Corticosteroids and male infertility with an immunological basis.
Explore the source record for details and available documents.
Adrenal Cortex Hormones↗
Biomedical subjects
C L Barratt
Publications and source records attributed to C L Barratt.
Round cells and sperm fertilizing capacity: the presence of immature germ cells but not seminal leukocytes are associated with reduced success of in vitro fertilization.
Fifty semen samples produced for IVF by patients diagnosed as having unexplained infertility were screened for leukocytes, leukocyte subsets, and immature germ cells using a mAB-based staining procedure. Nonfertilizing ejaculates were found to contain significantly larger numbers of immature germ cells, although no significant differences in leukocyte content were observed between groups. Neither sperm density or progressive motility were significantly different between fertilizing and nonfertilizing groups. We conclude that seminal leukocytes have little if any influence on the fertilizing capacity of the spermatozoa in patients undergoing IVF for unexplained infertility, but the presence of large numbers of germinal elements is associated with reduced fertilizing capacity and may be indicative of an immature sperm population.
Fertilization in Vitro↗
The poor prognostic value of low to moderate levels of sperm surface-bound antibodies.
The clinical significance of antisperm antibodies for fertility remains controversial. In this study, we determined whether the presence, isotype, region and/or amount of sperm-bound antibody was of any predictive value for future fertility in 534 men using Cox's proportional hazards model. Significant correlations between the presence of antibodies and semen parameters were recorded, such as sperm mucus penetration and sperm motility. However, low (less than 10%) negative binding and moderate (less than 50%) binding had no significant effect on the probability of conception or the time to conception. This study confirms in-vitro data suggesting that sperm function is not impaired unless the degree of antibody binding to spermatozoa is very high.
Antibodies↗
Effect of human cervical mucus on human sperm motion and hyperactivation in vitro.
The aim of our experiment was to examine the effect of exposure to human cervical mucus on quantitative sperm motility with specific reference to hyperactivated sperm motility. Human spermatozoa were allowed to penetrate cervical mucus for 20 min before swimming into Earle's balanced salt solution tissue culture medium for 25 min. The sperm motion characteristics were compared to those which had been obtained from a direct swim-up for 45 min. Spermatozoa treated with mucus were more 'active' than the control group. Multivariate statistical analysis indicated that cervical mucus promotes hyperactivated motility and that sperm sub-populations exposed to cervical mucus are very heterogeneous, as indicated by the numbers and motility characteristics of spermatozoa.
Cervix Mucus↗
Recovery of artificially inseminated spermatozoa from the fallopian tubes of a woman undergoing total abdominal hysterectomy.
Investigation of the process of sperm transport within the human female reproductive tract must involve the recovery of spermatozoa from the oviducts of women post-coitum or insemination. This case report describes the insemination of a 40-year-old woman with her partner's semen and the subsequent recovery of spermatozoa from her Fallopian tubes, removed at hysterectomy, 2 days post-ovulation. The number of spermatozoa present within the tubes and their location was ascertained using a flushing technique and scanning electron microscopy (SEM). The total number of spermatozoa present within the flushed tube was calculated to be 142, whilst the total number of spermatozoa calculated to be present within the scanned tube was 673. The proportional distribution of spermatozoa within the tubes was virtually identical by the two techniques used. The largest population of spermatozoa resided within the ampulla (66.1% SEM, 68.3% flush), and the smallest population resided within the intramural region (14.9% SEM, 13.4% flush).
Adult↗
The removal of morphologically abnormal sperm forms by phagocytes: a positive role for seminal leukocytes?
A preliminary investigation was undertaken further to determine the function of the leukocytic cells found in semen. We performed semen analysis and quantified leukocyte subsets using immunocytochemical staining techniques in ejaculates of 351 patients. Leukocyte profiles were examined in relation to sperm morphological data for evidence of a sperm removal/selection process. Three types of seminal phagocytic cell were found to contain spermatozoa: small polymorphonuclear leukocytes (approximately 10-12 microns), monocytes of similar size and much larger (30-40 microns) macrophages capable of engulfing multiple sperm heads. The total leukocyte count (P less than 0.01), the numbers of phagocytic cells i.e. polymorphonuclear leukocytes (P less than 0.05), monocyte/macrophages (P less than 0.01) and HLA-DR positive cells (P less than 0.01), were significantly higher in those samples with greater than 50% ideal sperm forms. Significantly fewer of these same cell types were observed in samples with greater than 50% head defects. There was no difference in the number of tail or midpiece defects between leukocytospermic (greater than 10(6)/ml) and non-leukocytospermic semen samples. Oligozoospermic samples contained significantly fewer leukocytes (P less than 0.005), although above a concentration of 5 x 10(6)/ml, the sperm number was not correlated with leukocyte number. These data, along with repeated observation of spermatozoa or sperm fragments within phagocytic cells, support the hypothesis that leukocytes have a role in the removal of abnormal spermatozoa from the ejaculate.
