Infertility, male Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(5):241-247
DOI 10.1590/S0100-72032008000500006
PURPOSE: to evaluate the meiotic spindle and the chromosome distribution of in vitro matured oocytes obtained from stimulated cycles of infertile women with polycystic ovary syndrome (PCOS) and with male factor and/or tubal infertility (Control Group) and compare in vitro maturation (IVM) rates between the groups analyzed. METHODS: five infertile patients with PCOS and eight controls, submitted to stimulated cycles for intracytoplasmic sperm injection, were selected prospectively and consecutively, and respectively assigned to the study group and the Control Group. Immature oocytes (21 and 29, respectively, from PCOS and Control Group) were submitted to IVM. After IVM, oocytes with first polar body extruded were fixed and submitted to immunostaining and fluorescence microscopy for morphological evaluation of the spindle and of chromosome distribution. Statistical analysis was performed by the Fisher test with significance, when p<0.05. RESULTS: IVM rates were similar between groups (47.6 e 44.8%, respectively, for PCOS and Control Group). Six of the ten oocytes (60%) from the study group and four of the 12 oocytes (33.3%) from the Control Group presented meiotic anomalies of the spindle and/or anomalous chromosome distribution, without statistical difference between groups. CONCLUSIONS: data from the present study did not demonstrate significant difference neither in IVM rates nor in the proportions of meiotic anomalies between in vitro matured oocytes obtained from stimulated cycles from PCOS patients and control ones.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(5):241-247
DOI 10.1590/S0100-72032008000500006
PURPOSE: to evaluate the meiotic spindle and the chromosome distribution of in vitro matured oocytes obtained from stimulated cycles of infertile women with polycystic ovary syndrome (PCOS) and with male factor and/or tubal infertility (Control Group) and compare in vitro maturation (IVM) rates between the groups analyzed. METHODS: five infertile patients with PCOS and eight controls, submitted to stimulated cycles for intracytoplasmic sperm injection, were selected prospectively and consecutively, and respectively assigned to the study group and the Control Group. Immature oocytes (21 and 29, respectively, from PCOS and Control Group) were submitted to IVM. After IVM, oocytes with first polar body extruded were fixed and submitted to immunostaining and fluorescence microscopy for morphological evaluation of the spindle and of chromosome distribution. Statistical analysis was performed by the Fisher test with significance, when p<0.05. RESULTS: IVM rates were similar between groups (47.6 e 44.8%, respectively, for PCOS and Control Group). Six of the ten oocytes (60%) from the study group and four of the 12 oocytes (33.3%) from the Control Group presented meiotic anomalies of the spindle and/or anomalous chromosome distribution, without statistical difference between groups. CONCLUSIONS: data from the present study did not demonstrate significant difference neither in IVM rates nor in the proportions of meiotic anomalies between in vitro matured oocytes obtained from stimulated cycles from PCOS patients and control ones.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):103-112
DOI 10.1590/S0100-72032007000200008
Male infertility affects 10% of couples in the reproductive age worldwide and is treatable in many cases. In addition to other well-described etiologies, genetic causes of male infertility are now more commonly diagnosed. In men with prior vasectomy or varicocele, microsurgical reconstruction of the reproductive tract or varicocelectomy is more cost-effective than sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection if no female fertility risk factors are present. If epididymal obstruction after vasectomy is detected or advanced female age is present, the decision to use either microsurgical reconstruction or sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection should be individualized. Sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection is preferred to surgical treatment when female factors requiring in vitro fertilization are present or when the chance for success with sperm retrieval and intracytoplasmic sperm injection exceeds the chance for success with surgical treatment.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):103-112
DOI 10.1590/S0100-72032007000200008
Male infertility affects 10% of couples in the reproductive age worldwide and is treatable in many cases. In addition to other well-described etiologies, genetic causes of male infertility are now more commonly diagnosed. In men with prior vasectomy or varicocele, microsurgical reconstruction of the reproductive tract or varicocelectomy is more cost-effective than sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection if no female fertility risk factors are present. If epididymal obstruction after vasectomy is detected or advanced female age is present, the decision to use either microsurgical reconstruction or sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection should be individualized. Sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection is preferred to surgical treatment when female factors requiring in vitro fertilization are present or when the chance for success with sperm retrieval and intracytoplasmic sperm injection exceeds the chance for success with surgical treatment.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(11):652-657
DOI 10.1590/S0100-72032006001100004
PURPOSE: to determine if the previous fertility history can predict current fertility status of a patient examined for couple’s infertility. METHODS: retrospective study involving semen analyses from 183 consecutive subfertile patients evaluated from September 2002 to March 2004. We excluded those patients who had undergone radio or chemotherapy, orchiectomy or vasectomy. Mean values of all analyses were used for patients with multiple semen analysis. Patients with more than 20x10(6) sperm/mL, motility higher than 50% and with normal strict sperm morphology higher than 14% were considered normal. Patients were divided into two groups, according to the fertility status: primary infertility (118 patients) and secondary infertility (65 patients). Data were analyzed according to the chi2 test and the Student t-test. RESULTS: no differences were detected in the mean age between patients with primary infertility, 37.3±6.3, and secondary infertility, 38.1±5.9; p=0.08. In the group of patients with primary infertility, 51.9% (61 patients) had a normal sperm concentration, 70.3% (83 patients) had normal sperm motility and 26.3% (31 patients) had normal sperm morphology. In the group of patients with secondary infertility, 53.8% (35 patients) had normal sperm concentration, 75.4% (49 patients) had normal sperm motility and 32.3% (21 patients) had normal sperm morphology. No significant differences were detected in sperm concentration (21.3x10(6)/mL versus 23.1x10(6)/mL; p=0.07), motility (45.2 versus 48.1%; p=0.08) and morphology (6.1 versus 6.4%; p=0.09) between groups of patients with primary and secondary infertility. CONCLUSIONS: semen analysis should be requested even in cases of prior male fertility. Physicians should not presume a patient to have a normal semen analysis based on his previous history of initiating a pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(11):652-657
