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[The effect of lectins on human spermatozoa in the capillary sperm penetration test].

The effect of the commercial lectin (Con A, PHA, SRA, WGA and UEA) as well as of the prepared by us extract from roots of Arum maculatum (Am and AM 80 degrees C) was studied on migration of human spermatozoa in bovine estrous cervical mucus, using the capillary sperm penetration test of Kremmer. It was established that Con A, PHA and AM inhibited the migration of spermatozoa in a concentration, in which they agglutinated human spermatozoa in vitro. Nonagglutinating human spermatozoa SBA and AM 80 degrees C inhibited also the migration of spermatozoa in the mucus.

Adult↗

Oral contraceptives and uterine peristalsis: evaluation with MRI.

PURPOSE: To evaluate the effects of oral contraceptives (OCs) on uterine contractility using cine MRI, and correlate the kinematic findings with the static findings. MATERIALS AND METHODS: Healthy female volunteers of reproductive age (23 taking OCs, and 15 not) were evaluated at mid-cycle. MR images were obtained with a 1.5T magnet, with 60 serial images taken every three seconds by half-Fourier acquisition single-shot turbo spin echo (HASTE) to be displayed in cine mode. Assessments were based on the 1) detectability of uterine peristalsis in cine mode, 2) peristaltic frequency and direction, 3) thickness of the endometrium, myometrium, and junctional zone (JZ) on T2-weighted images (T2WIs), and 4) intensity of the myometrium and cervical mucus on T2WIs and T1-weighted images (T1WIs), respectively. RESULTS: Uterine peristalsis was markedly decreased in the OC users. The endometrium and JZ were significantly thinner, and the myometrium was thicker in the OC users compared to controls. The signal intensity of the myometrium and cervical mucus was significantly higher in the OC users than in controls. CONCLUSION: OCs markedly suppressed uterine peristalsis at mid-cycle, and the uterus displayed a globular configuration with a thin JZ that may be related to decreased uterine peristalsis in OC users.

Adult↗

Stimulation of early embryonic development in cattle by coculture with surfactant.

PURPOSE: Our purpose was to determine the efficacy of Surfacten, a bovine pulmonary surfactant, on the maturation of in vitro bovine ova. METHODS: We used Surfacten as a supplement to the coculture media both at the onset of coculture and after cleavage in bovine ova had been determined. The controls received no Surfacten. RESULTS: The maturation rate in bovine embryos to the blastocyst stage statistically improved (P < 0.05) in the series in which Surfacten was added to the media at the onset of coculture, compared with the controls and the series in which Surfacten was added after cleavage had been determined. CONCLUSIONS: Surfacten, a commercially available surfactant which is a naturally occurring phospholipid that dramatically increases in the cervical mucus and the ampullaris of the oviduct at or near the time of ovulation, improves the maturation of bovine embryos in vitro by making the coculture medium approach the conditions found in the oviducts.

Animals↗

The sperm acrosome: functional and clinical aspects.

The acrosome of mammalian spermatozoa contains high amounts of acrosin, which is believed to be essential for gamete fusion, particularly for binding to, and penetration of, the zona pellucida. In addition, its activation from proacrosin seems to be associated with the capacitation process. Furthermore, it might facilitate cervical mucus penetration and intrauterine sperm migration by releasing kinins from kininogen, as well as participating in the acrosome reaction and in chromatin decondensation in the oocyte. Considering these functions of the acrosome during the process of fertilization, the morphology and functional integrity of the acrosome in ejaculated human spermatozoa are of fundamental importance in attachment, species-specific binding and zona penetration preceding gamete fusion. It is therefore mandatory to focus on acrosomal membrane functions and consider particularly the occurrence of acrosomal disturbances in spermatozoa from men of barren marriages. For this purpose, biochemical and immunocytochemical methods have been used to investigate acrosin activity and possible alterations of the acrosomal membrane system in different groups of sub- and infertile patients. Of particular interest is the ability of spermatozoa to undergo the acrosome reaction, which can be studied using the triple-stain technique. Of all the spermatological groups investigated (normo-, astheno-, oligo-, terato- and polyzoospermia), polyzoospermic semen samples showed severe acrosomal disturbances indicating functionally defective acrosomes which might hinder fertilization. The data indicate the need for the introduction of acrosomal markers in clinical andrology for proper diagnosis of acrosomal sperm defects.

