A randomized prospective study comparing pregnancy rates after clomiphene citrate and human menopausal gonadotropin before intrauterine insemination.

OBJECTIVE: To determine whether hMG offers an advantage over clomiphene citrate (CC) in achieving pregnancy after IUI with husband's sperm. DESIGN: Randomized prospective trial. SETTING: Infertility patients in a university teaching hospital. PATIENT(S): Fifty-eight women under 39 years old undergoing ovulation induction before IUI. INTERVENTION(S): The women were assigned randomly to one of two treatment groups. Patients in group I (CCHH) received CC for the first two cycles and hMG for the last two cycles. Patients in group II (HHCC) received hMG for the first two cycles and CC for the last two cycles. MAIN OUTCOME MEASURE(S): Cycle fecundity rates for the two treatment modalities were compared statistically with use of life-table analysis. RESULT(S): Of the 174 cycles studied, overall cycle fecundity rate was 11.11 (9 of 81 cycles) in the CCHH group and 10.75 (10 of 93 cycles) in the HHCC group. The difference was not statistically significant. The cycle fecundity rate was 14.44% (13 of 90 cycles) for cycles with CC and 7.14% (6 of 84) with hMG. The difference was not statistically significant. CONCLUSION(S): These data suggest that CC is an effective alternative to hMG in the population examined.

Enzymes in the seminal plasma from azoospermic men: correlation with the origin of their azoospermia.

Semi-quantitative estimations of the activities of 65 enzymes were studied for cases of azoospermia in an attempt to correlate the seminal enzyme profile with the origin of the azoospermia. One single enzyme--alpha-glucosidase--showed variation. All other specificities tested gave identical results for all the azoospermic samples and for normal controls. The alpha-glucosidase activity that is present in normal semen was absent from samples from patients with azoospermia associated with a complete obstruction of the genital tract, and also from all semen samples from vasectomized subjects. This enzyme appears to be secreted by the epididymis, and the activity present in azoospermic semen can provide information concerning the origin of the azoospermia and the functional state of the epididymis. Positive but reduced alpha-glucosidase activity appears to be frequently associated with inflammatory disease. The consequences of these findings are discussed.

Effect of tenotomy on self-reinnervated and randomly reinnervated soleus muscle of rat.

The time course and degree of atrophic changes caused by tenotomy were compared in normal, self-reinnervated and randomly reinnervated soleus muscle 6 months after transsection and reunion of the nerve at different distances from the muscle. Comparison was made between the behaviour of Type I and Type II fibers, distinguished on the basis of histochemical myofibrillar ATPase and succinic dehydrogenase reactions. Cross-sectional areas of individual muscle fibers were measured using Quantimet 720 image analyser. Selective atrophy of Type I muscle fibers as determined by structural and histochemical changes was observed after tenotomy of normal, self-reinnervated and randomly reinnervated soleus muscles after transsection of the muscular branch of the tibial nerve, Type II muscle fibers in randomly reinnervated muscles were found to be relatively insensitive to tenotomy, as in normal muscle. In randomly reinnervated muscles after transsection and reunion of the sciatic nerve, tenotomy did not cause any visible structural and histochemical abnormalities although a decrease of muscle weight and cross-sectional surface area of fibers was noted. Since in these muscles Type II fibers increased to about 70% of the muscle fiber population, it is suggested that the increased percentage of Type II fibers seemed to prevent the atrophic changes in Type I fibers after tenotomy.

Alpha-glucosidase as a specific epididymal enzyme marker. Its validity for the etiologic diagnosis of azoospermia.

Azoospermic semen was obtained from 39 vasectomized men and 93 patients consulting for infertility. The latter underwent bioclinical investigations including measurement of plasma FSH and testicular biopsies. Carnitine content and alpha-glucosidase activity in semen samples were measured. The activity of alpha-glucosidase was determined systematically by a semiquantitative microtechnique and was verified by a spectrophotometric assay. A positive correlation was observed between carnitine and alpha-glucosidase activity. Both parameters were severely diminished in semen from the vasectomized men and the patients suffering from a complete obstruction of the genital tract. Enzyme activity was the most discriminant parameter in terms of sensitivity and specificity. The measurement of alpha-glucosidase in semen is a simple and sensitive method for determining the origin of azoospermia when used in conjunction with assays for plasma FSH.