Alkaline Phosphatase↗
Prognostic value of two putative sperm function tests: hypo-osmotic swelling and bovine sperm mucus penetration test (Penetrak).
The clinical value of two inexpensive and easy to perform sperm function tests (hypo-osmotic swelling and bovine sperm mucus penetration tests) were examined in a prospective study of in-vivo conception rates in 325 couples. Both tests were of no significant value alone or in combination with traditional semen characteristics in predicting pregnancy outcome. The two most predictive factors of conception were the length of infertility and percentage of progressively motile spermatozoa. Our data support the further investigation of sperm function using more sophisticated quantitative tests, specifically the examination of sperm motility.
Adult↗
The leukocytic reaction of the human uterine cervix.
PROBLEM: Sperm interaction with the immune system of the human cervix is poorly understood. METHOD: The leukocytic response of the human cervix to sperm was examined in a closely monitored patient population (N = 10), using monoclonal antibody cell identification techniques. Baseline data were collected from both cervical mucus and smears sampled before treatment by donor insemination. Donor insemination was timed to coincide with ovulation by monitoring plasma LH concentrations twice daily. Following insemination the numbers of leukocytes were recorded in cervical mucus and smear samples taken over a 24-h period relative to the time of treatment. Controls treated with "pure sperm," seminal plasma, cryopreservative, and cervical smearing alone were also included in the study. RESULTS: Only those women treated with sperm cells exhibited substantial elevations in leukocyte numbers following inseminations. Additionally, serial cervical smearing induced an inflammatory response of the cervix. In all the women, the neutrophil was the predominant leukocyte of the cervix both during the baseline and treatment periods (median values ranged from 77 to 86%). Macrophages, T-helper lymphocytes, and T-suppressor lymphocytes were also detected, but only in low numbers (2-10.6%). Two patients and one control ("pure sperm") became pregnant during their study cycle. CONCLUSIONS: We conclude that the leukocytic reaction is a physiological response of the cervix to sperm, the function of which remains to be established.
Cell Movement↗
Origin of reactive oxygen species in human semen: spermatozoa or leucocytes?
Peroxidative damage induced by reactive oxygen species (ROS) has been proposed as one of the major causes of defective sperm function. In previous studies of the production of ROS in semen, the contribution of contaminating leucocytes was not assessed. We determined the levels of ROS in 60 semen samples from men attending our infertility clinic and demonstrated by performing extraction experiments with antibody-coated magnetic beads that, within this unselected population of patients, leucocytes were the major source of ROS in the low-density Percoll fraction. Of the sperm motion parameters examined using computerized semen analysis, beat-cross frequency was the only one significantly affected by the ROS in semen.
Cell Separation↗
Detection of white blood cell populations in the ejaculates of fertile men.
Using a now established, reliable technique for detecting white blood cells in human semen, we have examined the ejaculates of a fertile group of men. We have also highlighted the need for strict recruitment criteria to be established to enable accurate comparisons to be drawn between different patient groups and results from different laboratories.
Antibodies, Monoclonal↗
Sperm transport in the human female reproductive tract--a dynamic interaction.
The interaction between sperm and the human female tract has been largely ignored. This review summarizes the data available from animal species with specific reference to sperm in the oviduct. Our knowledge of sperm transport within the human female tract is explored and, using the data available from animal species, three lines of future experimental design are suggested. Firstly, there is the need to improve and develop techniques to recover sperm successfully from the tract. Second, an in-vitro approach which examines the modulation of reproductive tract fluids on sperm function is advocated. Third, an in-vitro tissue/cell culture system is required to investigate in more detail the interaction between the epithelium and sperm. Using such approaches many of the questions posed in this review can be addressed confidently in the near future.