Acrosome↗

Effect of cyclofenil on hormonal dynamics, follicular development and cervical mucus in normal and oligomenorrhoeic women.

Cyclofenil is a triphenylethylene derivative, similar in structure to clomiphene citrate, which is used to induce ovulation in anovulatory women. The effects of cyclofenil on a group of 10 normal cyclic and 10 oligomenorrhoeic subjects were examined in a double blind controlled cross-over study. Both groups of women were administered either cyclofenil or, following a washout cycle, a placebo in two treatment cycles. Urinary oestrone and pregnanediol excretion were measured daily and ultrasound scans performed to assess follicular development. Frequent sampling of blood was performed on day 6 to study luteinizing hormone (LH) and follicle stimulating hormone (FSH) pulsatile release. Cervical mucus changes and sperm-cervical mucus interaction were studied after identification of the LH peak. There were no significant differences between cyclofenil and placebo cycles in the following: ovulation rates, daily urinary oestrone and pregnanediol excretion, the number or size of developing follicles, LH pulsatility (parameters studied: number of peaks, pulse interval, pulse amplitude, pulse area and mean nadir LH), mean FSH level on day 6, cervical mucus and sperm-cervical mucus interaction. In view of our inability to demonstrate an effect on any parameter of endocrine function in normal and oligomenorrhoeic women, these results throw doubt on the therapeutic value of cyclofenil in its present dosage and formulation.

Adult↗

Intrauterine insemination versus timed intercourse for cervical hostility in subfertile couples.

The postcoital test has poor diagnostic and prognostic characteristics. Nevertheless, some physicians believe it can identify scanty or abnormal mucus that might impair fertility. One way to avoid "hostile" cervical mucus is intrauterine insemination. With this technique, the physician injects sperm directly into the uterine cavity through a small catheter passed through the cervix; the theory is to bypass the "hostile" cervical mucus. Although most gynecologic societies do not endorse use of intrauterine insemination for hostile cervical mucus, some physicians consider it an effective treatment for women with infertility thought the result of cervical mucus problems. The aim of this review was to determine the effectiveness of intrauterine insemination with or without ovarian stimulation in women with cervical hostility who failed to conceive.We searched Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library Issue 2, 2005, MEDLINE (1966 to June 2005), EMBASE (1980 to June 2005), POPLINE (to June 2005), and LILACS (to June 2005). In addition, we contacted experts and searched the reference list of relevant articles and book chapters. We included randomized and quasirandomized, controlled trials comparing intrauterine insemination with intercourse timed at the presumed fertile period. Participants were women with cervical hostility who failed to conceive for at least 1 year. We assessed the titles and abstracts of 386 publications and 2 reviewers independently abstracted data on methods and results from 5 studies identified for inclusion. The main outcome is pregnancy rate per couple. We did not pool the outcomes of the included 5 studies in a meta-analysis resulting from the methodological quality of the trials and variations in the patient characteristics and interventions. Narrative summaries of the outcomes are provided. Each study was too small for a clinically relevant conclusion. None of the studies provided information on important outcomes such as spontaneous abortion, multiple pregnancies, and ovarian hyperstimulation syndrome. There is no evidence from the published studies that intrauterine insemination is an effective treatment for cervical hostility. Given the poor diagnostic and prognostic properties of the postcoital test and the observation that the test has no benefit on pregnancy rates, intrauterine insemination (with or without ovarian stimulation) is unlikely to be a useful treatment for putative problems identified by postcoital testing. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader should be able to recall that there is a lack of adequate studies that support that intrauterine insemination (IUI) is an effective treatment of cervical hostility, explain that the postcoital test has poor diagnostic and prognostic properties, and state that the use of both tests has no benefit on pregnancy rates. EDITOR'S NOTE: Although many assisted reproductive technology (ART) programs no longer perform postcoital tests, many perform intrauterine insemination (IUI), often with gonadotropins or clomiphene citrate, in their subfertile patients. Therefore, this review article will be of value to our readers who treat subfertile patients with IUI, whether or not they perform postcoital tests. For additional explanations of the statistical tests employed in this review, see D. Grimes, KF Schulz, Obstetrical and Gynecologic Survey, 57; Supplement 3: S35, September 2002; and D. Grimes, KF Schulz, Obstetrical and Gynecologic Survey, Supplement 2, S53-S69, September 2005.-RBJ.

Cervix Mucus↗

Investigations on the influence of bradykinin upon the motility of ram spermatozoa.

