the outcome of assisted reproduction.

The effect of peritoneal fluid from patients with endometriosis on human sperm function in vitro

OBJECTIVE

Our purpose was to evaluate the effect of peritoneal fluid from women with endometriosis on sperm motility and function in an in vitro model.

STUDY DESIGN

Peritoneal fluid was collected at laparoscopy from patients with and without endometriosis. Human donor sperm was diluted with this fluid, and its effect on sperm function and motility was measured was measured with the zona-free hamster egg sperm penetration assay and computer-assisted semen analysis.

RESULTS

The mean number of eggs penetrated by the sperm mixed with peritoneal fluid from patients with endometriosis was significantly fewer than the number penetrated by the sperm mixed with fluid from control patients (22.9 +/- 5.31 vs 44.4 +/- 4.96, p < 0.01, Student t test, n = 20). When evaluated by computer-assisted semen analysis, sperm mixed with peritoneal fluid from patients with endometriosis showed a significant decrease in mean swimming velocity compared with sperm mixed with peritoneal fluid from control patients (54.0 +/- 1.77 vs 59.2 +/- 1.05, p = 0.02, Student t test, n = 20). A significant increase in the fraction of sperm swimming at slower velocities was also found. A trend toward a positive correlation between eggs penetrated and sperm velocity was seen, but statistical significance was not achieved (correlation coefficient 0.4392, p = 0.053, n = 20).

CONCLUSION

These data suggest that substances found in the peritoneal fluid of patients with endometriosis could contribute to infertility through impairment of both sperm function and motion kinematics.

Intrauterine insemination in male subfertility: a comparative study of sperm preparation using a commercial Percoll kit and conventional sperm wash

In order to evaluate the possible benefit of sperm preparation using a commercially available, ready-to-use Percoll gradient kit (PerWash, FertiPro, Belgium) for intrauterine insemination (IUI), a two-centre study was performed comparing this method with conventional sperm preparation by means of centrifugation-resuspension. In the Percoll group, 25 couples out of 52 (48%) achieved pregnancy requiring 136 cycles of insemination, with a per cycle success rate of 18.4%. This result was significantly better (P < 0.01) than the per cycle pregnancy rate of 8.9%, which is 23 pregnancies out of 65 cases treated during 259 cycles of insemination with conventionally prepared semen. Also, the 10th percentile of sperm characteristics among successful cases was lower for sperm concentration, proportion and concentration of grade (a) motile spermatozoa in the Percoll group as compared to couples inseminated with conventionally prepared semen. In contrast, cases with elevated proportion of grade (a) motility (> 22%) were significantly less likely (P < 0.001) to obtain pregnancy with IUI, using either sperm preparation method. It is concluded that sperm preparation for intrauterine insemination using the Percoll gradient kit gives a better success rate and can be applied in cases with more severe sperm deficiency.

Choosing among different technical variations of Percoll centrifugation for sperm selection

We compared the efficiency of different methodological variations of the centrifugation through discontinuous Percoll gradients (PC) to improve semen samples in the laboratory. Five different combinations of the number, volume and density of PC layers were assayed in 14 semen samples presenting various qualities. Each specimen was divided into five aliquots and processed simultaneously. The percentage of spermatozoa showing optimal movement (VAP > 30 microns s-1 and STR > 80%) after PC selection when the number of gradients was reduced to three or two (PC-3: 43.3%, PC-2: 41.3%) and when the volume of layers was diminished to 0.5 ml (mPC-3: 44.2%, and mPC-2: 48.1%), was higher than in classical columns with four gradients of 1 ml (PC-4: 26.3%). The absolute recovery of optimal sperm was better with PC-2, mPC-2 and mPC-3. In samples showing low concentration or motility of spermatozoa, mPC-2 was the most effective technique. PC-2 and mPC-2 showed a tendency to eliminate more red blood cells contaminating the samples. Straight line velocity and straightness were similarly improved by all the methods. We conclude that the technique of PC centrifugation with only two gradients is simpler and more effective for sperm selection and in cases of poor samples can be used with low-volume layers.

