[Artificial insemination in the AIDS era].
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
G Paz
Publications and source records attributed to G Paz.
The use of hemizona assay in the evaluation of the optimal sperm preparation technique.
The objective of the study was to evaluate the benefit of different sperm preparation methods by using the hemizona assay. A total of 58 men admitted to the male infertility clinic for evaluation were tested by routine semen analysis and hemizona assay. Five different techniques (swim-up, TEST-yolk buffer, Percoll, pentoxifylline and progesterone) were used for preparation of sperm suspensions. The effect of these treatments on the sperm-binding capacity using the hemizona assay was assessed. The routine swim-up preparation was used as the reference method. Of the four preparation methods, only the TEST-yolk buffer and pentoxifylline exhibited an overall statistically significant improvement in sperm-binding capacity in comparison with the swim-up preparation method (P = 0.01 and 0.001 respectively). Following preparation with Percoll and progesterone there was no change in the mean value of binding capacity, compared with swim-up. However, examination of the effect of the four treatments on each specimen individually yielded a diversity in the response, e.g. having the capability to enhance, damage or be ineffective in sperm binding capacity. The results support the conclusion that in-vitro sperm preparation methods can affect sperm binding to the zona pellucida. Since there is a diversity in the response of sperm samples to different treatments, the hemizona assay can be used in selecting the optimal sperm preparation method prior to its use for assisted reproductive techniques. This is advocated mainly for the 'male factor' group.
Cell Separation↗
Female age does not affect the capacity of human zona pellucida to bind spermatozoa.
The purpose of this study was to evaluate the effect of female age on the capacity of the zona pellucida to bind spermatozoa. A total of 1008 unfertilized oocytes obtained from 210 women (aged 21-43 years) participating in the in-vitro fertilization programme were tested using a hemizona assay. Spermatozoa taken from a cryopreserved pool of fertile donor specimens served as a control in the hemizona assay, and were used to assess the ability of the zona pellucida to bind spermatozoa. The mean +/- SD number of spermatozoa attached to the hemizona was 107 +/- 42. The binding capacity of different oocytes from the same cohort varied substantially (coefficient of variation = 28%). Age was not found to be correlated with the number of spermatozoa bound to the zona pellucida (r = -0.02; P > 0.1). It was concluded that female age has no role in the ability of the human zona pellucida to bind spermatozoa.
Adult↗
Immigrant families coping with schizophrenia. Behavioral family intervention v. case management with a low-income Spanish-speaking population.
BACKGROUND: This investigation compared the effectiveness and cross-cultural applicability of behavioural family management (BFM) and standard case management in preventing exacerbation of symptoms and relapse in schizophrenia. METHOD: Forty low-income Spanish-speaking people with a diagnosis of schizophrenia were randomly assigned to receive standard case management or behavioural family management after stabilisation with neuroleptic medication. RESULTS: Survival analyses indicated that among the less acculturated patients BFM was significantly related to greater risk of exacerbation of symptoms. Among the more acculturated patients, risk of exacerbation could be predicted by medication compliance but not by type of intervention. In analyses of symptom severity and functional status at 1-year follow-up, the level of patient acculturation was found to be significantly related to various measures of treatment outcome. CONCLUSION: Sociocultural factors affect responses to different types of intervention. The results did not support earlier findings of a beneficial effect of BFM when applied to a socioculturally diverse population.
Acculturation↗
Pentoxifylline improves sperm binding to the zona pellucida in the hemizona assay.
OBJECTIVE: To evaluate the effect of pentoxifylline on sperm binding capacity to zona pellucida (ZP) using the hemizona assay (HZA). DESIGN: The fertility potential of 82 men was evaluated by routine semen analysis. Each ejaculate was incubated with or without pentoxifylline (3 mM) in Ham's F-10 medium (Flow Laboratories, Irvine, Scotland) before the HZA. The effect of the pentoxifylline treatment on sperm-binding capacity to ZP was assessed by the hemizona index. RESULTS: The mean hemizona indexes with medium or pentoxifylline treatment were 23% +/- 2.1% (mean +/- SE) and 41% +/- 3.4%, respectively. Taking into consideration a significant change of the hemizona index on rising above the intra-assay coefficient of variation (+/- 8%) after pentoxifylline treatment, 73.1% of specimens improved, 19.5% deteriorated, and 7.4% remained unchanged. Using a threshold hemizona index of 23% as a discriminator between fertile and infertile specimens, 43.5% of the "pentoxifylline-improved" samples ascended to the fertile zone (> 23%). No correlations were found between sperm variables in the raw semen and the effect of pentoxifylline on sperm binding capacity. CONCLUSION: Pentoxifylline may improve the binding capacity of human spermatozoa. However, this effect is confined to a selected group of patients and cannot be predicted by the basic sperm variables. Thus, to avoid uncertain or damaging effects of pentoxifylline while preparing sperm suspension for assisted reproductive techniques, it is recommended that its effect be tested by the HZA system before its use.