Animals↗
Seminal white blood cells in men with urethral tract infection. A monoclonal antibody study.
Monoclonal antibodies were used to detect seminal leucocytes in 19 men with urethritis. A wide range in the number and type of leucocytes between individuals was documented (median 2.06 x 10(6)/ml, range 0.6-29.89 x 10(6)/ml); 22% of the men had less than 1 x 10(6) leucocytes/ml. The results suggest that the threshold of greater than or equal to 1 x 10(6)/ml proposed by the World Health Organisation to indicate genital tract infection is unsuitable for men with urethritis.
Antibodies, Monoclonal↗
Positive immunoselection--a method of isolating leukocytes from leukocytic reacted human cervical mucus samples.
In this brief communication we report a simple and accurate method of isolating and quantifying specific leukocytes from midcycle human cervical mucus, using monoclonal antibody-coated magnetic beads. Cervical mucus samples (pre- and postinsemination) were broken down enzymatically and incubated with a series of these beads. This method of positive immunoselection consistently retrieved representative levels of leukocytes (means = 73.8% +/- 1.59%; mean leukocyte retrieval rate +/- S.E.) from the cervical mucus samples. Significantly more leukocytes (P less than 0.0001) were isolated from the postinsemination samples, the predominant leukocyte of which was the neutrophil, which comprised 83% of the leukocyte population. These results reaffirm that a leukocytic influx is initiated across the human uterine cervix following the introduction of semen samples, the function of which is possibly phagocytic clearance of the nonfertilizing population of sperm.
Antibodies, Monoclonal↗
Peritoneal sperm recovery can be consistently demonstrated in women with unexplained infertility.
Diligent analysis of PF 10 to 20 hours after midcycle intracervical insemination with husband's semen in couples with unexplained infertility showed that sperm are consistently able to transverse the reproductive tract in this group of patients. However, this finding does not necessarily imply that the sperm were retained at the site of fertilization or that they were competent to achieve oocyte fertilization. Therefore, further experiments obtaining sperm from the tubal isthmus to assess the effects of their sequestration there on their ability to fertilize human oocytes are needed.
Adolescent↗
Donor insemination--a look to the future.
In this article we have reviewed many aspects of donor insemination. The deficiencies in the screening of semen donors especially for sexually-transmitted diseases has been discussed and importance of a rational protocol for recruitment and screening of potential donors has been emphasized. Factors influencing the success and outcome of donor insemination have been reviewed with particular emphasis on providing prognostic guidelines to potential donor insemination couples as to the success and outcome of the treatment. The importance of accurate timing of inseminations in determining the success of donor insemination has also been discussed. However, as has been highlighted throughout this review, there is a lack of specific prospective controlled trials, which are clearly necessary to answer specific important questions. Also emphasized has been the need of these trials to answer such basic questions as the influence of accurate timing on conception rates in specific groups of insemination recipients.
Female↗
Using a donor insemination management system.
A computerized database management system has been developed for an expanding donor insemination service. The programs have been written in dBASEIV language and they will run on a single personal computer (IBM or compatible, with a hard disc) or on a network. The central database enables access to stock, donor and couple details and routine statistics e.g. pregnancy rates, although levels of access to the system are restricted by password control. The central database provides an archival component, with data recorded on a daily basis, a service management component assisting in the routine administration of a donor insemination service, a financial component and a statistical component providing for both local and national statistics. Data may be converted for use in other software packages, e.g. SPSSX, SAS (statistical packages), encouraging data manipulation and enabling specific research questions to be addressed more readily.
Database Management Systems↗
Functional significance of white blood cells in the male and female reproductive tract.
The functional significance of white blood cells in the modulation of an anti-sperm antibody response, prevention of infection (including HIV) sperm transport/storage and sperm function is extensively discussed. A critical review of the existing literature is presented with future experimental lines of investigation outlined. A lack of controlled clinical studies in the human to validate data from animal species--for example--the involvement of white blood cells in the transport and storage of sperm in the female tract and the possible adverse effect of pathology (i.e. endometriosis) on these functions are presented. In conclusion, with the advent of modern techniques, e.g. monoclonal antibodies and sophisticated sperm function tests, many of the questions raised should be answered in the near future.
Female↗