Development of an objective, semiautomated method for assessment of sperm motility

Study of sperm motility is associated to the development of precise and economical systems of evaluation. The purpose of this work was to develop an Objective Semi-Automated Method (MOSA) to evaluate the sperm motility. Human semen samples were registered by video-microscopy. The same videofilms were analysed with the MOSA, the subjective method and the automated CellSoft method. The percentages of motile and immotile sperms were equivalent with the three methods. The percentages of rapidly and slowly motile sperms were similar both with the MOSA and the subjective method. The curvilinear and linear velocities as well as the linearity values obtained with the MOSA were different to those obtained with the CellSoft, although such differences would be biologically acceptable. MOSA is an inexpensive, objective and precise method that does not require trained technicians and allows evaluation of several parameters of sperm motility.

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.

The routine assessment of sperm motility at room temperature and 37 degrees C

The World Health Organization (WHO) laboratory manual (1992) states that assessment of sperm motility can be performed at either 37 degrees C or room temperature (20-24 degrees C). The motility of spermatozoa in 44 semen samples (22 fresh samples and 22 frozen-thawed samples) was assessed at both of these temperatures and a significant difference in the motility profiles was noted, specifically an increase at 37 degrees C in the percentage (expressed here as median and ranges) of spermatozoa with excellent progressive motility and an overall increase in the percentage with total progressive motility. With fresh samples the excellent progressive motility increased from 41 (19-53) to 54 (30-66) and the overall motility from 58.5 (39-74) to 65.0 (40-79). With the frozen-thawed samples the excellent motility increased from 14 (1-33) to 25 (6-45) and the overall motility from 30.5 (14-51) to 33.0 (16-52). As the WHO laboratory manual was published 'In response to a growing need for the standardisation of procedures for the examination of human spermatozoa' it is proposed that only one temperature for routine analysis should be used, namely 37 degrees C, which may have more physiological relevance and eliminate effects of fluctuations in ambient laboratory temperature.

Computerized human sperm analysis

The recent introduction of various devices for computer-assisted sperm analysis allows us to have not only objective measurements of the seminal parameters but also to determine some characteristics of sperm motion such as curvilinear and linear velocity and amplitude of lateral head displacement that cannot be obtained by routine analysis. These new seminal parameters seem to be very useful in the diagnosis of male infertility and, among them, ALH seems to play a more important role; in one of our studies we found a significant correlation between this parameter and the results of the bovine cervical mucus penetration test (Penetrak). Furthermore it is possible to determine sperm subpopulations for each parameter and so it will be possible to express a more accurate judgement not only on the fertilizing capacity of semen but also to know the effects on spermatozoa of different activating and capacitating treatments.

Comparison between cell motion analyser, autosperm, and conventional semen analysis

With the aim of explaining some of the controversy on the value of computer-assisted methods of semen analysis, a study was conducted comparing the fully automated cell motion analyzer (CMA), the semi-computerized autosperm system (AS) and the conventional manual method. The CMA equipment gave higher values for sperm concentration than the mean of the three methods. Sperm concentration estimated with the conventional method was below the average of the three methods. The conventional method overestimated sperm motility, which was underestimated by CMA. The correlation between sperm velocity characteristics estimated by CMA and AS was significant, but only 18% of variability of one method could be explained by variability of the other. The reasons for the discrepancy between velocity measurements in the two methods are discussed in relation to possible shortcomings in sperm paths smoothing using the CMA method and the effect of technician training in the AS method. The AS method was found to provide more reproducible results which correlated better with those of the manual method as recommended by the World Health Organization.

