Comparison of FACSCount AF system, Improved Neubauer hemocytometer, Corning 254 photometer, SpermVision, UltiMate and NucleoCounter SP-100 for determination of sperm concentration of boar semen.

Current research aims at reducing the number of sperm per insemination dose thereby making measurement of sperm concentration in raw semen and the production of uniform insemination doses much more crucial. The present study evaluated the determination of sperm concentration using FACSCount AF System (FACS), Improved Neubauer hemocytometer (HEMO), Corning 254 photometer (Photo C254), SpermVision CASA System (SpermVision), UltiMate CASA System (UltiMate) and NucleoCounter SP-100 (SP-100). The instruments were evaluated with respect to repeatability and to establishing the regression curve towards both HEMO and FACS. Repeatability for the instruments was 2.7, 7.1, 10.4, 8.1, 5.4 and 3.1% for FACS, HEMO, Photo C254, SpermVision, UltiMate and SP-100, respectively. Correlation between instruments was highest between FACS and SP-100. This was made possible due to the high repeatability for both instruments. The agreement between the instruments and HEMO as the gold standard was lower than expected as the largest difference in estimation of concentration was -25 to +50%. The largest percentage difference was observed for measurements of dilute semen. It was clear that percentage difference between instruments depended on sperm concentration. In comparison to the gold standard, agreement was highest between SpermVision and HEMO for dilute semen, but for concentrated semen, agreement was highest between SP-100 and HEMO. However, the agreement between HEMO and all other instruments was not as good as expected. The reason may lie within the presence of agglutinated sperm, preventing proper HEMO counts.

Further considerations on natural or mild hyperstimulation cycles for intrauterine insemination treatment: effects on pregnancy and multiple pregnancy rates.

BACKGROUND: The high iatrogenic multiple pregnancy rate associated with intrauterine insemination (IUI) in hyperstimulated cycles is becoming less acceptable. Therefore we investigated data from an earlier prospective trial with regard to the specific question of whether the application of mild hyperstimulation in IUI cycles could be an alternative strategy for obtaining acceptable pregnancy rates while preventing a high multiple pregnancy rate, compared with natural cycles for IUI. METHODS: Pregnancy outcome of 310 natural and 334 mildly hyperstimulated cycles for IUI in 171 couples with unexplained or mild male factor subfertility was analysed on a patient level with random coefficient models. RESULTS: Pregnancy rates were similar: 35 and 39.8% per couple in the natural and mildly hyperstimulated cycles respectively (P = 0.60). Multiple pregnancies, all twin pregnancies, were conceived significantly more frequently in the mild hyperstimulation group (27% of the pregnancies) than in the natural cycle group (4% of the pregnancies) (P = 0.01). All multiple pregnancies in the hyperstimulation group were conceived in multifollicular cycles. Multifollicular development was strongly associated with the application of mild hyperstimulation only (odds ratio 21.14, 95% confidence interval 8.15-54.79). CONCLUSION: The application of a mild hyperstimulation protocol as an alternative to a standard hyperstimulation protocol for IUI does not result in higher pregnancy rates than IUI in the natural cycle, while at the same time multiple pregnancies cannot be avoided. Therefore, there is no place for the use of gonadotrophins in IUI treatment.

Ovarian response to standard gonadotrophin stimulation for IVF is decreased not only in older but also in younger women in couples with idiopathic and male subfertility.

BACKGROUND: With the occasional reports of unexpectedly poor ovarian response to controlled ovarian hyperstimulation (COH) for IVF in young normally cyclic women in mind, we studied age-related ovarian response to COH in a group of women who underwent standard IVF. METHODS: Ovarian response to COH was defined as the number of follicles > or = 14 mm on the day of hCG administration. Ovarian response to COH was analysed by multiple regression analysis with woman's age and basal FSH concentration as explanatory variables in a prospective cohort of patients with idiopathic and mild male factor subfertility (n = 85), and additionally in a large retrospective cohort of women with unexplained, mild male and tubal subfertility (n = 1155), with age as explanatory variable. RESULTS: Ovarian response to COH was associated significantly with age (P < 0.001) and basal FSH concentration (P = 0.002). However, in women with idiopathic or mild male subfertility, in both cohorts the relationship took the form of an inverted U-shape with both older and--surprisingly--young women having a reduced ovarian response (P < 0.001). Maximum ovarian response was around the age of 28 years. In women with tubal infertility, there was only a linear decline of ovarian response with age. CONCLUSION: It is hypothesized that diminished ovarian response to COH in IVF is the very first sign of ovarian ageing in young women diagnosed with idiopathic and mild male subfertility.