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Biomedical subjects

J H Check

Publications and source records attributed to J H Check.

At least 307 records · Page 17Linked to original sources
PubMedDate not supplied

Evaluation of sperm nuclear morphology in specimens with abnormal sperm chromatin structural assays.

Two recent tests have claimed to identify the subfertile male even when other semen parameters were normal: the sperm chromatin structure assay (SCSA) and abnormal sperm nuclear morphology using much higher magnification. The present study attempted to determine if having a high (> 30%) DNA fragmentation index (DFI), thus resulting in an abnormal SCSA test, is associated with a greater likelihood of sperm with abnormal nuclei. Four males with high DFI scores (57.6%, 65.4%, 31.0%, and 35.3%) had their nuclei evaluated by a complex microscope set-up that magnifies the sperm at least 6000x. The corresponding % of normal nuclei was 0%, 20.0%, 23.7% and 40.0%. The mean and median % of normal nuclei was 20.9+/-16.43 and 21.8, respectively. More studies of similarly matched refractory in vitro fertilization cases, where males have normal DFI scores, are needed to determine if having a high DFI index is associated with a lower percentage of normal nuclei.

Cell Nucleus↗
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Effect of an abnormal sperm chromatin structural assay (SCSA) on pregnancy outcome following (IVF) with ICSI in previous IVF failures.

A high DNA fragmentation index (DFI) when performing the sperm chromatin structural (SCSA) assay was claimed to be so specific for male subfertility that even IVF and ICSI did not result in live pregnancies. The present study was designed to corroborate or refute these findings. The SCSA test was performed on the male partner from couples failing to have a successful pregnancy despite at least 2 previous IVF attempts. In contrast to the aforementioned studies, ongoing pregnancies were found despite working with a group of recalcitrant patients. Nevertheless, a high DFI score was associated with a trend for lower ongoing pregnancy rates especially related to a high miscarriage rate. Other more recent studies seem to support our conclusions. A high DFI score should influence a patient to choose IVF as a therapeutic modality sooner, especially with ICSI.

Chromatin↗
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Absence of sperm with rapid motility is not detrimental to IVF outcome measures when ICSI is used.

The objective of the current study was to investigate the association between rapid motility of sperm and IVF outcome when ICSI is used for insemination of oocytes. The first IVF cycle of women up to age 42 were evaluated. Patients were classified into groups by the presence/absence of sperm with rapid motility ("A" sperm) in the specimen before and after sperm preparation. Group 1 had 0% A sperm prewash and 0% A postwash (n = 45); Group 2 had 0% A sperm prewash but some A sperm postwash (n = 47); Group 3 had A sperm both pre and postwash (n = 141). Statistical analysis demonstrated no difference in the fertilization, PRs, or implantation rates in the three groups. These data suggest that absence of sperm with rapid motility postseparation of sperm from seminal plasma is not detrimental to IVF outcome when ICSI is used for insemination.

Adult↗
PubMedDate not supplied

Oligoasthenozoospermia is not associated with spontaneous abortions following in vivo pregnancies contrasting with in vitro fertilization data.

Previous data showed an association between low motile density (< 10 million motile/mL) and spontaneous abortion (SAB) following in vitro fertilization-embryo transfer (IVF-ET). The purpose of this study was to determine if the same association existed following intrauterine insemination (IUI). A retrospective review of IUI pregnancies was conducted. Patients with antisperm antibodies, a low hypo-osmotic swelling (HOS) test score (< 50%), or those using donor sperm were excluded. A total of 52 couples were enrolled in the study: 34 in the normal motile density (MD) group and 18 in the low MD group. The SAB rate in the normal group was 29.4% and in the low group was 27.8%. Thus, these data fail to corroborate the conclusions reached after evaluation of IVF pregnancies that low MD is a cause of SAB. However, since there is a large difference in the number of sperm that come in contact with the oocyte following IVF versus IUI, it may be that the implantation defect is not evident until the oocyte is exposed to a certain number of abnormal sperm.

