ABSTRACT
We report our experience with artificial insemination with husband's semen (AIH) using cervical cap. Forty-four couples were admitted to our AIH program over a two-year period. In 4 couples, AIH was performed due to impotence or hypospadia, while in the remaining 40 couples indications for AIH were abnormal semen, poor post-coital test, anti-sperm antibodies, poor cervical mucus. Overall, six pregnancies were obtained (pregnancy rate = 15%) in the latter group; in particular, AIH was able to elicit pregnancy in 5 out of the 25 cases of abnormal semen (20%). Our data emphasize the importance of female factors associated with infertility since significantly higher pregnancy rates (45.4% versus 0%) were observed in subjects in whom these factors were absent.
Subject(s)
Insemination, Artificial, Homologous/instrumentation , Insemination, Artificial/instrumentation , Adult , Cervix Mucus/physiopathology , Female , Humans , Infertility, Female/physiopathology , Infertility, Female/therapy , Infertility, Male/therapy , Insemination, Artificial, Homologous/methods , Male , PregnancyABSTRACT
The different causes of infertility and evaluation of the infertile couple are reviewed in this paper. Forty to 50 percent of cases are due to male factors, and special emphasis is placed in describing techniques to diagnosis this type of infertility. Five to ten percent of infertile couples have infertility of unknown etiology even after a complete, appropriate evaluation. Special instruction in how to diagnose and treat these types of patients is described. A step by step evaluation of peritoneal factors, ovulation factors, and male and cervical mucus interaction is presented for the clinicians' use.
Subject(s)
Infertility/etiology , Cervix Mucus/physiopathology , Corpus Luteum Maintenance , Fallopian Tube Diseases/complications , Fallopian Tube Diseases/diagnosis , Female , Humans , Infertility/diagnosis , Infertility/physiopathology , Male , Ovulation Detection , Pregnancy , Sexual Behavior , Spermatozoa/physiopathology , Uterine Diseases/complications , Uterine Diseases/diagnosisABSTRACT
Standardized bovine cervical mucus penetration by human sperm in vitro provides information for evaluating male fertility. Normal semen specimens from 20 sperm donors and 17 infertile men were tested for cervical mucus penetration. Rigorous control of test temperature was necessary to guarantee the reliability and reproducibility of cervical mucus penetration. Sperm washing was found to significantly improve cervical mucus penetration for infertile men, from 18 +/- 2.2 to 27 +/- 3.4 mm, P less than .025. Sperm washing for normal donors had no apparent effect on cervical mucus penetration (58 +/- 1.5 mm prewash, 55 +/- 1.7 mm postwash, P greater than .1). The authors conclude that: 1) temperature for cervical mucus penetration testing is critical to reliability, and 2) cervical mucus penetration is a useful screening tool for in vitro procedures proposed to improve sperm function.
Subject(s)
Cervix Mucus/physiology , Cold Temperature , Infertility, Male/physiopathology , Sperm-Ovum Interactions , Spermatozoa/physiology , Adult , Animals , Cattle , Cervix Mucus/physiopathology , Female , Humans , Insemination, Artificial/methods , Male , Sperm Motility , Spermatozoa/physiopathologyABSTRACT
The use of an in vitro bovine cervical mucus penetration test (CMPT) provides unique data for fertility assessment. Flat capillary tubes were filled, kept frozen until use, exposed to a subsample of semen for 90 minutes, and microscopically evaluated. Adequate penetration was based on results of semen specimens from donors used for artificial insemination. of 161 patients being evaluated for infertility, 37% had semen that penetrated the CMPT inadequately. Of the patients with inadequate penetration, 70% had sperm densities of greater than 21 x 10(6)/ml, and 62% had over 50% motility. Thus neither evaluation of count nor motility provided the same information as the CMPT. Human spermatozoa had a similar swimming pattern in human and bovine mucus. Spermatozoa that exhibited poor in vitro penetration of human mucus also failed to penetrate bovine mucus. Comparison of the CMPT with postcoital tests of 42 couples revealed a good correlation. When the incidence of pregnancy for individuals with adequate and inadequate penetration was compared, more individuals with a good CMPT caused a pregnancy. It appears that the CMPT, an easy office test, allows greater discrimination of sperm function than semen analysis alone and is a useful tool for the diagnosis and management of infertility.
Subject(s)
Cervix Mucus/physiopathology , Infertility, Male/diagnosis , Sperm Motility , Animals , Cattle , Coitus , Female , Humans , Male , Pregnancy , Spermatozoa/cytology , Time FactorsABSTRACT
Spermagglutinins were demonstrated by the tray agglutination technique in cervical mucus collected during presumably-ovulatory cycles in 8 women among 21 patients with spermagglutinating antibodies in serum treated for infertility. A "poor" sperm penetration test was recorded exclusively in women with spermagglutinins in cervical mucus, and the results of the sperm-cervical mucus contact test were significantly correlated to the spermagglutinin titers in cervical mucus. The incidence of spermagglutinating antibodies in cervical mucus from infertile women was estimated to be 2.2% on the basis of the results in the present study. However, an inhibiting effect on sperm penetration in cervical mucus by spermagglutinins is expected to occur in less than 1% of women from infertile couples. A decrease in spermagglutinin titers in cervical mucus observed during estrogen medication was significantly associated with improved sperm penetration in vitro. The latter results may indicate a new approach to the treatment of infertility due to the presence of spermagglutinating antibodies in cervical mucus.
