Does seminal fluid viscosity influence sperm chromatin integrity?

A retrospective study was undertaken to investigate whether viscosity alters sperm chromatin integrity. Semen samples were obtained from 269 men attending the infertility clinic. The viscosity was measured quantitatively by needle and syringe method and the viscosity ratio was calculated against distilled water. The chromatin integrity was evaluated by in vitro decondensation test using 1% SDS and 6 mM EDTA. According to the viscosity ratios the samples were divided into 2 groups: I, normal (ratio < 9, n = 239): and II, abnormal (ratio > 9, n = 30) viscosity. Chromatin integrity was significantly lower in the group with higher viscosity. Significant decrease in sperm count and motility were seen in group II as compared to group I. Thus, hyperviscosity of seminal fluid alters the sperm chromatin integrity.

Use of acridine orange to evaluate chromatin integrity of human spermatozoa in different groups of infertile men.

To study the sperm chromatin compactness various methods, such as acidic aniline blue or acridine orange staining, have been applied. Due to its metachromatic properties, acridine orange dye fluoresces green with double- and red with single-stranded DNA. Samples (n = 181) were evaluated and grouped as follows: group I, normal recently fertile; group II, male having female partner with repeated early pregnancy loss; group III, male with varicocele; and group IV in-vitro fertilization and intrauterine insemination failures. Routine semen analyses were carried out in all the cases. Amorphous particulate matter as observed under phase contrast microscope was graded on the scale of nil to +4. Fixed smears were stained with an aqueous solution of acridine orange and viewed under a fluorescence microscope. Two hundred cells were counted and the percentage of fluorescence calculated. Groups II, III and IV exhibited significantly low green fluorescence compared with the control group. The study also indicates that increased amorphous particulate matter (indicating infection) might be one of the contributing factors to lower acridine orange stainability. Thus acridine orange staining can be used to evaluate the integrity of the nucleus, disorders of which can cause unexplained infertility or lower fertilization potential that may go undetected by routine analysis.

Contraceptive knowledge, attitude and practices of men in rural Maharashtra.

Since men are the dominant decision makers in India, it is prudent to discover the knowledge, perception, attitudes and contraceptive practices of men to improve their involvement in the reproductive health needs of families. Three thousand and seventy-two married men from a tribal Primary Health Centre (PHC) area in Thane district of Maharashtra State, India were surveyed with special emphasis on investigating the reasons for not accepting male methods. The majority of them not only had no concept of family spacing, but had not even taken any initiative to improve their knowledge or acceptance of condom/ vasectomy. Men who were aware of contraceptive methods had little knowledge of their correct use. Of the men, 53.7% had positive views about their role in family planning while 66.2% of men stressed the need to improve the acceptance of male methods by providing knowledge and information through sources such as radio, television, door-to-door campaigning and interpersonal communications. Thirty per cent emphasized the need to improve the availability and quality of services. This study indicates a pressing need for effective intervention strategies, both at the community and the clinic level, backed with efficient counselling, motivation and provision of services in rural and remote areas.

Increased male responsibility and participation: a key to improving the reproductive health.

PIP: This article examines the role of male responsibility and participation in the enhancement of reproductive health in India. Men are recognized to be responsible for the large proportion of reproductive ill health suffered by their female partners. Lack of knowledge, nonavailability of acceptable contraceptives and lack of services with quality of care deter men from sharing the responsibility in reproductive health matters. Misinformation regarding male sexuality and limited availability of scientific data contributed men's less involvement in reproductive health. Thus, various strategies are implemented to increase men's awareness of reproductive health and the accessibility of products and services. These strategies include: 1) increasing contraceptive options for men; 2) supporting women's contraceptive use; 3) improving sexual behavior and safe sex practices; and 4) narrowing the gender gap for better fertility control. Moreover, extensive research is required in order to understand men's perceptions and needs about fertility regulation and sexual behavior as well as services development.^ieng

Computer-assisted semen analysis parameters in men with varicocele: is surgery helpful?

OBJECTIVE: To assess sperm characteristics and fertility before and after varicocelectomy using computer-assisted semen analysis (CASA). DESIGN: Preoperative and postoperative sperm parameters of infertile men with varicocele were analyzed statistically and the outcome of pregnancy was determined. SETTING: Department of Infertility Management and Assisted Reproduction, Jaslok Hospital and Research Centre, Bombay. PATIENTS: Semen samples of 49 men with varicocele-related infertility were analyzed using CASA. INTERVENTIONS: Sperm parameters of 26 men who underwent varicocelectomy were evaluated 3, 6, and 9 months postoperatively. Conception, occurring either naturally or therapeutically, was recorded. MAIN OUTCOME MEASURES: Evaluation of improvement of sperm parameters after surgery. RESULTS: Sperm count, motility parameters, curvilinear velocity, straightline velocity, lateral head displacement, and normal morphology were significantly lower in men with varicocele. Postoperatively, there was significant improvement in count, motility, and normal morphology, with a decrease in proportion of acrosome-deficient heads and tapering forms. After varicocelectomy, 46.2% of the men had normal semen parameters, with the overall pregnancy rate being 50%. CONCLUSIONS: Computer-assisted semen analysis provides the potential for accurate quantitative evaluation of semen in men with varicocele. Varicocelectomy results in improvement in semen quality with pregnancy rates of 50%.

The importance of computer-assisted semen analysis and sperm function testing in an IVF program.

