Extracellular volume and ionic content of frog ventricle.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to D Lurie.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The results of the sperm count, motility, and hamster oocyte penetration (SPA) tests have been found to vary greatly in individuals who have had tests performed on more than one occasion. The study presented herein was designed to evaluate the stability of the hypoosmotic swelling (HOS) test over time. A total of 444 patients were classified into categories according to the time interval between HOS tests: 0-90 days (n = 267), 91-180 days (n = 35), 181-270 days (n = 37), 271-360 days (n = 30), 1-2 years (n = 54), and > 2 years (n = 21). A paired t test was used to compare mean HOS scores. The correlation between the HOS test of the first specimen and the HOS of the second specimen was calculated. For those who had 2 tests the only significant difference was found in the > 2 year group (69.67 +/- 9.13 vs. 64.23 +/- 12.83%), p < .05. When comparing the first and third HOS test in 74 patients, there was a significant (p < .05) decrease in the later test when the interval was greater than 270 days. The difference was not significant when the HOS results were classified as subnormal (< 50%) and normal (> or = 50%) for that same time period. It would appear that this test is reproducible, rarely fluctuates, but tends to become less dependable over longer intervals of time.
A comparison was made of three sperm separation techniques--direct swim-up, mini-Percoll, and Sephadex G-10--on semen parameters, including count, % motility, forward progression, and hypoosmotic swelling (HOS) test scores. Overall, the best quality sperm (less debris, best % and quality motility, and best HOS scores) were noted with the direct swim-up procedure. Mini-Percoll resulted in the highest count, but the worst HOS score. Sephadex G-10 resulted in quality of semen specimen almost as good as the direct swim-up procedure, but did allow some noncellular debris and bacteria to filter through the column.
Many previous studies evaluating various hormone levels in males with subnormal semen analyses were performed when the normal semen parameters were considerably higher than now. This study evaluated sera levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TET), free TET, and prolactin (PRL) in 60 males with oligospermia and decreased motility according to recent World Health Organization standards. Three separate groups were evaluated: group 1, motile density (MD) < 5 x 10(6)/mL (but not azoospermia); group 2, 5 < or = MD < 10 x 10(6)/mL; group 3, MD > 10 x 10(6)/mL, but % motility < 30%. There were no significant differences in mean FSH levels between groups. Overall FSH was increased in 47.1% of the cases. In contrast, mean LH levels were normal in all three groups. Only 17.3% of the entire group had elevated LH levels. The TET level was below normal in 32.3% of the entire group, with a fairly equal distribution between the three groups. Overall, only 7.8% had elevated PRL levels, with the highest percentage found in group 3 (22.2%). Only a small minority of patients with increased FSH had low TET levels compared to 48.0% of those with normal FSH. These data demonstrate that when using the lower semen parameters, the most common serum hormone abnormality is increased FSH; men with MD < 5 x 10(6)/mL do not have a higher incidence of elevated FSH than those with higher MDs.(ABSTRACT TRUNCATED AT 250 WORDS)
Intrauterine insemination (IUI) has been used for the treatment of various causes of infertility, including unexplained infertility, male factor, and cervical factor. Some centers frequently use superovulation combined with IUI. The study presented herein attempted to evaluate the efficacy of IUI without superovulation in cases where all causes of infertility other than cervical or male factors have been eliminated. However, in the case of poor or absent cervical mucus, the use of controlled ovarian hyperstimulation (COH) may obscure the actual importance of the IUI, since it is possible that the poor cervical mucus is related to poor timing, inadequate follicular maturation, or low estradiol levels, which if corrected will obviate the need for IUI. In this study IUI was targeted for 36-40 h following the sera luteinizing hormone surge. A total of 108 patients were enrolled in this study: 47 with male factor, 61 with cervical factor. Patients were followed for a maximum of three cycles unless a pregnancy occurred within 3 months of treatment. Comparison of pregnancy rates (PRs) were based on diagnosis. The cumulative PRs per cycle for each of the three cycles studied were as follows: cervical factor--19.7, 36.8, and 36.8%; male factor--12.8, 29.3, and 38.3%. Thus, PRs were comparable for both groups after three treatment cycles. These data demonstrate that IUI is an effective therapy for cervical and/or male factor, even without superovulation.
Infertility due to male factor has been associated with reduced implantation rates despite normal fertilization. The mechanism responsible for lower pregnancy rates is not known. One cause of failure to achieve pregnancy despite transfer of embryos is impairment of zona pellucida (ZP) thinning, which inhibits the embryo from hatching despite initial cell cleavage. This study was designed to evaluate whether there is an association between the ability of the ZP to thin, as measured by ZP thickness on day of transfer, and subnormal semen parameters. Significant differences in ZP thickness (p < 0.05, Kruskal-Wallis) were noted according to median concentration of sperm, total motile sperm, and motile density in that these values were the highest in the group of embryos with the thinnest zona pellucida and lowest in the group with the thickest zona pellucida. Thus, some factor may be missing from sperm from subnormal specimens that normally assists in zona thinning.
