[Prostatitis and fertility: the biologist's point of view]. / Prostatite, fertilité : le point de vue du biologiste.

There are two leukocytospermia: the leukocytospermia below 10(6) cells/ml comes from the epididymis. It is physiological, improves sperm quality and ART outcomes and therefore must be respected. Leukocytospermia above 10(6) cells/ml are of prostatic origin and reflect a chronic prostatitis. The results of IVF and ICSI with these sperm are always surprisingly improved when compared to those obtained using semen without leukocytes at all. But this improvement is offset by a dramatic increase in the miscarriage rate. Should we treat this leukocytospermia or its cause? A clinical trial is conducted in Cochin hospital with the PHRC Sigma (Male Genital Track Inflammatory Syndrome) that will help us answer this question. It seems, a priori, that it is better to treat the cause and to respect the leukospermia.

[ART with sperm donor after intraconjugal ICSI failure]. / Prise en charge en don de sperme après échec(s) d'ICSI intraconjugale.

OBJECTIVES: To evaluate the ART results with sperm donation for couples who do not succeed after IC ICSI treatment for male infertility. PATIENTS AND METHODS: Retrospective study of 71 couples (November 1994-February 2009). Two control populations were determined to analyse this two-steps treatment (IC and sperm donation) based on different criteria such as the date of ICSI, the female age at the time of the first attempt and the male indication. RESULTS: In IC-ICSI, the proportion of azoospermic subjects and/or carrying chromosomal abnormalities was significantly higher in the studied population as compared to control. The fertilization rate (FR) and the embryo quality were significantly lower in the studied population. After donation, 30 couples (42.2%) succeeded in being parents. The donor IA pregnancy rates were similar to those of the control population except for the azoospermic patients with poor results. When IVF/ICSI-D was performed, the pregnancy rates were lower than in the control population. DISCUSSION AND CONCLUSION: Sperm donation constitutes an option for half of the couples initially treated with IC-ICSI for male infertility. For couples who failed in sperm donation, a female implication cannot be excluded, even though not detected.

Semen alterations in HIV-1 infected men.

BACKGROUND: Couples in whom the man is infected by human immunodeficiency virus (HIV) increasingly request assisted reproductive technology (ART) to allow safe procreation. Semen quality is critical in such situations. METHODS: Semen characteristics were evaluated in 189 HIV-infected men requesting ART. At the time of semen analysis all men were healthy and 177 were receiving anti-retroviral therapy. Comparisons were made with HIV-seronegative men, partners of women requiring IVF because of tubal infertility, after matching for age and sexual abstinence delay. RESULTS: The most significant semen alterations found in the HIV-infected men were reduced percentages of rapidly progressive sperm [median (range), 10% (0-30%) compared with 15% (5-30%) in the controls, P < 0.001], and increased concentrations of non-spermatic cells [3 x 10(6)/ml (0.2-16 x 10(6)/ml) compared with 1.1 x 10(6)/ml (0.1-14 x 10(6)/ml) in the controls, P < 0.001]. HIV-infected men also showed lower ejaculate volumes [2.8 ml (0.6-9.3 ml) compared with 3.6 ml (1.1-11 ml), P < 0.05] and total sperm counts [262.5 x 10(6) (0-1003 x 10(6)) compared with 310.5 x 10(6) (48.3-1679 x 10(6)), P < 0.05]. CONCLUSIONS: Semen evaluation in a large population of HIV-infected men requesting ART evidenced several alterations. Some of these anomalies might be related to anti-retroviral treatments.