OBJECTIVE: To study the relationship of sperm motion characteristics, sperm morphology, and hypo-osmotic swelling test with fertilization rates in vitro. DESIGN: Computer-assisted measures of fresh seminal and processed sperm preparations, sperm morphology, and hypo-osmotic swelling test results were assessed for predicting fertilization by step-wise regression analysis. SETTINGS: In vitro fertilization laboratory, department of infertility management, university affiliated-hospital. INTERVENTIONS: None. PATIENTS: One hundred and two couples who underwent IVF were studied. MAIN OUTCOME MEASURES: Computer-assisted sperm motion variables in semen and following semen processing in capacitating media; hypo-osmotic swelling of sperm tails before and after semen processing; morphology of sperm before and after processing; fertilization of oocytes as evidenced by presence of two pronuclei as the end point. RESULTS: Various sperm motion parameters, hypo-osmotic swelling test results, and normal morphology of sperm were directly correlated to fertilization as judged by the Karl-Pearsons test. However, in step-wise regression analysis, normal morphology of sperm from seminal fraction exhibited 61% correlation with fertilization rates (P < .001). In step 2, normal morphology along with percent motility exhibited a 64% correlation with fertilization rates (P < .001). In step 3, normal morphology, percent motility, and linearity showed a 67% correlation with fertilization rates (P < .001). The hypo-osmotic swelling test did not predict fertilization rates (regression coefficient = 0.066, P = 0.474). In the processed sample preparations, normal sperm morphology showed a 72% correlation with fertilization rate (P < .001). In step 2, normal morphology along with curvilinear velocity exhibited a 77% correlation with fertilization rates (P < .001). In step 3, normal morphology, curvilinear velocity, and average path velocity showed a 79% correlation with fertilization rates (P < .001). The hypo-osmotic swelling test did not predict fertilization rates (regression coefficient = 0.076, P = 0.512). CONCLUSIONS: Morphology of sperm and computer-assisted sperm motion variables, such as motility, linearity, curvilinear velocity, and average path velocity, may serve as prognostic indicators for fertilization potential of sperm. The hypo-osmotic swelling test may describe only physiological intactness, rather than the fertilization potential of sperm. The results suggest that objective analysis of sperm motion characteristics and precise sperm morphology may form a first, and obligatory, step for critical evaluation of patients before they start IVF treatment.

Efficiency of routine semen analysis to predict functional and structural integrity of human spermatozoa.

The study is to examine the ability of routine semen analysis to predict the functional and structural integrity of spermatozoa in in vitro conditions. Since large number of subjects were evaluated over a long period of time, the value of routine analysis to prognosticate the functional and structural integrity in the same sample was assessed. Routine semen analysis was done on 354 subjects. In the same sample, functional tests were carried out. The functional tests applied were hypoosmotic swelling test, test for acrosome intactness, nuclear chromatin decondensation test and sperm mitochondrial activity index. A scoring system was adopted for both routine and functional analysis. According to the scores obtained, the samples were categorized into fertile, subfertile and infertile. Analysis of the data indicated that efficiency of routine semen analysis was 38.13%. Prediction of functional integrity by routine analysis of semen specially in subnormal cases is only partly fulfilled. The study also indicates that functional tests are definitely indicated in cases with subnormal score.

Menstrual irregularities and lactation failure may precede thyroid dysfunction or goitre.

Menstrual and reproductive history of 178 women referred to the thyroid clinic was compared with 49 healthy controls. Cases were classified as euthyroid, hypothyroid or hyperthyroid after clinical examination and after serum T3, T4, TSH measurements. Reproductive history was related chronologically to symptoms and signs of thyroid dysfunction. Only 31.8% of hypothyroid and 35.3% of hyperthyroid women had normal menstrual pattern in contrast with 56.3% of Euthyroid and 87.8% of healthy controls (p < 0.001). Reproductive failure (infertility, pregnancy wastage, failure of lactation) occurred in 37.5% of hypothyroid and 36.5% of hyperthyroid cases against 16.3% of euthyroid and 16.7% of healthy controls (p < 0.05). Interestingly, in 45% of cases with menstrual abnormality, the anomaly was antecedent to other clinical features by a variable period of two months to ten years. Reproductive failure and lactation failure also preceded thyroid dysfunction or goitre. Reproductive dysfunction may therefore be considered as one of the presenting symptoms of thyroid disorders in women, keeping in mind both menstrual irregularities and lactation failure may also arise from other common or idiopathic origins. Especially in women with menstrual irregularities in the perimenopausal age if thyroid dysfunction is detected, pharmacotherapy may be a superior alternative to surgical interventions like hysterectomy.

Contraceptive acceptance in a tribal area of Maharashtra.

BACKGROUND: The performance of rural areas of Maharashtra in the family welfare programme has not been previously investigated. METHODS: A study was carried out on the knowledge, attitudes and practice of contraception in 254eligible women from a rural area in Thane district, Maharashtra. RESULTS: The knowledge and practice of different contraceptives, particularly of spacing methods, was significantly less amongst non-acceptors than acceptors. Husbands, health staff and media made little contribution towards contraceptive information, particularly, amongst nonacceptors, and teachers did not contribute to any extent in both groups. Significantly more non-acceptors reported the husband's attitude to be unfavourable. The tribals were poor (94%), illiterate (85%), reported an unfavourable attitude of the husband (35%) and wanted their daughters to be married at or below 17 years of age (63%). CONCLUSIONS: The rural areas in Maharashtra need special attention in the family welfare programme.