Abortion, Spontaneous↗
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Sperm extracted and cryopreserved from testes several hours after death results in pregnancy following frozen embryo transfer: case report.

A 38-year-old male died suddenly on his honeymoon. Sperm was extracted from his testes 3 h following his death and cryopreserved. His wife had in vitro fertilization (IVF) and the eggs were inseminated by intracytoplasmic sperm injection (ICSI). None of the sperm were motile. Selection was based on softness and pliability. There were 4 embryos formed that cleaved, but only 2 were transferred on the retrieval cycle. The wife failed to conceive, but then had a second transfer of the 2 cryopreserved embryos. She achieved a chemical pregnancy with the beta-human chorionic gonadotropin level attaining a maximum level of 107 mIU/mL (rising from 19 mIU/mL). Though this retrieval cycle did not result in a successful pregnancy the achievement of a clinical pregnancy following frozen embryo transfer at least provides cautious optimism for other cases with similar conditions.

Adult↗
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Poor hypo-osmotic swelling test results from cryopreserved sperm despite preservation of sperm motility.

Cryopreservation thawing of sperm leads to decreased motile density. Most donor programs select for cryopreservation a male with a high initial motile density and if the post-thaw semen has a motile density over 10 x 10(6)/ml, the specimen is thought to represent a fertile specimen. Some recent data suggest that males with normal motile densities but subnormal hypo-osmotic swelling (HOS) tests may be infertile. A study was thus performed to see if males with an adequate motile density after cryopreservation may still demonstrate membrane damage as evidenced by decreased viability and a poor HOS test. The semen species from seven men with motile densities greater than or equal to 10 x 10(6)/ml after freeze-thawing were evaluated for HOS changes and viability. Despite preservation of normal motile density, all 7 men had HOS scores below 50% following cryopreservation (though all were significantly above this level pre-freeze). The mean viability and HOS scores prefreezing were 70 +/- 9.7 and 68.5 +/- 9.5, and post thaw they dropped to 33.7 +/- 6.9 and 32.8 +/- 6.2. These data suggest a mechanism for impaired fertility even with adequate motile density of a thawed specimen that had been cryopreserved.

Cryopreservation↗
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Fresh versus frozen seminal plasma for enhancing sperm motility in asthenozoospermic males.

Previous data demonstrated improvement in severe asthenozoospermia in men with retrograde ejaculates by adding donor seminal plasma (DSP); interestingly, no such improvement was demonstrated following suspension in Ham's F-10 medium. A study was performed to examine whether DSP would also improve asthenozoospermic ejaculates from men with antegrade semen. In addition, the study further explored whether the ameliorative effect of DSP could be maintained after freeze-thawing. The mean increase in motility following fresh DSP in 37 specimens was 102% and was -1.3% for DSP frozen at -20 degrees C and 16.7% for DSP frozen at -196 degrees C. The only statistical difference (using Student's t test) was seen in the comparison of fresh DSP to DSP frozen at -20 degrees C (p = .001). Nine of twenty-four men exhibited doubled baseline motility rates following addition of fresh DSP, compared to only 1 of 20 and 1 of 5, respectively, following addition of semen treated with DSP frozen at -20 degrees C and -196 degrees C, respectively. The data suggest that poor motility may improve when DSP is added to the specimen. However, proper quarantine may not be possible because efficacy is lost after freezing.

Cryopreservation↗
PubMedDate not supplied

Effect of antisperm antibodies on computerized semen analysis.

The effect of antisperm antibodies (ASA) in males was determined in 239 men by the use of a computerized semen analyzer (CASA). ASA was assessed using the direct immunobead test (IBT). Sperm variables for men with positive ASA were significantly lower than those with negative results in percentages of motility, velocity, and linearity.

Autoanalysis↗
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Effect of time interval between ejaculations on semen parameters.

