Transvaginal ultrasonographic quantitative assessment of accumulated cul-de-sac fluid.

Preoperative quantitative assessment of pelvic fluid is an important diagnostic tool in clinical decision making. In this study, we used high-frequency transvaginal ultrasonography in 10 healthy women to assess both the correlation between various amounts of fluid installed in the cul-de-sac and ultrasonic imaging and to determine whether correct estimation of fluid volume can be reached. No fluid could be ultrasonically detected when the volume was less than 35 to 40 ml. Between 35 and 100 ml there was a clear image of accumulated fluid in the cul-de-sac with good correlation between volume and image, whereas with larger amounts no clear correlation between the amount of fluid introduced and size of fluid area visualized by ultrasonography was possible. Transvaginal ultrasonography may enable quantitative evaluation of certain volumes of pelvic fluid, although amounts less than 35 ml cannot be visualized.

The influence of human follicular fluid on the acrosome reaction, fertilizing capacity and proteinase activity of human spermatozoa.

The present study was designed to assess physiological and enzymatic changes in human spermatozoa following incubation in human follicular fluid (HFF). Initially, it was determined that infertility patients (n = 29) scored dramatically higher on the hamster egg penetration test (HEPT) when spermatozoa were incubated with HFF (22.9 +/- 4.4%) rather than the standard swim-up alone (4.6 +/- 1.1%). To further evaluate this effect, in experiment I, spermatozoa were obtained from proven fertile individuals and evaluated following exposure to three different HFF samples as well as control treatments (medium, cul de sac fluid and heparin). There were no significant differences in HEPT scores following sperm incubation in the three different follicular fluids although incubation in all the fluids significantly (P less than 0.01) enhanced sperm penetration (%PEN) when compared to the standard swim-up and other control treatments. The absence of an effect of cul de sac fluid on spermatozoa indicates that not all body fluids contain factors which stimulate sperm fertilizing capacity. The effect of HFF was demonstrated in a infertile patient population as well as in donors of proven fertility. In experiment II, the effect of HFF on the acrosome reaction (%AR), sperm fertilizing capacity and changes in sperm proteolytic enzymes were determined. There was no significant difference in the %AR between freshly ejaculated (7.9 +/- 3.1) and medium incubated (9.4 +/- 1.6) spermatozoa; however, in both of these treatments the %AR was less (P less than 0.01) than for spermatozoa treated with HFF (45.6 +/- 4.7). The %PEN following incubation of spermatozoa in HFF (52.2 +/- 6.8) was greatly increased (P +/- 0.01) compared to the standard swim-up (19 +/- 3.9).