ABSTRACT
OBJECTIVE: To assess the feasibility of detecting Chlamydia trachomatis in cryopreserved donor semen by a specific, direct polymerase chain reaction (PCR). DESIGN: Cryopreserved donor semen was tested for the presence of C. trachomatis by a specific PCR, directly applied to semen without prior DNA purification. SETTING: Tertiary care fertility center in a teaching hospital and university-based laboratory for molecular pathology. PARTICIPANTS: Cryopreserved semen from 30 donors was investigated. These semen samples had previously given negative results in cell culture for C. trachomatis. Two different ejaculates of each donor, cryopreserved with an interval of 2 years, were retrospectively analyzed. INTERVENTIONS: None. MAIN OUTCOME MEASURE: The presence of C. trachomatis as demonstrated by PCR. RESULTS: In 3 of 30 donors C. trachomatis was detected in both ejaculates, whereas in 2 additional donors only one of the two samples tested positive. Additional samples from 2 positive donors, together with samples from 3 negative donors, were studied more extensively, to test the reproducibility and reliability of PCR results. All ejaculates of the donors, previously positive for C. trachomatis by PCR, indeed appeared to be positive, whereas the samples of the negative donors remained negative. CONCLUSIONS: The direct PCR is a reliable, sensitive, and valuable method for detection of C. trachomatis in semen. The incidence of contamination of donor semen with C. trachomatis in the donor population in this study stresses the need for rigorous screening of donor semen before artificial insemination, preferably using a sensitive method such as the PCR.
Subject(s)
Chlamydia trachomatis/isolation & purification , Insemination, Artificial, Heterologous , Polymerase Chain Reaction/methods , Semen/microbiology , Adult , Base Sequence , Blotting, Southern , Chlamydia Infections/diagnosis , Chlamydia Infections/drug therapy , Chlamydia trachomatis/genetics , Cryopreservation , DNA, Viral/genetics , DNA, Viral/isolation & purification , Doxycycline/therapeutic use , Humans , Male , Molecular Sequence Data , Oligodeoxyribonucleotides , Semen Preservation , Tissue DonorsABSTRACT
The use of cryopreserved semen offers the possibility of home insemination by the instructed partner. A comparative study was designed whereby participants were randomly allocated to use home or clinic insemination for six cycles. If no pregnancy had occurred after six cycles, the site of insemination was switched to the opposite location for a maximum of six further cycles. Fifty-three women with primary infertility fulfilling all entry criteria entered the study. In the first 6 cycles out of 29 home starters, 13 pregnancies were conceived, whereas in 24 clinic starters 11 pregnancies occurred, yielding no statistical difference in pregnancy rate. Of 138 couples who did not meet the criteria in the same period, 45 opted for home insemination, resulting in 20 home-inseminated pregnancies. Again, for comparable subgroups no statistical difference in pregnancy rate between home and clinic insemination was found.
Subject(s)
Insemination, Artificial, Heterologous/methods , Insemination, Artificial/methods , Semen Preservation , Evaluation Studies as Topic , Female , Freezing , Humans , Male , Menstrual Cycle , Pregnancy , Prospective Studies , Random AllocationABSTRACT
From 1967 to 1973 serum samples of 1709 infertile women were tested for antispermatozoal antibodies with the gelatin agglutination test. In 110 cases sperm agglutinins were demonstrated in titers ranging from 4 to 1024. The clinical data of 99 couples were evaluable, and in 65 there appeared to be unexplained infertility. Out of these 65 women, 44 became pregnant in the posttesting follow-up period of 6 to 13.5 years (median, 10 years). With increasing titers there was a significant decrease in the probability of becoming pregnant. Of the women who became pregnant, in general, those with higher titers had to wait longer for their pregnancy than those with lower titers. Moreover, with increasing titers there was a tendency toward a longer duration of infertility before the serum was tested. This latter observation supports the contention that the agglutinin titer influences the fecundability rate. The titers of those becoming pregnant and those remaining infertile, however, showed considerable overlap. Favorable results in the postcoital test were associated with a better prognosis, but this was independent of the titers.
Subject(s)
Agglutinins/analysis , Fertility , Infertility, Female/immunology , Spermatozoa/immunology , Abortion, Spontaneous/epidemiology , Agglutination Tests , Female , Humans , Male , Pregnancy , Prognosis , Sperm Agglutination , Time FactorsABSTRACT
PIP: A retrospective study of 254 infertile men with serum sperm agglutination titers ranging from 4 to 1024 determined by the Kibrick agglutination test between 1954 and 1968 and reexamined in the 1970s is presented. 36 of the subjects had become fertile in the years following the testing, 30 of whom were normospermic. With titers of 32 or more, the probability of becoming fertile was considerably lower than with lower titers. It was confirmed that the longer infertility existed, the less probable was fertility to occur (p less than .01). The serum of 22 men who regained fertility was tested. 19 of the subjects showed no difference in titers between the first and last test. 2 of the 3 remaining fertile men had fathered 2 children each despite titers of 1024 in 1970. The 3rd subject's titer value decreased from 512 to 4 in 1970. It was concluded that sperm agglutinins are involved in the pathogenesis of male infertility.^ieng
