Efficiency of routine semen analysis to predict functional and structural integrity of human spermatozoa.

The study is to examine the ability of routine semen analysis to predict the functional and structural integrity of spermatozoa in in vitro conditions. Since large number of subjects were evaluated over a long period of time, the value of routine analysis to prognosticate the functional and structural integrity in the same sample was assessed. Routine semen analysis was done on 354 subjects. In the same sample, functional tests were carried out. The functional tests applied were hypoosmotic swelling test, test for acrosome intactness, nuclear chromatin decondensation test and sperm mitochondrial activity index. A scoring system was adopted for both routine and functional analysis. According to the scores obtained, the samples were categorized into fertile, subfertile and infertile. Analysis of the data indicated that efficiency of routine semen analysis was 38.13%. Prediction of functional integrity by routine analysis of semen specially in subnormal cases is only partly fulfilled. The study also indicates that functional tests are definitely indicated in cases with subnormal score.

Menstrual irregularities and lactation failure may precede thyroid dysfunction or goitre.

Menstrual and reproductive history of 178 women referred to the thyroid clinic was compared with 49 healthy controls. Cases were classified as euthyroid, hypothyroid or hyperthyroid after clinical examination and after serum T3, T4, TSH measurements. Reproductive history was related chronologically to symptoms and signs of thyroid dysfunction. Only 31.8% of hypothyroid and 35.3% of hyperthyroid women had normal menstrual pattern in contrast with 56.3% of Euthyroid and 87.8% of healthy controls (p < 0.001). Reproductive failure (infertility, pregnancy wastage, failure of lactation) occurred in 37.5% of hypothyroid and 36.5% of hyperthyroid cases against 16.3% of euthyroid and 16.7% of healthy controls (p < 0.05). Interestingly, in 45% of cases with menstrual abnormality, the anomaly was antecedent to other clinical features by a variable period of two months to ten years. Reproductive failure and lactation failure also preceded thyroid dysfunction or goitre. Reproductive dysfunction may therefore be considered as one of the presenting symptoms of thyroid disorders in women, keeping in mind both menstrual irregularities and lactation failure may also arise from other common or idiopathic origins. Especially in women with menstrual irregularities in the perimenopausal age if thyroid dysfunction is detected, pharmacotherapy may be a superior alternative to surgical interventions like hysterectomy.