Female↗
Blood luteinizing hormone and prolactin concentrations in response to naltrexone challenge: studies on rats with diabetes induced by different doses of streptozotocin.
Opiate system involvement in diabetes induced by three different doses of streptozotocin (STZ; 40, 50, and 60 mg/kg body weight [BW]) was studied by monitoring luteinizing hormone (LH) and prolactin (PRL) levels as a response to naltrexone (Nalt) administration. After four weeks of diabetes a marked decrease in BW, as well as severe hyperglycemia and increased blood urea nitrogen (BUN) levels were found. The rats, whose diabetes was induced by 50 mg/kg of STZ, exhibited the highest amount of blood glucose (P < 0.05, compared with the 40 mg/kg induced group) and BUN levels (P < 0.004 compared with the other two groups) and BW loss. The normal response to Nalt, which is expressed by elevation of plasma LH and decreased plasma PRL levels was observed only in the low-dose STZ (40 mg/kg BW) diabetes-induced group, while in the other two diabetic groups (50 and 60 mg/kg BW) there was no significant change in plasma LH and PRL as a result of the Nalt challenge. Presensitization of the endogenous opioid receptors by morphine in normoglycemic (control) and "low-dose diabetic" rats (40 mg/kg BW of STZ), presented a clear difference between the two. Morphine pretreatment inhibited LH response to Nalt in the low-dose, STZ-induced diabetic rats, while no effect of morphine pretreatment on LH response to Nalt could be recorded in the normoglycemic group. Thus it can be concluded that in STZ-induced diabetes, plasma glucose and BUN levels do not reflect the neuroendocrine injury observed when monitored by LH and PRL secretion in response to Nalt challenge. Supersensitization of the opioid receptors before the Nalt challenge may increase the ability to reveal neuroendocrine system impairment.
Animals↗
The effect of egg yolk on the binding capacity of human spermatozoa to zona pellucida.
OBJECTIVE: To evaluate the effects of Tes and Tris (TEST)-yolk buffer (TYB) incubation on sperm function. DESIGN: Sperm samples obtained from 61 patients attending the infertility clinic were incubated in TYB and control medium. Binding to the zona pellucida (ZP), evaluated by the hemizona assay, membrane functional integrity evaluated by the hypoosmotic swelling test, and acrosome reaction and penetration through cervical mucus were assessed to ascertain the effect of TYB treatment. RESULTS: The only substantial effect of TYB treatment was enhanced sperm binding to the ZP. The mean number of sperm cells attached to the hemizonae with TYB or medium treatment, was 42 +/- 6.1 (+/- SE) and 31 +/- 5.8, respectively (n = 61). However, this improvement was most obvious in 12 patients whose sperm samples exhibited a marked increase in sperm binding capacity following TYB treatment compared to medium without TYB, 71 +/- 5.6 and 12 +/- 2.7, respectively. In the other sperm samples (n = 49), sperm binding capacity was similar following TYB and medium treatment (both 35 +/- 6.0). CONCLUSIONS: A 2-hour incubation of sperm samples with TYB-containing medium (at room temperature) enhances the binding capacity of human spermatozoa in approximately 20% of patients considered to have male factor infertility. The basis of this selective effect has yet to be studied further.
Egg Yolk↗
Retrograde ejaculation.
Retrograde ejaculation is an uncommon cause of male infertility. It should be suspected in any case of azoospermia, and might be congenital, acquired or idiopathic in origin. When pharmacological attempts to restore anterograde ejaculation fail, it is suggested that spermatozoa should be recovered from post-ejaculation urine to be applied in one of the modern techniques of assisted reproduction. The successful recovery of viable spermatozoa from the urine is dependent upon careful regulation of pH and osmolarity of the urine at the time of ejaculation. Careful handling of the retrieved spermatozoa enables isolation of sperm cells with good quality for insemination of ovulated oocytes (in vivo) or retrieved oocytes (in vitro).
Ejaculation↗
Serum prolactin response to ether stress in diabetic rats: opiate system contribution.
