Membrane Potential Assessment by Fluorimetry as a Predictor Tool of Human Sperm Fertilizing Capacity.

Mammalian sperm acquire the ability to fertilize eggs by undergoing a process known as capacitation. Capacitation is triggered as the sperm travels through the female reproductive tract. This process involves specific physiological changes such as rearrangement of the cell plasma membrane, post-translational modifications of certain proteins, and changes in the cellular permeability to ions - with the subsequent impact on the plasma membrane potential (Em). Capacitation-associated Em hyperpolarization has been well studied in mouse sperm, and shown to be both necessary and sufficient to promote the acrosome reaction (AR) and fertilize the egg. However, the relevance of the sperm Em upon capacitation on human fertility has not been thoroughly characterized. Here, we performed an extensive study of the Em change during capacitation in human sperm samples using a potentiometric dye in a fluorimetric assay. Normospermic donors showed significant Em hyperpolarization after capacitation. Em values from capacitated samples correlated significantly with the sperm ability to undergo induced AR, highlighting the role of hyperpolarization in acrosomal responsiveness, and with successful in vitro fertilization (IVF) rates. These results show that Em hyperpolarization could be an indicator of human sperm fertilizing capacity, setting the basis for the use of Em values as a robust predictor of the success rate of IVF.

Cabergoline reduces the early onset of ovarian hyperstimulation syndrome: a prospective randomized study.

Prophylactic use of cabergoline has been associated with a decrease in the severity of ovarian hyperstimulation syndrome (OHSS). A prospective randomized study was designed to evaluate the potential of cabergoline to decrease the incidence of OHSS in high-risk patients undergoing assisted reproductive technology treatment; 166 patients with oestradiol concentrations over 4000 pg/ml on the day of human chorionic gonadotrophin (HCG) administration were evaluated. They all received 20 g routine preventive intravenous human albumin on the day of oocyte retrieval. They were then randomized into two groups: group A (n = 83) received 0.5 mg oral cabergoline per day for 3 weeks beginning on the day after oocyte retrieval, and group B (n = 83) received no medication. 'Early' OHSS was defined as being when the onset of the syndrome was initiated during the first 9 days after HCG administration, and 'late' OHSS was defined as being when the onset of the syndrome was initiated from 10 days after HCG administration. In group A, no patients progressed to 'early' OHSS and nine patients (10.8%) developed 'late' OHSS; in group B, 12 patients (15.0%) progressed to 'early' OHSS and three (3.8%) to 'late' OHSS. Although the risk of 'early' OHSS decreased significantly (P < 0.001), the risk of 'late' onset OHSS did not. The two groups presented no changes in pregnancy, implantation or miscarriages rates.