Cyclodextrin enhances spermicidal effects of magainin-2-amide.

Magainins are antimicrobial peptides with known spermicidal activity. Their activity is inhibited by cholesterol present in eukaryotic cell membranes. Pretreatment of spermatozoa with methyl-beta-cyclodextrin, which extracts cholesterol from cell membranes and induces capacitation, sensitizes them to magainin-2-amide as shown by a decrease in human sperm motility determined by computer-assisted sperm analysis and a concomitant decrease in sperm viability, as measured by MitoTracker(R) Red CMXRos labeling. Magainin-2-amide affects mainly the fast progressive spermatozoa inducing them directly into an immotile state, without an increase in motile non-progressive and slow progressive spermatozoa. We conclude that methyl-beta-cyclodextrin highly potentiates the deleterious effect of magainin-2-amide on human spermatozoa. Most probably, this effect can be explained by cholesterol extraction from sperm cell membranes.

Computer classification of cells from hamster vaginal smears based on morphometric measurements of Feulgen stained cell nuclei.

Feulgen-stained cell nuclei from a hamster vaginal smear were subjected to measurements by an image analyzing computer, Quantimet 720. Twenty features were measured for each nuclear image. The data were then processed by computer using the TAXI classification procedure. This resulted in the partition of the sample of nuclear images into five classes.

DNA content of cells in human buccal smears. A preliminary study.

The DNA content of the cells from human buccal smears, stained by the Feulgen method, was estimated by absorbtion microdensitometry using a Quantimet 720 D image analyser. It was concluded from measurements that most of the cells in buccal smears contained 2C DNA; however, among the cells from male donors a substantial proportion of cells (about 17%) contained less than 2C DNA. This difference between population of male cells versus female cells was statistically significant. The mean value of DNA content was estimated to be 7.7% lower for male cells than for female cells. The conclusions are preliminary because relatively small samples of cells have been measured.

[Relationships between seminal enzymes and fertility (author's transl)]. / Enzymes du sperme et fécondité.

Various enzyme activities can be detected in human seminal plasma; these are mainly hydrolases which traduct high proteolytic activities. Acid phosphatase constitutes the best prostatic marker, while alpha glucosidase characterizes well epididymal function. The enzymatic equipment of spermatozoa -excepted for acrosin- is very similar to that of seminal plasma, which suggests that most of sperm enzymes are incorporated from male genital secretions. Tight relationships exist between the enzymatic equipment of spermatozoa and their fertilizing capacity: motility is depending of enzymes contained in sperm mid piece and flagellum; acrosomal enzymes are necessary for penetration of oocytes. However we could only very rarely explain some case of male sterility by defect of semen enzymes.

[Disturbances in ovulation following on artificial insemination with donors (A.I.D.) (author's transl)]. / Perturbations de l'ovulation consécutives à l'insémination artificielle avec donneurs (I.A.D.).

The authors report on the results of statistical analysis of temperature curves in 139 patients before artificial insemination from donors (A.I.D.) and in the cycles in which they were inseminated. It appears that frequently the practice of A.I.D. causes ovulation to come early or late. Late ovulation seems to be the most frequent cause of failures which are then considered to be due to "psychogenic sterility".

[The value of the level of alpha-1,4-glucosidase and seminal l-carnitine in patients with oligoasthenospermia]. / Intérêt du dosage de l'alpha-1,4-glucosidase et de la L-carnitine séminales chez des sujets oligoasthénospermiques.