Diabetes in streptozotocin-treated rats is associated with alterations in various neuroendocrine systems, including endogenous opioids. These changes are suggested to be responsible for the significant reduction in serum prolactin (PRL) response to a brief restraint stress in diabetic male rats, as compared with normoglycemic controls. The present study examines serum PRL response to ether exposure in diabetic male rats. The animals' response to ether stress, which is known to be related to the opioid system, was examined twice in each rat: shortly after cannula insertion (Day 1), and seven days later. In order to evaluate the opiate system involvement, the experiment was repeated on Day 1 and 7 after surgery in a group of rats which were pretreated with naltrexone (Nalt), an opioid receptor antagonist. Opioid receptor sensitization was also performed by prior acute morphine administration on Day 7 after cannulation surgery. Following adaptation to the cannulation, no difference in serum PRL response to ether stress was found between diabetic and normoglycemic rats. However, on Day 1 after surgery, a significant difference was found between the diabetic and control groups: the normoglycemic (control) group exposed to ether responded to the surgical stress by augmented serum PRL levels. This response was not recorded in the diabetic rats. Opioid receptor blockade by Nalt administration 30 min before ether exposure eliminated this difference. Opioid receptor sensitization by morphine pretreatment facilitated PRL secretion in normoglycemic rats exposed to either, while no effect could be distinguished in the diabetic group. It is therefore concluded that the streptozotocin-induced diabetic rats do not differ from normoglycemic ones in their ability to respond to acute ether stress by itself. However, enhanced PRL secretion induced by ether exposure under additional surgical stress, or by presensitization of the opioid receptors by morphine, is prevented in diabetic rats, probably due to diminished opioid receptor response.
Animals↗
[Hemizona assay for evaluating fertilizing capacity of human spermatozoa].
The hemizona assay (HZA), which tests the binding capacity of human spermatozoa to the zona pellucida, is described. This assay has very high sensitivity (86-100%) in predicting fertilizing capacity in the in vitro fertilization (IVF) system. It is recommended that it be carried out on semen samples before entering the IVF program. In addition, it can also help evaluate unexplained infertility and assess the quality of ova. The necessity for a control fertilized sample in each HZA might complicate the assay. To simplify the test, the use of sperm from the sperm bank was investigated. It was shown that fresh and frozen-thawed sperm have the same capacity to bind to the hemizonae. Thus, frozen donor semen preserved in the sperm bank can be used for controlling the HZA.
Cryopreservation↗
Experimental uremia in male rats: effect on the reproductive tract and fertility.
Chronic renal failure was induced in 3-month-old male rats by 5/6 nephrectomy. Potency and fertility studies were performed after 3 months of chronic uremia. The mean serum testosterone at the end of the experiments was significantly lower: 0.96 +/- 0.14 ng/mL compared to a control group of sham-operated male rats, 2.86 +/- 0.59 ng/mL, p < .001. All the uremic male rats had normal accessory gland weights at the end of the study. Fertility and, in most animals, sexual behavior and mating were not different from the normal control group. It is concluded that in 5/6-nephrectomized uremic male rats, in spite of low testosterone level, fertility and reproductive system are maintained similar to normal control male rats.
Animals↗
[New methods for predicting sperm fertilizing ability].
There is no reliable method for screening for the fertilizing ability of sperm. 3 new methods are presented: the freezing test (FT), hypoosmotic swelling test (HOST) and migration-sedimentation test (MST). The first 2, test the functional integrity and stability of the sperm membrane under certain osmotic conditions. The MST determines ability to separate high quality sperm. All tests were performed using either fresh semen of husbands, or thawed semen of donors used for fertilization in the IVF unit. Results of the FT were not correlated with the fertilizing ability of sperm in IVF, but HOST results with fresh, but not thawed semen, were correlated. Fertilization of oocytes in IVF was significantly better when HOST value of fresh semen was 45% or more. Motility and morphological normality of sperm separated by MST were better in ejaculates that fertilized ova under in vitro conditions, than in those that did not. Sperm separation by MST of 25% or more of motile sperm, or of more than 1.5 million motile sperm in the sample, indicated statistically significant ability for oocyte fertilization in an IVF system.
Cell Membrane↗
[Risk of low birth weight in the Plaza de la Habana region].