The suggested abstinence period prior to performing a semen analysis has been 2-5 days. If one allows too long of an interval between ejaculates, motility will decrease significantly. This study was designed to evaluate whether any of the semen parameters change with increasing intervals of time between ejaculates and, if so, what parameters are involved. A derived calculation total-live sperm count (product of count/milliliter x volume x percent motility) was significantly lower at 3 days than at 7-, 10-, and 14-day intervals. Sperm count and motility showed a significant decrease at 14 days as compared to 7 days but not to 3 days. There were no significant differences between motility, the hypoosmotic swelling test, velocity, linearity, motile density, or morphology (with strict criteria). The ideal abstinence interval is between 7 and 10 days not 2-3 days, and motility does not appear to significantly decrease with a long interval between ejaculates.

Analysis of Variance↗
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Adverse effect of clomiphene citrate on sperm morphology.

The beneficial effect of clomiphene citrate (CC) in treating male infertility is controversial. To evaluate the effects of CC on sperm morphology using strict criteria, the semen analyses of 74 men were evaluated at intervals ranging from 1 to 18 months of treatment. Seventy patients receiving no medication were used as control. The patients in each category were divided into three subgroups: A (1-3 months), B (4-6 months), and C (greater than 6 months). In the control group, there were no significant differences in percentages or total normal forms between baseline and repeat semen analysis at any interval. Treatment with CC for 1-3 months did not adversely affect percentages of normal forms. Treatment for greater than 3 months caused a highly significant decrease in percentage of normal forms. Three months of CC caused no change in the absolute number of morphologically normal sperm, but longer periods (greater than 6 months) were associated with a significant decrease. There was significant deterioration of sperm function as measured by percentage of normal forms in patients treated with CC for 4-18 months. The physiological clinical significance remains to be investigated.

Clomiphene↗
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Detrimental effects of cryopreservation on the structural and functional integrity of the sperm membrane.

Many centers have been disappointed with the pregnancy rate following the insemination of cryopreserved-thawed sperm, despite the maintenance of an adequate motile density. The possibility exists that damage to the sperm membrane might occur despite preservation of other semen parameters. Simple measurements of structural integrity (viability) and functional integrity (hypoosmotic swelling test) were performed on thawed specimens. In each instance, both the viability and HOS scores were less than the critical 50% level. Specimens from three different commercial centers had very poor HOS and viability scores from two of the centers, and, though the scores were generally greater than or equal to 50% from the third center, this was achieved by eliminating 11 of 12 donors. Reducing the glycerol concentration from 12 to 7% and switching from Nunc vials to plastic embryo straws did not improve the poor sperm membrane tests. The possibility exists that if modification of the cryopreservation technique leads to improved HOS and viability scores, perhaps improved pregnancy results will be realized.

Cell Membrane↗
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Evaluation of sperm morphology using Kruger's strict criteria.

Prospective and retrospective studies were conducted to evaluate sperm morphology using strict criteria for predicting fertilization capacity in males. Severely impaired male fertility potential was measured by a result of less than or equal to 4% (denotes percentage sperm having normal morphology) and scores of greater than 14% indicated normal fertilization potential. There were no statistically significant differences found in pregnancy rates in partners of men with normal morphology of less than or equal to 4% vs. those with 14% or greater (chi 2 analysis): the prospective study showed a 41% pregnancy rate in less than or equal to 4% group vs. 29% rate in greater than 14% group (p = 0.44 NS); the retrospective analysis showed a 50% pregnancy rate in the group with less than or equal to 4% morphology scores vs. 67% in greater than 14% group (p = 0.45 NS). When only the men with normal motile density (greater than 10 x 10(6)/ml) were evaluated, a statistical difference was found in the retrospective study between the group with morphology results greater than 14% (93%) vs. the group less than or equal to 4% (40%). However, the 56% success rate in the men with less than 10 x 10(6)/ml sperm and normal morphology less than or equal to 4% reduces the significance of the diagnosis of sperm morphology using the new strict criteria.

Evaluation Studies as Topic↗
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Effect of antisperm antibodies on postcoital results and effect of intrauterine insemination on pregnancy outcome.

