The influence of peritoneal fluid from patients with minimal stage or treated endometriosis on sperm motility parameters using computer-assisted semen analysis.
ABSTRACT The aim of this study was to determine the influence of peritoneal fluid from patients with minimal stage or treated endometriosis on sperm motility parameters. Peritoneal fluid aspirated at diagnostic laparoscopy for unexplained infertility from women during the luteal phase of the menstrual cycle (days 20-23) was incubated for 5 h with fresh semen samples obtained from men of recently proven fertility. Spermatozoa were prepared by a swim-up technique from unprocessed semen. Using computer-assisted semen analysis (Hamilton-Thorn Research, MA, USA), sperm motility and motion parameters were observed at 0, 120, 180 and 300 min. Compared with spermatozoa incubated in Earle's balanced salt solution/human serum albumin, the percentage motility, percentage progressive motility and progressive velocity of spermatozoa incubated in peritoneal fluid from patients without visible endometriosis were significantly higher (P < 0.05). Maximal effect was observed at 3 h and maintained until 5 h. We conclude that in an in-vitro study, in contrast to peritoneal fluid from patients with minimal stage endometriosis, peritoneal fluid from patients with unexplained infertility and no visible endometriosis can improve sperm motility when compared with culture medium.
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ABSTRACT: Evidence of pituitary-ovarian dysfunction in unexplained and endometriosis-associated infertility has been reported previously. Hormone-suppressive therapy is often used in an attempt to improve fertility, although benefits have not been proven. Our study examines the effect of progestogen (medroxyprogesterone acetate) treatment on women with endometriosis-associated and unexplained infertility, compared with women with tubal damage as functional controls. Pre-ovulatory follicular size and serum and follicular fluid hormone concentrations were measured, and oocyte collection and in-vitro fertilization were attempted, in natural cycles totally unperturbed by exogenous gonadotrophins, for two cycles before and two cycles following treatment with medroxyprogesterone acetate for 2 months. In the endometriosis and unexplained infertility groups, compared with the tubal group, the treatment led to significant reductions in the integrated luteinizing hormone (LH) values (483 versus 664, 559 versus 762 and 864 versus 820 notional IU/l respectively). There were no changes in serum oestradiol or follicular fluid oestradiol, progesterone, follicle stimulating hormone or LH concentrations after treatment. The results suggest that progestogen therapy has no beneficial effect on the pituitary-ovarian dysfunction which contributes to endometriosis-associated and unexplained infertility.Human Reproduction 04/1996; 11(3):647-50. · 4.67 Impact Factor
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ABSTRACT: To clarify the effect of peritoneal fluids (PF) of women with various stages of endometriosis on sperm motility, we utilized computer-aides sperm analysis (CASA) to analyze sperm movement characteristics. PF was collected in the early follicular phase (days 4-8) of the menstrual cycle from 48 women undergoing diagnostic laparoscopy. Only sperm samples having normal sperm parameters were chosen for study. Swim-up separation was performed for 1 h at 37 degrees C. Sperm suspension was mixed at a ratio of 1:1 with each of the following four groups: group 1, human tubal fluid (HTF) with 10% fetal bovine serum (control), group 2, normal PF (n = 16); group 3, minimal or mild endometriosis PF (n = 16); and group 4, moderate or severe endometriosis PF (n = 16). The mixtures were analyzed at 0, 1, 3, 6, and 24 h of co-incubation using the CASA system. At the end of the 24 h incubation, Supravital staining of sperm was done to check the viability of sperm in each group. Only time (F = 126.6, p < .001) has a significant effect on sperm motion parameters. At 6 h, sperm velocity (mean curvilinear velocity and mean straight line velocity) of the PF groups was significantly greater than that of the control, but there was no significant difference between each PF group. At 24 h, the PF groups maintained 50% of initial sperm viability, compared with 13% of initial viability in the control group (p < .001). There was no adverse effect of PF in patients with endometriosis on sperm motion parameters.Archives of Andrology 01/1997; 38(1):49-55. · 0.89 Impact Factor
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ABSTRACT: To compare intrauterine insemination (IUI), direct intraperitoneal insemination (DIPI), and timed-intercourse (TI), each combined with superovulation, in the treatment of couples with unexplained infertility, including couples with minimal endometriosis. A retrospective analysis of 233 superovulation cycles in 70 couples with unexplained infertility or minimal endometriosis. Stimulation protocol, pregnancy rate, pregnancy outcome, and complications of treatment were analyzed. The pregnancy rare was 8.6% per cycle and 28.5% per couple. A majority of all treatment pregnancies (85%) occurred during the first four cycles of treatment. The duration of infertility did not influence the pregnancy rate. The pregnancy rate in patients with unexplained infertility was higher, but not significantly, than in patients with minimal endometriosis (27.7% versus 18.4%). No predictive marker for successful stimulation was found, except for the higher luteal progesterone level in cycles resulting in pregnancy. The multiple pregnancy rate was high: 30% of all pregnancies and 40% of all deliveries were multiple. Superovulation in combination with insemination or intercourse is effective and is still recommended in the treatment of couples with unexplained infertility.Acta Obstetricia Et Gynecologica Scandinavica 08/1997; 76(6):550-4. · 1.85 Impact Factor