OBJECTIVE: To compare the midcycle endocrine steroidal variables in 32 infertile women with follicular maturation defects treated with ultra-low-dose pure follicle-stimulating hormone (FSH) or human menopausal gonadotropins (hMG). METHODS: A crossover design was used in which women were randomly assigned to a treatment modality (pure FSH or hMG) in the first cycle, and the alternative treatment was used in the second cycle. In the ultra-low-dose regimen, the dosage began at 1 ampule/day (75 IU) and could increase to a maximum of 1.5 ampules/day. The mean midcycle serum levels determined at the time of peak follicular maturation and before the administration of human chorionic gonadotropin or gonadotropin-releasing hormone for release of oocytes were compared. RESULTS: In the pure FSH cycle, the mean estradiol (E2), progesterone, and luteinizing hormone (LH) levels were 316 +/- 119 pg/mL, 0.6 +/- 0.4 ng/mL, and 23 +/- 22 IU/L, respectively; in the hMG cycle, the mean E2, progesterone, and LH levels were 361 +/- 193 pg/mL, 0.5 +/- 0.4 ng/mL, and 21 +/- 18 IU/L, respectively. CONCLUSION: Ultra-low-dose gonadotropin therapy produces similar midcycle steroidal levels (E2, progesterone, and LH) whether or not LH is present in addition to FSH in the medications used for follicle stimulation.
The efficacy of intrauterine insemination (IUI) for male or cervical factor by age of female partner was determined in a retrospective analysis. Patients who underwent IUI therapy for cervical and/or male factor (n = 281) were classified by age at first IUI cycle: <40 years (n = 232), > or =40 years (n = 49). The indication for IUI was cervical factor if a postcoital test failed to show sperm with good forward progression at time of mature follicle; male factor was diagnosed if the semen analysis demonstrated either low count, low motility, antisperm antibodies, or subnormal hypoosmotic swelling test. Intrauterine insemination was performed in either natural cycles or following ovarian stimulation for the treatment of anovulation or follicular maturation defects. Cumulative probability of ongoing pregnancy (viable at end of first trimester) following 3 cycles of IUI was evaluated. Cumulative probability of ongoing pregnancy following 3 cycles of IUI was 28.2% for the younger group and 0.0% for the older group. The age groups did not differ in terms of infertility history, use of ovarian stimulation, or baseline semen parameters. Thus, the treatment of male and/or cervical factor by IUI is ineffective for women > or =40 years.
The objective of this study was to investigate the association of rapid and linear progressive motility in seminal and Percoll-separated sperm with the outcome of intrauterine insemination (IUI) and in vitro fertilization (IVF) cycles. Motility was graded using the qualitative system proposed by the World Health Organization: grade A, rapid and linear, grade B, slow or nonlinear; grade C, non-progressive; or grade D, nonmotile. Absence of rapid and linear motility was defined as grade A sperm absent. Nine-hundred-fifty IVF and 1,448 IUI cycles were analyzed. In 7.9% (75) of the IVF cycles, grade A sperm were absent in the semen. Although the mean fertilization rate was lower in the absence of grade A sperm in the semen (44.5% vs. 63.4%, P < 0.05), the pregnancy rates were similar irrespective of their presence or absence (18.7% vs. 17.8%). In the cycles in which grade A sperm were absent following Percoll separation (26/950; 2.7%), the fertilization rate (29% vs. 62.8%) and the clinical pregnancy rate/retrieval were significantly lower (3.8% vs. 18.3%, P < 0.05). In 26.4% (382) of the IUI cycles, grade A sperm were absent in the semen and conception occurred in 30 (7.9%), compared to a pregnancy rate of 10.4% in the group with grade A sperm present in the semen. Following Percoll separation, only a 2.5% (2/80) pregnancy rate was observed in the group with no grade A sperm, compared to 10.2% in the group with grade A sperm (P < 0.05). The absence of rapid and linear motile sperm in the Percoll-separated sperm significantly reduced fertilization rates in vitro and pregnancy rates in both IUI and IVF cycles. The use of the total number of grade A sperm was also effective in predicting reduced fertilization in IVF and reduced pregnancy rates in IUI, but no better than the use of the mere presence/absence of grade A sperm. In a clinical situation, the simpler test is preferable. This type of evaluation is available to all centers as opposed to the more expensive computer-assisted semen analysis.