DOI 10.1590/S0100-72032006001100004
PURPOSE: to determine if the previous fertility history can predict current fertility status of a patient examined for couple’s infertility. METHODS: retrospective study involving semen analyses from 183 consecutive subfertile patients evaluated from September 2002 to March 2004. We excluded those patients who had undergone radio or chemotherapy, orchiectomy or vasectomy. Mean values of all analyses were used for patients with multiple semen analysis. Patients with more than 20x10(6) sperm/mL, motility higher than 50% and with normal strict sperm morphology higher than 14% were considered normal. Patients were divided into two groups, according to the fertility status: primary infertility (118 patients) and secondary infertility (65 patients). Data were analyzed according to the chi2 test and the Student t-test. RESULTS: no differences were detected in the mean age between patients with primary infertility, 37.3±6.3, and secondary infertility, 38.1±5.9; p=0.08. In the group of patients with primary infertility, 51.9% (61 patients) had a normal sperm concentration, 70.3% (83 patients) had normal sperm motility and 26.3% (31 patients) had normal sperm morphology. In the group of patients with secondary infertility, 53.8% (35 patients) had normal sperm concentration, 75.4% (49 patients) had normal sperm motility and 32.3% (21 patients) had normal sperm morphology. No significant differences were detected in sperm concentration (21.3x10(6)/mL versus 23.1x10(6)/mL; p=0.07), motility (45.2 versus 48.1%; p=0.08) and morphology (6.1 versus 6.4%; p=0.09) between groups of patients with primary and secondary infertility. CONCLUSIONS: semen analysis should be requested even in cases of prior male fertility. Physicians should not presume a patient to have a normal semen analysis based on his previous history of initiating a pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(1):44-49
DOI 10.1590/S0100-72032006000100008
PURPOSE: to evaluate the influence of abstinence period on seminal characteristics in infertile men and to establish a better seminal quality after pooling the samples. METHODS: a retrospective study was performed on 88 oligozoospermic (n=25), asthenozoospermic (n=43), and oligoasthenozoospermic (n=20) men whose partners underwent intrauterine insemination between September 2002 and December 2004. We excluded men with a normal semen analysis or women with abnormalities suggestive of infertility. Each man produced two semen samples in a short period of time (30 min to 1 h). We evaluated semen volume, total motile sperm count and percentage sperm motility. Comparisons were made between the first and second semen samples. After pooling the samples, we compared the total motile sperm count between the first sample and the pooled samples. Statistical evaluation was performed by Student's t test and the chi2 test. RESULTS: in oligozoospermic men, there were no differences in the semen characteristics between the first and the second seminal samples (p>0.05). The total motile sperm count increased significantly in the second sample in comparison to the first sample in asthenozoospermic (42.4±6.8 vs 51.5±7.2x10(6) sperm/mL) and oligoasthenozoospermic men (11.1±7.4 vs 14.35±7.2x10(6) sperm/mL (p<0.05). The pool of two ejaculates increased the total motile sperm count in comparison to the first sample (p<0.05) in oligozoospermic, asthenozoospermic and oligoasthenozoospermic men by 110.5, 110.3 and 136.03%, respectively. CONCLUSIONS: a short period of abstinence is associated with higher sperm motility in infertile men. The pool of two semen samples is a way to increase the total motile sperm count in this group of patients whose wives want to undergo an intrauterine insemination instead of in vitro fertilization.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(1):44-49
DOI 10.1590/S0100-72032006000100008
PURPOSE: to evaluate the influence of abstinence period on seminal characteristics in infertile men and to establish a better seminal quality after pooling the samples. METHODS: a retrospective study was performed on 88 oligozoospermic (n=25), asthenozoospermic (n=43), and oligoasthenozoospermic (n=20) men whose partners underwent intrauterine insemination between September 2002 and December 2004. We excluded men with a normal semen analysis or women with abnormalities suggestive of infertility. Each man produced two semen samples in a short period of time (30 min to 1 h). We evaluated semen volume, total motile sperm count and percentage sperm motility. Comparisons were made between the first and second semen samples. After pooling the samples, we compared the total motile sperm count between the first sample and the pooled samples. Statistical evaluation was performed by Student's t test and the chi2 test. RESULTS: in oligozoospermic men, there were no differences in the semen characteristics between the first and the second seminal samples (p>0.05). The total motile sperm count increased significantly in the second sample in comparison to the first sample in asthenozoospermic (42.4±6.8 vs 51.5±7.2x10(6) sperm/mL) and oligoasthenozoospermic men (11.1±7.4 vs 14.35±7.2x10(6) sperm/mL (p<0.05). The pool of two ejaculates increased the total motile sperm count in comparison to the first sample (p<0.05) in oligozoospermic, asthenozoospermic and oligoasthenozoospermic men by 110.5, 110.3 and 136.03%, respectively. CONCLUSIONS: a short period of abstinence is associated with higher sperm motility in infertile men. The pool of two semen samples is a way to increase the total motile sperm count in this group of patients whose wives want to undergo an intrauterine insemination instead of in vitro fertilization.