The objective of this study was to confirm the risk factors (RF) for low birth-weight (LBW) and suggest new risk factors, which were analyzed separately and together, in order to define a program to be coordinated by family doctors to reduce the frequency of this problem. For this purpose, a retrospective cross-sectional survey was carried out with 57 cases (mothers who had had LBW babies) and 58 controls (mothers who had not had LBW babies). In addition, data were obtained from the prenatal records of mothers who received care at family doctors' offices and at the clinica in the Plaza de la Habana Area. Estimates were made of the relative risk and the percentage attributable risk of 107 hypothetical RF for LBW from a clinical-epidemiological and social standpoint. One-way analysis of variance, the chi-square test, multiple linear regression, and logistic regression were used to analyze the results, which suggested the following RF for LBW: family dysfunction, family crisis, lack of spousal support, extended family, failure to attend prenatal group sessions for pregnant women, and failure to receive education on how to prevent LBW. The multifactorial risk profile was the following: risk of [corrected] intrauterine growth retardation, family dysfunction, threat of preterm delivery, coffee-drinking, attendance at fewer than 11 prenatal checkups, and failure to attend prenatal group sessions for pregnant women. The variables excluded from the model were: low weight-for-height, lack of spousal support, smoking more than 10 cigarettes a day, and family history of LBW. The findings confirmed 10 of the suspected risk factors for LBW in Cuba and nine of those described in the international literature. Maternal age, spontaneous abortion, and alcohol consumption were not confirmed. Six RF for LBW preventable by the family doctor through his/her actions at the family and community level are identified, as is a multifactorial profile of six RF for LBW. On the basis of these results, proposals are made in regard to programming priorities and the implementation of strategies aimed at preventing LBW, and it is recommended that the study be continued with a larger sample.
Adolescent↗
[Chemical composition of seminal fluid as a diagnostic aid in clinical andrology].
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Humans↗
Mumps orchitis among soldiers: frequency, effect on sperm quality, and sperm antibodies.
This study reports on 72 young soldiers who suffered from a recent epidemic of acute mumps, with special emphasis on 19 who suffered from mumps orchitis and whose spermograms were in the fertility range. The immunological work-up for antibodies in sera or seminal plasma gave normal results for the patients diagnosed with orchitis, as well as the controls. The only remarkable finding was an increased risk of borderline significance for orchitis in smokers. The present study has proven that the presence of antisperm antibodies does not play a role in the etiology of mumps orchitis.
Antibodies↗
Improved fertilization rate in an in vitro fertilization program by egg yolk-treated sperm.
High fertilization and PRs have been achieved by using thawed donor sperm cryopreserved with medium containing EY. The aim of our study was to examine the possible effect of EY on the fertilizing capacity of fresh sperm in an IVF program. Preincubation of spermatozoa in EY for 2 hours at room temperature significantly improved fertilization (P less than 0.001) in couples who had low fertilization rates in previous cycles, whereas no effect was found concerning couples with high fertilization rates.
Egg Proteins↗
Fresh and frozen-thawed human sperm bind in a similar pattern to the zona pellucida in the hemizona assay.
This study evaluated the impact of sperm cryopreservation on sperm quality. The HZA was used to test the binding capacity of fresh as opposed to frozen-thawed sperm from 12 donors. Fresh and frozen-thawed sperm motility was 47% +/- 1.5% and 24% +/- 3.8% (mean +/- SE), respectively. However, the number of sperm cells attached to the hemizonae was 75 +/- 12.0 and 74 +/- 11.9, respectively. We conclude that cryopreservation results in a reduced number of motile sperm cells but does not adversely affect the ability of rescued sperm cells to bind to the ZP. The study also supports the use of frozen-thawed rather than fresh donor sperm for control in the HZA procedure.
Cryopreservation↗
Efficacy of varicocele embolization versus ligation of the left internal spermatic vein for improvement of sperm quality.
Efficacy of surgical varicocelectomy versus embolization of the spermatic vein was studied in 137 men diagnosed as suffering from left varicocele. The men were divided randomly into three groups according to the methods of treatment: A--embolization of the internal spermatic vein (51 men); B--Ivanissevich technique of high ligation of the spermatic veins (43 men); and C--Bernardi technique of high ligation (43 men). The groups were similar in terms of age, duration of infertility and possessed semen characterized as oligoteratoasthenozoospermia. The fertility of the female partners was evaluated carefully and they were found to be potentially fertile. Varicocele was diagnosed by at least two of the following methods: physical palpation during valsalva manoeuvre, venography, or scrotal scanning using the technetium pertechnetate radioactive method. Semen quality was assessed before treatment and at 3, 6 and 9 months post-treatment. Fecundity was followed-up for 18 months. The major results were: (i) Shrinkage of the varicocele was found in all three groups studied. The same rate of recurrence was recorded in the three groups (24%, 37% and 35% in groups A, B and C, respectively). (ii) Improvement of sperm quality was significant in groups A and B, with better results in group B. (iii) The pregnancy rate was significantly higher in group B, compared with A (38.2% vs. 20.6%; P less than 0.05). Thus, high ligation of the internal spermatic vein yields better results than low ligation or embolization as far as semen quality and pregnancy is concerned.
Embolization, Therapeutic↗