Clinical pregnancy rate after the double method wash and intrauterine insemination

The protocol for intrauterine insemination (IUI) involves sperm processing using different methods that have produced varying results. These sperm wash methods do not take into consideration the problems of the exact timing of ovulation and the requirements of sperm cells at different stages of capacitation. The objectives of this study were 1) to use the double method wash previously reported to produce a mixture of different populations of sperm cells and determine the pregnancy outcome after IUI and 2) to compare the sperm kinematic parameters after the double method wash with those after the centrifuge (or whole-population) wash method. Patients were divided into either the double method group (n = 119) or the centrifuge method group (n = 76). The Hamilton-Thorn HTM-C automated sperm motility analyzer (Hamilton-Thorn Research, Danvers, MA) was used to analyze sperm motility parameters. Pregnancy outcomes were evaluated after controlled ovarian stimulation and IUI. An almost 2-fold increase was seen in the pregnancy rate with the double method wash compared with the centrifuge method wash. Sperm motility and velocity were also enhanced in the double method wash groups. The results support the usefulness of the double method wash for the preparation of sperm for IUI.

Sperm motility index: a new parameter for human sperm evaluation

OBJECTIVE

The study was performed to evaluate the correlation between sperm motility index, a novel parameter of semen quality, and routine semen analysis parameters by microscopic evaluation.

DESIGN

Sperm motility index was measured by an electro-optical device, the Sperm Quality Analyzer (United Medical Systems Inc., Santa Ana, CA). Human semen samples covering the whole span of qualities were analyzed prospectively and simultaneously by both methods.

SETTING

Samples were collected from patients referred to university hospital infertility clinics.

PATIENTS, PARTICIPANTS

Nine hundred sixty-eight semen samples of 812 patients and healthy men were analyzed.

MAIN OUTCOME MEASURE(S)

Sperm motility index is a measurement of optical density fluctuations caused by motile cells; therefore, a positive correlation was anticipated between its values and semen motility parameters.

RESULTS

Sperm motility index values demonstrated statistically significant correlation with motile cell concentration, total cell concentration, and percent motile cells. They were also shown to reliably represent semen quality assessment obtained by two experienced andrologists.

CONCLUSIONS

The sperm motility index provides a reliable and objective reflection of semen motility parameters and quality.

Cyclic CMP (cytidine 3',5'-monophosphate) suppresses changes in human sperm amplitude of lateral head displacement and hyperactivation

The dibutyryl analog of cCMP suppressed sperm amplitude of lateral head displacement and hyperactivation. Sperm motility was inhibited by dibutyryl cCMP with a shift toward less linear trajectory sperm movements. The results suggest a role of cCMP as an inhibitory signal on sperm motility patterns related to sperm capacitation.

Value of sperm characteristics and the result of in-vitro fertilization for predicting the outcome of assisted reproduction

The outcome of procedures for assisted reproduction, namely in-vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT) were used as end-points to assess the capacity of particular sperm characteristics to predict the fertilizing potential of semen. In addition, the result of IVF performed with spare oocytes from the GIFT procedure, was used to predict the pregnancy outcome of GIFT. The power of sperm characteristics to predict the outcome of assisted reproduction procedures was poor. With regard to the outcome of IVF, sperm morphology was the best discriminant. The threshold value of 16% normal sperm morphology could be used as a good predictor of successful IVF, but could not be applied as a criterion to reject an IVF trial. For the latter purpose, the limit of 5% sperm with normal morphology should be used. The proportion of sperm with grade A motility in native semen provided the best discrimination between GIFT-fertile and GIFT-infertile cases. A negative result from IVF performed with spare oocytes was 93% accurate in predicting unsuccessful outcome of GIFT. Hence, diagnostic IVF is the most sensitive assay for male fertility. The occurrence of oocyte fertilization during IVF predicts a successful outcome of GIFT in only 50% of cases. Hence, a negative result in IVF indicates that semen is almost certainly infertile, but a positive result does not guarantee the successful outcome of GIFT.

