[Intra-uterine inseminations with hyperstimulation in male infertility]. / Inséminations intra-utérines avec hyperstimulation dans les indications masculines.

Our aim is to evaluate the efficacity of intrauterine insemination in male infertility after controlled ovarian hyperstimulation. 96 cycles were carried out. 16 pregnancies were achieved, the pregnancy rate per cycle is 16.7% (43.3% per couple) and 12.5% ongoing pregnancies. Six cycles were proposed and the higher cumulative probability of pregnancy is obtained at the 4th cycle. The best pregnancy rate per cycle is obtained with 5.10(6) to 10.10(6) inseminated. The success rate is not associated with the number of sperm abnormalities in our study.

[Evolution of the practice of sperm cryopreservation and fate of the preserved specimens : retrospective study of testicular cancer]. / Evolution de la pratique d'autoconservation de sperme et devenir des paillettes mises en garde: étude rétrospective à propos du cancer du testicule. Fédération Française des CECOS.

Testis cancer, chemotherapy and radiation can induce temporary or permanent infertility in men. Cryopreservation of spermatozoa seems an absolute prerequisite in such situation for male patients who are old enough to procreate. We propose a national retrospective study carried out in 17 CECOS. This survey demonstrates a regular increase for semen preservation in testis cancer and analyses the modalities of gametes preservation and their possible use. In view of this activity, we propose a discussion of the attitude of the various CECOS and of particular cases involving ethical issues.

[Value of a meiotic study of male sterility]. / Intérêt d'une étude méiotique dans les stérilités masculines.

Both in men where the somatic karyotype is abnormal as well as in cases where it is normal, it is worth while studying meiosis in the male. The picture of meiosis has been studied in the main from testicular biopsies and also partly from spermatic line cells found in sperm. Studying the haploid portion of the male pronucleus using the hamster test reflects the process of meiosis. In this way it has been possible to individualise different pathological entities such as asynapsis or desynapsis, alterations in synaptic complexes, the presence of several nucleoli or micronucleoli in the pachytene stage, hyper or hypo polidies, the presence of univalents and the breakdown of bivalents, oligochiasmatasis, chain or ring pictures or early desynapsis of the sexual vesicle in the diacinesis and in the first metaphase stage. Aneuploidies have been found in the second metaphase stage or when carrying out chromosome analysis on the male pronucleus. The abnormalities in the number of chromosomes which are found with the formula 47,XXY, may be due to faults in spermatogenesis, but in the case of the double Y in 47,XYY the extra Y will rarely be found during meiotic divisions. The Robertsonian translocations causing abnormalities in structure are due to the formation of trivalents whereas reciprocal translocations give rise to the idea of quadrivalent pictures mainly associated with faults in spermatogenesis. Finally, autosomal chromosome translocations seem to have more severe meiotic repercussions, particularly in cases where the inactive autosomal X chromosome is involved. Even where a somatic karyotype is normal in a fertile subject that does not mean that there is no meiotic abnormality present, because 8-10% of the cells that were studied showed such an abnormality.

[Antispermatozoa autoantibodies in male sterility. Value of the detection of surface immunoglobulins G by the MAR test]. / Autoanticorps antispermatozoïdes dans les stérilités masculines. Intérêt du dépistage des immunoglobulines G de surface par le MAR test.

The mixed antiglobulin reaction (MAR) test for immunoglobulins G was performed on 574 spermograms, resulting in the detection of surface auto-antibodies directed against spermatozoa in 4.18% of the cases. Concomitant investigations of spermograms for spontaneous agglutination and cross-penetration in a control cervical mucus, together with assays of antispermatozoa antibodies in serum and seminal fluid, have led to the diagnosis of asthenospermia in 87.5% of the cases. Spontaneous sperm agglutination was present in all cases; the cross-penetration test was negative or doubtful in 92.3%. Auto-antibodies against spermatozoa were found in 76.2% of serum and/or seminal fluid samples.