Population heterogeneity in human sperm DNA content.

The range of variability in the population distribution characteristics of sperm DNA content was surveyed in a selected group of donors. The donors included identical twins, carriers of chromosomal translocations, and oligospermics. The DNA content of sperm was measured individually in an automated cytofluorometer. In contrast to normal donors with high sperm counts and relatively constant modal values of sperm DNA, the balanced carriers of translocations were oligospermic and showed wide dispersion of modal values. This is an unexpected finding, since reciprocal events in the alternate form of segregation, which occurs predominantly in male carriers of balanced translocations, should not alter modal values of sperm DNA nor should they be associated with oligospermia. It appears that sperm DNA content in oligospermia, independent of its association with translocation, varies over a wide range. Thus, it is likely that genetic factor(s) unrelated to chromosome translocation control sperm DNA content.

A simple technique of laparoscopic tubal sterilization.

In the last several years the use of laparoscopy in gynecological practice has become very popular. It is indicated for a number of conditions. However, sterilization of the female has been the main indication for laparoscopy and will remain so until more efficient and reversible techniques are developed. A simple technique of laparoscopic tubal sterilization is presented. In the opinion of the authors it offers several advantages over other methods. Only one instrument is used and only one type of electrical current applied. A small portion of the fallopian tube is removed and the surrounding tissue--the tube and mesosalpinx-- is sufficiently cauterized to secure hemostasis. The histological quality of the removed specimen is excellent. Finally, less than 2 cm of fallopian tube is destroyed, providing an excellent opportunity for reanastomosis.

The clinical use of frozen semen banks.

PIP: In humans, use of frozen semen is still limited to the activities of a few centers. Procedure for freezing semen involves adding .1 ml of glycerol for each milliliter of semen to be frozen. The specimen is then transferred into sterilized ampules in 1 ml quantities and sealed. The ampules are then suspended in liquid nitrogen vapor at a temperature of -99 degrees C for 1/2 hour. Following this, ampules are maintained at -198 degrees C for storage, after appropriate coding. The major application is for donor inseminations. An experimental use is for pooling of a husband's specimens which are deficient in sperm numbers. Another clinical application is the storage of semen prior to sterility-inducing procedures in the husband, e.g., therapeutic irradiation. A similar application is for men contemplating vasectomy. Less than 1% of vasectomy patients have been interested in this procedure. There is no guarantee that the specimen will be usable at a later date. The longest successful utilization has been after 2 1/2 years. Results of insemination have been comparable with reports from elsewhere. Of a group of 92 pregnancies, 68 had delivered at term, 4 had spontaneous abortions, and 20 had not as yet delivered. Only 1 fetal abnormality was found, that of a child who had a missing digit. There were 1986 inseminations. Some required several inseminations. In this study, the total number of pregnancies through the use of frozen semen has been 137. The success rate is comparable to that obtained with nonfrozen specimens.^ieng

Present status of injectable contraceptives: results of seven-years study.

PIP: 2 experimental contraceptive injection programs are reported. 1 method provides for administration of a combined long-acting estrogen-progestogen product once a month, the other uses a long acting progestogen alone once every 90 days. In the once-a-month injection program in Los Angeles 615 patients representing 871 admissions were studied; treatment data are for both 1st and all admissions. Age distribution was 21-25 years. Patients received 150 mg of progestogen/10 mg estrogen injection. 88.1% reported cycles of 22-30 days/on admission. Some results are: For 1st and all admissions average duration of flow was 6.6 days; for 1st admission group complaints consisted of breast tenderness, 46% dysmenorrhea, 61.8%, weakness or dizziness, 42.8%, local reaction to injection, 37.4%. For all admissions, complaints were: breast tenderness, 43.3%, dysmenorrhea, 59.6%, weakness, 40.2%, local reaction, 33%. Reasons for dropout for both groups included rigidity of protocol, about 52%, moved away, 4.5%, extraneous illness, 1.5%; 64.4% of all admissions discontinued treatment due to unrelated reasons. No pregnancies were reported. The once every 90 day injection of medroxyprogesterone acetate given in doses of 150 mg were given to 243 women, of whom 57% were aged 20-29. Some results are: 1) number of days of bleeding ranged from 6-20 days, 2) 4.6% reported nervousness, 3.4% nausea, 2.1% headaches, 3) main reasons for dropouts were moving away, 11.8%, bleeding, 4.6%, and 4) 1/3 resumed ovulation within 1/2 year. Both methods are found to be extremely effective.^ieng

Studies of "mini-micro" contraceptive doses of a new progestrogen.

PIP: Studied involving the use of microdose progestogens are reported. The Family Planning Clinics of Los Angeles began employing norgestrel, Wy-3707, in 1966. It was first given in a combined form of .5 mg norgestrel with .05 ethinyl estradiol. In a report on 454 patients who had used the medication for 4354 cycles it was shown to be highly effective. There were no pregnancies, the length of the cycle was 27.7 days on the average, 98.1% were considered normal as far as the amount of bleeding was concerned, and the duration of withdrawal bleeding averaged 4.3 days. A low-dose program using this progestogen was begun. The first dose employed was .075 mg alone daily, and in a parallel series .05 mg was employed. Irregular bleeding patterns occurred. In Cycle 1 31% of the patients on the .05 dosage and 37% of the patients on the .075 mg dosage had breakthrough bleeding and/or spotting. At Cycle 5, 22% of the .05 mg patients and 17% of .075 patients had breakthrough bleeding and/or spotting. 59% of the women taking the .05 mg dosage and 19% of the women taking the .075 dosage dropped out of the study for a variety of reasons. A majority of the drop-outs just did not return or had breakthrough bleeding. Cervical mucus studies were carried out on a number of patients on .075 mg norgestrel. For the most part the cervical mucus was scanty, thick, and tenacious, cellular, with little spinnbarkeit or ferning, and unfavorable to sperm at the usual ovulatory time of the cycle. On some occasions it was of a relatively estrogenic type, profuse, thin, with normal ovulatory spinnbarkeit, and relatively good survival of highly active, motile sperm. Since the investigators have not been satisfied with the bleeding pattern of either the .05-mg or .075 mg-dosafe they have mg-dosage initiated a study using a dosage of .06 mg.^ieng