Headless spermatozoa in semen specimens from fertile and subfertile men.

OBJECTIVE: To investigate the frequency of headless, or unnucleated, spermatozoa, determine its percentage and evaluate its possible correlation with other semen parameters. STUDY DESIGN: Semen specimens from 94 subfertile men, aged 24-53 years (mean +/- SD 33.3 +/- 6.3) and from 52 fertile men, aged 24-44 (33.3 +/- 4.1) were studied. Two semen specimens were examined from each individual, with a six- to eight-week interval. Sperm morphology was evaluated from Papanicolaou-stained smears, and the classification of abnormal sperm forms was made according to the guidelines of the World Health Organization. RESULTS: The percentage of headless spermatozoa was 9.0% +/- 8.8 in subfertile and 2.7% +/- 3.1 in fertile men. Headless spermatozoa existed in semen specimens from 90% of subfertile and 70% of fertile men. Of subfertile men, 23.4% had headless spermatozoa at a higher percentage than the highest normal limit found in sperm smears from fertile men. CONCLUSION: In some cases of subfertile men with a high percentage of headless spermatozoa, their infertility can be attributed to the cause of this morphological abnormality. Moreover, tails but not heads were found in semen specimens from subfertile and fertile men.

Prophylactic administration of amoxicillin and clavulanic acid in pregnant women with premature rupture of the membranes.

Seventy-five pregnant women (mean gestational age 32.26 weeks, range 20-36 weeks) with premature rupture of the membranes (PROM) were admitted in our department during 1989 and the first 6 months of 1990. Amoxicillin and clavulanic acid was initially administered at a dose of 1.2 g i.v. every 8 hours for 3-4 days and was followed by oral administration of 625 mg every 8 hours until labor. Sixty-one patients (mean gestational age 32.6 +/- 2.3 weeks, range 26-36 weeks) achieved an uncomplicated course of their pregnancies with a mean time of 11.4 +/- 5.7 days (range 3-27 days), from rupture to delivery. Fourteen women (mean gestational age 30.8 +/- 5 weeks, range 20-36 weeks) developed chorioamnionitis 3.5 +/- 0.9 days (range 1.4-5.6 days) after the rupture with several degrees of leukocyte infiltration of the membranes, placenta and the umbilical cord. Five women (mean gestational age 23.8 +/- 2.3 weeks, range 20-26 weeks) had complications resulting in fetal/infant death, three of them because of fetal sepsis (Escherichia coli, Pseudomonas aeroginosa, Staphylococcus aureus). The newborns were followed up 6 months from delivery and had no signs of drug influence. Few side effects were observed with the chief complaints involving the gastrointestinal tract (4%). No one discontinued the drug. It seems therefore, that the prophylactic administration of amoxicillin and cluvalanic acid in women with PROM is associated with a significant prolongation of pregnancy and with a reduction in the incidence of fetal/maternal infections.

Experience with the MLCu250 IUD.

One thousand and thirty eight patients were fitted with MLCu250 IUDs over a six year period. The women were divided into three groups: group A, 224 women in whom the IUD was inserted postpartum; group B, 352 patients who had the IUD inserted immediately after an abortion; and group C, 462 women in whom insertions were performed at the end of menstruation. All women were followed up every six months for up to 24 months. All women experienced good contraceptive effects. The mean unexpected pregnancy rate was 2.1% (group A = 2.6%, group B = 2.0% and group C = 1.7%). The mean expulsion rate was 1.8% (group A = 2.2%, group B = 2.0% and group C = 1.3%). The bleeding-pain symptom was apparent in 5.5%. The mean rate for planning pregnancy was 3.8%. Removals for medical and personal reasons were 3.6% and 1.9% respectively. The continuation rate was considered very satisfactory (mean value 78.5%, group A = 76%, group B = 77.6% and group C = 82%). In the present study no perforations or ectopic pregnancies occurred.