The effect of antisperm antibodies (ASA) in males was determined in 59 men using the direct immunobead test (IBT). Postcoital tests were evaluated in couples for whom all female factors appeared to be corrected. Pregnancy rates in 6 months were compared in couples with good postcoital tests vs. those with poor results; the latter group was treated with timed intrauterine insemination (IUI). Thirty-one percent of males with positive ASA (greater than or equal to 50%) had normal postcoital tests and all four achieved pregnancies. Fifty-six percent of men with positive ASA and poor postcoital scores achieved pregnancies following IUI therapy of their wives in 6 months; 83% of couples with normal postcoital tests achieved pregnancies as did couples treated with IUI when the postcoital was poor but the male ASA negative.

Antibodies↗
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Standard sperm morphology as a predictor of male fertility potential.

There are many clinicians who believe that standard sperm morphological criteria as determined by the World Health Organization (WHO) may be one of the most reliable indices of male fertility potential. Many previous studies of sperm morphology have lacked meticulous correction of all female infertility factors in forming their conclusions. Other studies may have compared morphological analysis to either the zona-free hamster oocyte penetration test or fertilization rates with in vitro fertilization/embryo transfer (IVF-ET). The former may not be a valid "gold standard" with which to compare, and the latter might not truly reflect the in vivo situation in view of the markedly different type of sperm-oocyte interaction. These data failed to find a strong correlation of abnormal sperm morphology (as determined by WHO criteria) to identify the subnormal male. When motile densities were normal (greater than 10 x 10(6)/ml), 87% of the female partners of men with normal morphology achieved pregnancies within 6 months compared to 82% with subnormal morphology. Even subnormal motile densities and morphology did not predict the subfertile male. These data strongly suggest that the normals established by WHO for morphology are inadequate to distinguish normal from subnormal. Perhaps increasing the percentage of abnormal sperm morphology to be considered subfertile might prove more useful, or perhaps using another type of morphological assessment might be more effective.

Female↗
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Stability of the hypoosmotic swelling test over time.

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.

Humans↗
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Hypoosmotic swelling: evaluation of sperm tails using strict criteria in cases of globozoospermia.

The semen from two men with globozoospermia was evaluated for hypoosmotic swelling changes and morphologic evaluation of the tail using strict criteria. No abnormalities were noted. Globozoospermia is due to a genetic defect that results in the absence of acrosomal structures. The acrosomal vesicle in the Golgi region does not develop in close contact to the nucleus, which results in the formation of globe-shape heads. Although some semen parameters were abnormal in both cases, they were different types, suggesting no association with round-headed sperm.

Adult↗
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Effects of Percoll discontinuous density gradients vs SpermPrep II vs Sephadex G-50 gel infiltration on semen parameters.

There are various methods of separating sperm from seminal plasma for subsequent intrauterine insemination. Some of these same techniques have been employed for female sex selection. The purpose of the present study was to assess and compare semen parameters following Sephadex, Percoll, and SpermPrepII separation techniques. The SpermPrepII is also a Sephadex preparation but uses a different bead size, less Sephadex, and is a slightly quicker method. The specimens (n = 16) were initially evaluated for count, (C; x 10(6)/mL), percent motility (MO), grade of motility (GR; percent) and hypoosmotic swelling (HOS) test scores. Each specimen was then divided into three equal aliquots and prepared as follows: (1) layered onto a modified Percoll discontinuous density gradient column; (2) processed using SpermPrepII; and (3) filtered through a Sephadex gel filtration column (G-50). The results show all three treatments yielded lower (P < 0.01) counts as compared to control values, but no differences were noted among them. Percoll SpermPrepII increased MO (P < 0.01) whereas Sephadex reduced it (P = NS). Percoll and SpermPrepII improved the percentage of better quality sperm but not Sephadex; SpermPrepII was slightly higher than Percoll, but the difference was not significant. There were increases (P < 0.05) in HOS values in all experimental treatments, with SpermPrepII having the highest scores. However, this study did not show as many males with HOS scores below 50% as noted in other studies. Percoll and SpermPrepII seem to be equally effective methods for producing high-quality sperm for intrauterine insemination or in vitro fertilization.

Cell Separation↗