The influence of peritoneal fluid from patients with minimal stage or treated endometriosis on sperm motility parameters using computer-assisted semen analysis
Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin. Human Reproduction
(Impact Factor: 4.57).
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.
Available from: Tasuku Harada
- "PF is reported to be associated with infertility in several ways, e.g. inhibiting sperm motion (Drudy et al., 1994; Aeby et al., 1996), sperm acrosome reaction (Arumugam, 1994), mouse embryo growth (Prough et al., 1990), sperm binding to the zona pellucida (Coddington et al., 1992), and ciliary action in the human Fallopian tube (Lyons et al., 2002). Since the PF of infertile women with endometriosis contains abundant cytokines and growth factors, these factors may exert those detrimental effects on the reproductive process and possibly contribute to endometriosis-associated infertility (Harada et al., 2001). "
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ABSTRACT: We previously reported that the level of interleukin (IL)-6 is increased in the peritoneal fluid of women with endometriosis. This study was undertaken to assess the effects of IL-6 and soluble IL-6 receptor (sIL-6R) on in vitro sperm motility.
Sperm (n = 20) were cultured with IL-6 or sIL-6R, or with a combination of both. After 24 h cultures, sperm motility was evaluated using a computer-assisted semen analysis system. Gene and protein expressions of IL-6, IL-6 receptor (IL-6R), and glycoprotein 130 (gp130) were examined in sperm by RT-PCR analysis and western blot analysis.
Addition of IL-6 or sIL-6R individually to the culture media had no affect on sperm motion. However, adding a combination of IL-6 and sIL-6R dose-dependently reduced the percentage of motile and rapidly moving sperm. Adding anti-IL-6R antibody abolished these adverse effects. Sperm expressed the gp130 gene and protein, but not IL-6 or IL-6R.
A combination of IL-6 and sIL-6R may be associated with gp130 expressed in the sperm and reduce sperm motility. IL-6 and sIL-6R may contribute to the pathogenesis of endometriosis-associated infertility.
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ABSTRACT: The effect of peritoneal fluid (PF) from endometriosis patients was studied in spontaneous and stimulus-induced (Ca-ionophore; A23187) acrosome reactions. PF samples were obtained from 21 infertile women with endometriosis and five normal women (controls). Sperm acrosomes were examined by staining with Pisum sativum agglutinin labelled with fluorescein isothiocyanate. The incidence of spontaneous acrosome reaction after 1 and 6 h of incubation (6.7 +/- 1.6 and 6.9 +/- 1.4 respectively) was significantly (P < 0.001) lower when the incubation was performed with PF from endometriosis patients in comparison with spermatozoa incubated in PF from the control group (12.8 +/- 1.1 and 12.8 +/- 0.8). Similarly, the incidence of A23187-induced acrosome reaction after 1 and 6 h of incubation (19.8 +/- 2.7 and 20.0 +/- 2.4) was significantly (P < 0.001) lower when spermatozoa were incubated with PF from endometriosis patients in comparison with spermatozoa incubated with PF from the control group (34.6 +/- 9.8 and 34.4 +/- 1.1). The incidence of A23187-inducible acrosome reaction was also significantly (P < 0.001) lower when the incubation was performed with PF from endometriosis patients (13.1 +/- 2.8 and 13.1 +/- 2.4) when compared with that from the control group (21.8 +/- 2.6 and 21.6 +/- 1.5). No relationship was found between the stage of endometriosis and the incidence of acrosome loss. In conclusion, the PF from endometriosis patients decreased both spontaneous and stimulus-induced acrosome reaction. This may represent a mechanism for the detrimental effect of the PF from endometriosis patients on the spermatozoa-oocyte interaction and partially explain the aetiology of infertility in patients with endometriosis.
Available from: Peter G Wardle
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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.
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