Negative correlation between presence of reactive oxygen species and Sperm Motility Index in whole semen samples of infertile males / Correlación negativa entre la presencia de especies reactivas del oxígeno y el índice de movilidad espermática en muestras completas de semen de varones estériles

Objective. To investigate the relationship between the Sperm Motility Index and the presence of reactive oxygen species in semen. Methods. We retrospectively analyzed Sperm Motility Index measured by the Sperm Quality Analyzer and reactive oxygen species levels in 92 semen samples of infertile male patients who visited the Ebina Ladies’ Clinic between September 2011 and June 2012. Using the same semen samples, we also analyzed 8 sperm parameters measured by computer-assisted semen analysis and validated the relationship with the Sperm Motility Index. Results. The presence of reactive oxygen species in semen was positive in 19 samples and negative in 73 samples. In the reactive oxygen species-positive group, there was a significant negative correlation between the logarithm of reactive oxygen species level and Sperm Motility Index (p = 0.039). Conclusions. This is the first study to find a significant negative correlation between Sperm Motility Index and reactive oxygen species level. This result indicates that the presence of reactive oxygen species in semen may inhibit the fertilization ability of spermatazoa as measured by the Sperm Motility Index (AU)

Objetivo. Investigar la relación entre el índice de movilidad espermática y la presencia de especies reactivas del oxígeno en el semen. Métodos. Analizamos retrospectivamente el índice de movilidad espermática medido por el analizador de calidad del esperma y los niveles de especies reactivas del oxígeno en 92 muestras de semen de varones estériles que visitaron Ebina Ladies’ Clinic entre septiembre de 2011 y junio de 2012. Con las mismas muestras de semen también analizamos 8 parámetros del esperma medidos mediante un análisis de semen asistido por ordenador y validamos la relación con el índice de movilidad espermática. Resultados. La presencia de especies reactivas del oxígeno en el semen dio positivo en 19 muestras y negativo en 73. En el grupo positivo para especies reactivas del oxígeno hubo una correlación negativa significativa entre el logaritmo de nivel de especies reactivas del oxígeno y el índice de movilidad espermática (p = 0,039). Conclusiones. Este es el primer estudio que encuentra una correlación negativa significativa entre el índice de movilidad espermática y el nivel de especies reactivas del oxígeno. Este resultado indica que la presencia de especies reactivas del oxígeno en el semen podría inhibir la capacidad de fecundación de los espermatozoides según la medición del índice de movilidad espermática (AU)

A case of empty follicle syndrome who conceived after aspiration of an endometrial cyst.

Empty follicle syndrome (EFS) has been defined as a condition where no oocytes can be retrieved for in vitro fertilization (IVF) even though ultrasound findings and estradiol (E2) levels suggest the presence of potential follicles. The EFS is a rare condition with an incidence of 0.5-7 % of women undergoing IVF treatments. Although there are many hypotheses as to the cause of EFS, including advanced ovarian age, drug-related problems, and dysfunctional folliculogenesis, its cause remains unknown. A 37-year-old woman with endometriosis and a 5-year history of primary infertility underwent IVF treatment for 4 cycles. No oocytes were retrieved in 2 cycles and no fertilized eggs were obtained in the other 2 cycles. We assumed that endometriosis adversely affected folliculogenesis and fertilization. Aspiration of an endometrial cyst in the right ovary and subsequent administration of oral contraceptives resulted in successful folliculogenesis and fertilization. Thereafter, she conceived and delivered a 2,662 g female infant at 38 weeks of gestation. Here, we report a case of EFS who conceived in the 5th IVF cycle after aspiration of an endometrial cyst. We assumed that endometriosis might have been involved in the dysfunction of folliculogenesis and EFS.

Effects of Saireito on the ovarian function of patients with polycystic ovary syndrome.

PURPOSES: It is sometimes difficult to restore a regular ovulatory cycle in women with polycystic ovary syndrome (PCOS) using classic agents such as clomiphene citrate or gonadotropins. Saireito, a herbal medicine, is believed to have an effect similar to corticosteroids. We examined the effect of Saireito on ovulatory induction and endocrine status in women with PCOS. METHODS: Twenty-four women with PCOS were treated with Saireito for 3 months. Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), testosterone (T), estradiol (E2), adrenocorticotropic hormone (ACTH), and cortisol were measured before and after treatment, and ovulation was assessed. We compared serum LH levels between ovulation (n = 21) and anovulation (n = 3) groups, and compared ovulation rate and serum LH levels between obese (n = 6) and nonobese (n = 18) groups. RESULTS: Ovulation was restored in 21 (87.5%) of the 24 PCOS patients following administration of Saireito for 3 months. LH levels were significantly decreased 1 month after medication in ovulatory group (P < 0.001), but only slightly decreased in anovulatory group. Ovulation rate in the nonobese group (94.4%) was higher than in the obese group (66.7%). Serum LH levels were significantly reduced in the nonobese group, but only slightly reduced in the obese group. CONCLUSIONS: Saireito reduced serum LH levels and increased ovulatory rate, particularly in nonobese women.

Retrospective analysis of laparoscopic salpingostomy and conservative expectant management of tubal ectopic pregnancy.

PURPOSE: To identify predictive factors for successful expectant management of ectopic pregnancy and to evaluate the prognosis for fertility after expectant management and laparoscopic salpingostomy. METHODS: Forty-six cases of expectant management and eighty cases of laparoscopic salpingostomy for tubal ectopic pregnancy were retrospectively analyzed. Subjects were classified in three groups: those who underwent laparoscopic salpingostomy, those treated by expectant management only, and those treated by expectant management but requiring additional treatment. RESULTS: The rates of tubal patency, intrauterine pregnancy and repeated ectopic pregnancy in the laparoscopic salpingostomy group were 75, 40, and 16%. The rates in the expectant management group were not significantly different: 72, 42 and 15%. Finally, the rates in the extra treatment group were 75, 39 and 15%. Success rate of expectant management was 54%. In 93% of cases expectant management was successfully completed when the initial levels of urinal hCG were less than 3000 mIU/ml and the levels of hCG 48 h later were less than 80% of the initial levels. However, expectant management alone was insufficient and required extra treatment in 90% of cases when the initial levels of hCG were 3000 mIU/ml and above or when the levels of hCG level 48 h later was 80% of initial levels and above. CONCLUSIONS: Expectant management in combination with salpingostomy is not only minimally invasive but also a useful way to preserve fertility. Initial urine hCG levels and their variation over time can help predict whether expectant management will succeed.