Possible role of male factors in recurrent pregnancy loss.

Objective : To evaluate various causes possibly contributing towards recurrent pregnancy loss (RPL), particularly male factors. Prospective study of 75 couples with history of RPL who were investigated for genetic, anatomic, immunological, infective and systemic causes in both partners. Functional sperm capacity was assessed by the Hypo-osmotic swelling test (HOS), Acrosomal Reaction (AR), Nuclear condensationdecondensation test (NCD) and Seminal Total Leukocyte Count (TLC) along with semen analysis. Twenty male volunteers with recently proven fertility were also included for detailed sperm morphology and sperm functions test as controls. Amongst male partners 3(4%) had varicocele, 23(30.6%) had infection, 1(1.3%) immunological and 1(1.3%) had genetic abnormality. Sperm motility, viability and sperm function tests were significantly lower in the RPL group as compared to the control group (P=0.000). Male factor might be a possible contributing factor towards RPL. Both the partners should be evaluated and treated simultaneously in order to achieve desirable outcome.

Hypo-osmotic swelling test as a predictor for nuclear maturity of sperms assessed by aniline blue staining / 대한산부인과학회잡지

OBJECTIVE: Many cases of fertilization failure after ICSI is attributed to decondensation defect of sperm head, therefore, selection of sperm with well-condensed, fully-matured nucleus is critical for successful fertilization. During mammalian spermiogenesis, replacement of the somatic histones by protamines allows normal sperm nuclear condensation. The degree of condensation can be shown with the aid of acidic aniline blue staining, which is able to discriminate between lysine-rich histones and arginine- or cysteine-rich protamines. The objective of this study was to investigate the possible relation between nuclear maturity of human sperm and hypo-osmotic swelling patterns. Hypo-osmotic swelling test is very simple and convenient test to measure functional integrity of human sperm membrane, and each already tested sperms can be used for fertilization. METHODS: For assessment of sperm nuclear maturity, aniline blue staining was performed on the slides, already undergone hypo-osmotic swelling test in 5 subfertile patients with abnormal semen parameters and 8 fertile donors. After 3 hours swim-up, these procedures were repeated in each cases. RESULTS: Sperms with negative aniline blue were significantly increased after swim-up in each group. There was a significant increase in the proportion of negative aniline blue in sperms with swelling patterns(e+f+g) compared to sperms with non-swelling patterns(a), except swim-up group in subfertile patients. CONCLUSION: Choosing the swelling patterns, rather than non-swelling sperms after hypo-osmotic test may be beneficial for the selection of sperms with well-condensed, mature nucleus and intact membrane.

Hypo-osmotic swelling test of washing and swim-up sperm treated with pentoxifylline.

An experimental study was carried out in order to evaluate the effect to of pentoxifylline on the membrane function of washing and swim-up sperm in the process of sperm preparation for assisted reproductive techniques. Normal semen samples were taken according to World Health Organization criterias, from 30 male partners who attended the infertility clinic from November 1996 to January 1997, and divided into two aliquots. In the process of sperm preparation by the washing and swim-up method, pentoxifylline was added in only one aliquot. The hypo-osmotic swelling test was used to evaluate the outcome of both aliquots. From the study, the percentage of sperm that showed swollen tails in the hypo-osmotic solution prepared by the washing and swim-up method and treated by pentoxifylline was higher than that in the group which did not have pentoxifylline added in the process of sperm preparation. However, the difference was not atatistically significant (54.9 and 49.2 percent; P>0.01). It was therefore concluded that pentoxifylline added to washing and swim-up sperm in the process of sperm preparation dose not improve membrane function of spermatozoa. Thus, it may not be necessary to use pentoxifylline in the treatment of male infertility.