The diagnostic value of seminal a-glucosidase enzyme index for sperm motility and fertilizing capacity.

OBJECTIVE: To find out the diagnostic value of seminal a-glucosidase enzyme index in the ejaculated semen samples of proven-fertility and primary infertility patients, for the sperm motility and fertilizing capacity. METHODS: The study which lasted approximately 2 years was carried out in the Andrology Department of the Arab Fertility Center, Jeddah, Kingdom of Saudi Arabia. Eighty-five healthy male patients (age 25-38 years) were admitted into the study. They were divided into 2 main groups as proven-fertility group and primary infertility group. Each group was again subdivided into 4 classes based on the sperm concentrations. The sperm motility assessment was carried out quantitatively by Semi automated Computer assisted Semen analysis using Autosperm analyzer. Simultaneously, a-glucosidase enzyme index was determined in all the semen samples. RESULTS: The results were tabulated as per the standard sperm motility grades of the World Health Organisation, under the classified sperm concentrations of the study. The progressive motility grades were compared with the enzyme index of a-glucosidase in both the groups. The total progressive motility was found higher in the high-density (classes I and II) than the low-density (classes III and IV) semen samples. The enzyme index readings of the various classes of sperm concentrations were significant (p<0.05) and showed a stepwise fall from 89% +/-9% to 52%+/-3% in the proven fertility group. Although, a similar trend has been observed (48%+/-5% to 20%+/-2%) in the primary infertility group, the enzyme index class II sperm concentration (44%+/-6%) was not found significant with class 1 (48%+/-5%) sperm concentration, but the significance was achieved with the other 2 classes. The readings of enzyme index between the groups were found highly significant (p, 0.001). CONCLUSION: The enzyme index of a-glucosidase estimations in semen samples may indicate a positive correlation with progressive motility and fertilizing capacity of spermatozoa and may serve as diagnostic value in individuals showing normal levels of sperm concentration and serum androgen.

Prognostic significance of endometrial evaluation by ultrasonography in ovulation induced cycles.

OBJECTIVE: To find out prognostic significance of pre-ovulatory endometrial evaluation by ultrasound scanning after exposure to the drugs during different protocols of ovulation induction with particular reference to clomiphene citrate and to correlate with pregnancy rate. METHODS: The thickness and texture of endometrium were the two biophysical parameters considered to be evaluated by ultrasonography. The cycles of 47 women of primary infertility were studied after ovulation induction by 4 types of protocols with or without clomiphene citrate. RESULTS: The pregnancy rate was recorded highest (36%, 5/14) in the exclusive treatment group of clomiphene citrate protocol. Most of the women in this group suffered with low level (<6 mm) endometrial thickness, but all five women who showed A-grade endometrium became pregnant. The exclusive human menopausal gonadotrophin treated group and sequential protocol group achieved low pregnancy rates as 22% (2/9) and 27% (3,11). The luteinizing hormone releasing hormone analogue and follicle stimulating hormone protocol achieved 31% (4/13) pregnancy rate with more number of women showing A-grade endometrium quality. CONCLUSION: The quality of endometrial texture rather than thickness of endometrium, can be considered as one of the strong prognostic factors to predict pregnancy rate in a majority of women.

On the etiologic role of ureaplasma urealyticum (T-mycoplasma) infection in infertility.

Two hundred consecutive infertility patients and sixty-seven controls subjects were studied for the incidence of infection with Ureaplasma urealyticum (T-mycoplasma). On the basis of a complete infertility investigation, the infertility patients were subdivided into those with explained infertility and those with unexplained infertility. Of the patients with unexplained infertility, 55% had a positive culture for T-mycoplasma as compared with a 32% incidence of positive cultures in the control population. The differences were statistically significant. The 6-month pregnancy rate following successful antibiotic treatment in patients with unexplained infertility was 42%. The 6-month pregnancy rate in a comparable group of patients with unexplained infertility, seen during a 3-year period prior to mycoplasma culture and treatment, was 32%. The difference in pregnancy rates between the two groups was not statistically significant. No correlation was found between a poor postcoital test and the presence of T-mycoplasma infection nor between T-mycoplasma infection and poor cervical mucus. The role of T-mycoplasma infection in infertility was neither proven nor disproven by this study.