ABSTRACT
Fifty-three cycle of ovarian stimulation with human menopausal gonadotropins after suppression of endogenous gonadotropin release with leuprolide acetate were completed for the purpose of performing gamete intrafallopian transfer. Thirty-seven biochemical pregnancies resulted, with 29 progressing to clinical status, for rates of 69.8% and 54.7%, respectively, per cycle. In comparing characteristics of the follicular recruitment phases of failed cycles to those of cycles resulting in pregnancies, no differences were observed in serum estradiol concentrations or follicular development. However, pregnancy rates were highly associated with peak concentrations of progesterone prior to the administration of human chorionic gonadotropin. Three levels of progesterone range were found on the basis of outcome: 6 high-progesterone cycles produced no pregnancies (0%), 32 mid-range progesterone cycles produced 31 pregnancies (97%), and 15 low-progesterone cycles produced six pregnancies (40%). The pregnancy rate in the last group improved when the luteal support was doubled.
Subject(s)
Gamete Intrafallopian Transfer , Gonadotropin-Releasing Hormone/analogs & derivatives , Hormones/pharmacology , Menotropins/pharmacology , Progesterone/blood , Adult , Chorionic Gonadotropin/pharmacology , Estradiol/blood , Female , Gamete Intrafallopian Transfer/methods , Gonadotropin-Releasing Hormone/pharmacology , Humans , Leuprolide , Luteal Phase/drug effects , Luteinizing Hormone/blood , Menotropins/metabolism , Ovulation/drug effects , PregnancyABSTRACT
Anti-sperm antibodies from serum and seminal plasma were detected by concurrent flow cytometry and epifluorescence microscopy using fluorescein-conjugated antihuman immunoglobulins. Experimental conditions were designed, taking advantage of several monoclonal antisperm antibodies, to test aspects of the assay before clinical application. Perturbation of membrane integrity altered both the localization of binding and the number of sperm cells positive for bound antibodies. In specimens from selected infertility patients, 21.6% of the females and 40.8% of the males had significant levels of antisperm antibodies. Differences in the incidence of isoimmunity between female partners of antibody-positive or antibody-negative males and differences in the localization of antigens targeted by serum versus seminal plasma antibodies in men support the idea that, in some cases, immunity to sperm cells may be the result of altered sperm antigens.