Correlation of computerized semen analysis with successful fertilization of oocytes in an in vitro fertilization program

Sixty-nine couples enrolled in 123 in vitro fertilization-embryo transfer cycles were categorized by percentage fertilization; the results of categorization were compared with those of computerized semen analysis carried out with the CellSoft semen analyzer. Four groups were established: group 1 had 75% fertilization or greater; group 2 had 34% to 74% fertilization; group 3 had 1% to 33% fertilization; and group 4 had 0% fertilization. Statistical differences in certain semen parameters (motility, linearity, and straight-line velocity) were found comparing groups 1 and 3 using the initial ejaculate. A significant number of patients in group 1 had all normal semen parameters, but no statistical difference could be found in group 3 or 4 because of variations in specific abnormal parameters in the groups. When the straight-line velocity-motile density (SLVMD) calculation was used, a significant difference was seen between group 1 and group 3 and between group 1 and group 4 (p less than 0.01); 65% of group 3 and 76% of group 4 had an abnormal SLVMD. SLVMD is a useful calculation to predict fertilization rates in vitro from the initial ejaculate.

Time-related decline in sperm motility patterns in men with cytotoxic antibodies

Sperm motility patterns in semen from 10 fertile nonautoimmune men (fertile control group) and 33 infertile men with various titers of cytotoxic sperm antibodies in their seminal plasma (group 1: titers less than or equal to 16, n = 6; group 2: titers 64 to 512, n = 12; group 3: titers greater than or equal to 1024, n = 15) were evaluated every 2 hours for 12 hours and finally at 24 hours. A significant decline in sperm swimming speed and linearity was observed at 6 hours in semen from 27 infertile men with sperm antibodies. Beginning at 8 hours, semen from sperm antibody-positive men in group 2 showed a significant decline in percentage motile sperm (p less than 0.001) compared to the fertile controls. The percentage motility in semen of donors in groups 1 and 3 was significantly lower than that in semen of fertile donors at 10 hours (p less than 0.05), 12 hours (p less than 0.01), and 24 hours (p less than 0.001). The mean velocity in groups 2 and 3 was significantly less than that in fertile controls at 10 and 12 hours (p less than 0.05). The linearity of sperm motility started to decline 4 hours after semen samples were obtained from sperm antibody-positive groups 2 and 3 in contrast to sperm antibody-negative fertile or infertile groups (p less than 0.05). It is concluded that the presence of cytotoxic sperm antibodies in the seminal plasma adversely affects sperm linearity as early as 4 hours after semen collection.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical significance of crossed in vitro sperm-cervical mucus penetration test in infertility investigation

To evaluate the clinical significance of in vivo and in vitro testing of sperm ability to penetrate cervical mucus (CM), postcoital testing (PCT) and in vitro sperm-cervical mucus penetration testing were compared in a prospective study. Both in vivo and in vitro tests were standardized and performed after an oral course of estrogen therapy. Crossed in vitro sperm-cervical mucus penetration test, evaluated in 277 couples with CM of patients' wives and additionally with CM and semen of fertile donors, revealed that the male factor contributed to a significantly higher extent to deficient sperm-mucus interaction than the cervical factor. The overall pregnancy rate after 6 months was 23% (64/277). Whereas the outcome of PCT did not significantly predict subsequent fertility (PCT good pregnancy rate 24%/PCT poor 20%), significant differences were found for the sperm-cervical mucus penetration test with CM of patients' wives (pregnancy rate, 30.5% versus 8.5%) and for in vitro testing with donors' CM, but not for the mucus penetration test with donors' spermatozoa. Routine sperm analysis did not prove to be of prognostic value for a subsequent pregnancy. The results suggest that the in vitro sperm-cervical mucus penetration test is a good parameter of sperm function and, in particular, when performed as a cross-matching penetrability test, a valuable adjunct to PCT with regard to fertility prognosis.

Determination of adenosine triphosphate in human semen to estimate the fertilizing potential and to quantify sperm antibodies

The measurement of the ATP content of fresh semen is as accurate as the estimation of sperm motility by conventional methods in discriminating between semen of fertile versus subfertile men. The ATP content of frozen thawed donor semen is correlated with the probability of conception per cycle of insemination. Exact quantification of cytotoxic sperm antibodies in serum is possible with the adenosine-triphosphate-release-cytotoxicity test, since measurement is free of the bias of microscopic examination. The procedure has been simplified by testing only one serum dilution and calculating the 'sperm toxicity index'.