[Assessment of the fertilizing capacity of human spermatozoa using the zona free hamster ova penetration test].
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Biomedical subjects
Publications and source records attributed to E J Margalioth.
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Hyperprolactinemia associated with male infertility or impotence was found in ten patients. Mean prolactin level was 83 +/- 49 ng/ml (range 46-26- ng/ml). The etiological bases of the hyperprolactinemia were a microadenoma in one patient, liver disease in two, and idiopathic in seven patients. Bromocriptine treatment, 2.5-7.5 mg daily for 8-16 weeks lowered prolactin to normal levels in all patients. Three oligoasthenospermic subjects showed a marked increase in sperm motility; their wives conceived within 5-8 weeks of treatment after longstanding infertility. Two of these women gave birth to normal babies and one aborted in the first trimester of pregnancy. The mechanism by which hyperprolactinemia interferes with sperm production and the effect of bromocriptine on this mechanism is discussed.
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Four out of 19 male patients suffering from familial Mediterranean fever (FMF) had fertility problems while on colchicine therapy (0.5-2.0 mg daily for as long as 11 years). Three of the patients had had children while off therapy but their wives could not conceive while they were on therapy. In one patient primary sterility remained one year after cessation of colchicine. In this and two other patients the spermiogram was normal but the sperm penetration test was pathological. The fourth patient had azoospermia. Patients should be informed about this possible risk of colchicine therapy. The need for continued follow-up and the value of the sperm penetration test in the detection of fertility problems in male patients on long-term colchicine therapy are stressed. It is concluded however, that overall the benefits outweigh the danger of long-term colchicine treatment in male patients with FMF.
A successful pregnancy resulting from in vitro fertilization and embryo transfer in which bromocriptine was utilized for ovulation induction is reported. Suppression of transient hyperprolactinemia during induction of ovulation is suggested.
The Percoll density-gradient technique was used to select motile sperm from men who exhibited abnormal semen analysis or unexplained infertility. The fertilizing ability of the spermatozoa was evaluated by the hamster ova sperm penetration assay (SPA). The current work is a novel approach in the usage of Percoll in an attempt to improve the quality of the sperm of nonfertile patients and to examine its results by SPA. The method succeeded in improving the penetration score of the fertile controls by 15% to 30%. However, no improvement of the low penetration score of the nonfertile patients was demonstrable. The difficulties inherent in using the Percoll density gradient technique are discussed.