Samples of sperm have been obtained from 95 who consulted us for infertility. In each case seminal plasma was examined for levels of alpha-1,4-glucosidase and L-carnitine. Our results have led us to fix the threshold value of 42.6 mlU per ejaculate for alpha-1,4-glucosidase and 960 nanomoles of L-carnitine below those levels that we thought occur where the origin of the oligospermia is obstructive (series 1 patients). In series 2 patients the cause of the oligospermia purely being secretory, there is normal epididymal function and therefore the excretory doubts are proven. It is not impossible to have both pathologies because we have found this in men of the intermediate groups C and D. We have found that there is a correlation between the presence of epididymal pathology and a drop in epididymal markers which can be found in severe oligospermia (which can be epididymal in origin and not testicular). Also when there is non abnormalities in the spermogram. This last situation can occur in "invisible" abnormalities of spermaturation in the epidymus.

[Psychological approach of the infertile male]. / Approche psychologique de l'homme infécond et stérile.

Male infertility is usually anxiogenic, and it is often responsible for sexual dysfunctions due to the cultural indissociability of the virility and fertility concepts on the one hand, and to the timing of sexual intercourse in the ovulation period on the other hand. The intrusion of medicine in the life of the infertile couple frequently amplifies the existing psychological problems and discloses other problems by questioning the representation systems of identity, procreation and filiation.

[Pharmacological effects of veralipride on the mammary gland of female rats: a complementary study (author's transl)]. / Etude pharmacologique complémentaire des effets du véralipride sur la glande mammaire de la ratte castrée.

Administration of 2 mg/kg/day of veralipride to intact female rats for 3 weeks provokes mammary gland development and, in some animals, the onset of secretory activity. These modifications do not appear after veralipride administration, under the same conditions, to castrated female rats. In castrated female rats previously conditioned by estradiol benzoate administration, some development of several acinous islets is observed in about half of the animals treated or not with veralipride. This suggests the development of a sensitivity of the mammary gland to the action of pituitary hormones, the secretion of which is stimulated by either castration or veralipride. It would seem that the absence of corpora lutea secretions prevented as great a mammary gland development as that observed in intact animals treated with veralipride.

Psychological reactions of couples to artificial insemination with donor sperm.

The case histories of 62 couples successfully treated by AID were established through nondirective interviews, and were surprisingly similar in all cases. Several distinct stages were regularly observed: the awareness of wanting a child while the woman cannot become pregnant; the investigation of the couple's sterility with as a result, the announcement that the husband is sterile; a period in which the couple adapt to this situation; the disappearance of the feeling of guilt both of the husband, wounded in his "virility," and of the wife, ashamed of her desire for a child; acceptance of the idea of AID; request for AID; conflict with the medical profession; the disturbing seances of AID, usually in the presence of the husband; uneasiness at the beginning of pregnancy; euphoric continuation of pregnancy; uncomplicated delivery of a child whose father is very involved in its upbringing, and then request for a second child by AID.

Effects of ions and K+:Na+ ratio on motility and oxygen consumption of human spermatozoa.

Variations in the osmolarity of the medium altered motility, velocity, and oxygen consumption of human spermatozoa. Variations in the K+:Na+ ratio also altered their motility and velocity. These alterations, which reflect both the composition of the medium and individual characteristics of the donor, are discussed in relation to the diversity of milieu through which the sperm are transported.

[The effect of osmotic pressure on the mobility and metabolism of human spermatozoa]. / Effets de la pression osmotique sur la mobilité et le métabolisme des spermatozoïdes humains.

When human sperm was suspended in a hypertonic medium, their motility is damaged and their oxygen consumption is reduced. Hypotonic conditions are more disastrous because the cells become immotile. These results are discussed with reference to high osmolarity of seminal fluid.

[Effect of exogenous ADP and ATP on the motility and respiratory activity of human spermatozoa]. / Influence de la fourniture exogène d'ADP et d'ATP sur la motilité et l'activité respiratoire des spermatozoïdes humains.

The respiratory activity of human sperms suspended in a salved solution, is varying when ADP or ATP are added to the medium. Those results seem to indicate that the apparent lack of regulation of the energetic metabolism, which is observed in this cell, could be partially due to low endogenous concentrations of nucleotide-phosphates. The enrichment of the medium with ATP does not lead to any effect on sperm motility and this negative result is discussed.