The influence of bradykinin, a component of the kallikrein-kinin system, on the motility of ram spermatozoa was examined in vitro (photometric motility evaluation, penetration test in cervical mucus of sheep, estimation of the percentage of forward-moving spermatozoa in the thermal resistance test). Whereas the motility was found to be influenced by bradykinin the acrosomal status remained undisturbed by it. With fresh as well as with frozen semen, the drug mainly increased the motility of samples with a low initial motility. With frozen semen, the penetration test revealed greater motility rises at 22 degrees C than at 38 degrees C. The importance of the results in relation to the angiotensin-converting enzyme (kininase) as well as the motility evaluation capabilities of the methods used are discussed. There was, however, no positive drug effect after adding the drug in the course of cryopreservation prior to freezing semen in straws although bradykinin solutions frozen in liquid nitrogen maintained their effectiveness.

Animals↗

The immunocytochemical detection of herpes simplex virus in cervical smears--a valuable technique for routine use.

Herpes simplex virus type 2 is demonstrated in routine cervical smears by immunocytochemistry. Optimum antibody dilution and suitable fixation were determined and immunostaining results were found to compare favourably with those obtained by screening Papanicolaou-stained smears or by virus culture methods (virus isolation). Results obtained for immunostaining of smears from 158 patients agreed with those of virus isolation in 47 of 50 cases where virus isolation was performed. It is suggested that this immunocytochemical technique is valuable in detection of Herpes simplex virus in cervical smears, offering an inexpensive and rapid laboratory diagnosis with advantage to both patient and clinician.

Biopsy↗

Prevalence of cervical Chlamydia trachomatis and Neisseria gonorrhoeae in female adolescents.

The prevalence of cervical infection with Chlamydia trachomatis and Neisseria gonorrhoeae was examined in 125 girls receiving primary gynecologic care in a general adolescent clinic. C trachomatis was isolated in 8% of the patients using a microtiter tissue-culture method, and N gonorrhoeae was found in 12%. A significant association was found between the use of oral contraceptives and positive chlamydial cultures. Patients with Chlamydia-positive cultures were frequently asymptomatic and exhibited no positive findings on physical examination. Three of ten women with cervical chlamydial infection developed pelvic inflammatory disease. These results support the use of cervical screening for both of these pathogens in sexually active adolescents.

Adolescent↗

The contraceptive effects of a new low-dose combination type oral contraceptive.

A study was carried out in 9 women volunteers to investigate the centron of 0.75 mg lynestrenol plus 0.0375 mg ethinyl oestradiol given for 22 days per cycle over a period of 6 cycles. The results of assessments of a number of hormonal, vaginal and cervical parameters showed that this combination has a two-fold effect: a central effect on the pituitary and a peripheral effect on the ovaries and on endometrial development. The findings of an effect on cervical mucus, as with higher dose combinations, were not sufficiently consistent to warrant a claim for a cervical barrier. The preparation appeared to be well tolerated but there was a high incidence of irregular bleeding in the first treatment cycle. In most of the women, however, this had corrected itself by the second cycle.

Adult↗

[Biophysical parameters of early puberty in girls].

OBJECTIVE: The appearance of breast development in girls characterizes an early period of puberty. Ultrasonographic examinations of the uterus and ovaries make possible the estimation of first pubertal changes in sexual organs. DESIGN: The aim of this work was to study the clinical and ultrasonographical features of early puberty in girls. MATERIAL AND METHODS: 33 healthy girls were observed quarterly in the course of prepuberty. Body mass, height, body mass index (BMI), quantity of adipose tissue were investigated. Stage of puberty was established according to Tanner. The uterus and ovaries were studied ultrasonographically, and the volume of the uterine body, length of the cervix and ovarian volume and size of ovarian follicles were scrutinised. RESULTS: Statistical differences were observed in weight, height, quantity of adipose tissue and the volume of body and that of the uterus, in length of the cervix between prepuberty and early puberty periods. Luminastity of mucus in the cervical canal in half of girls in the breast stage M1 was obtained. CONCLUSION: Ultrasonographic investigations of internal sexual organs with estimation of clinical sexual features are helpful in examination of early stage of puberty.

Adolescent↗

[Bovine cervical mucus as a substitute of human cervical mucus].

The sperm penetration test (SPT) in cervical mucus (CM) is an important test in screening for sperm-CM incompatibility. For a routine SPT, a sufficient amount of preovulatory CM is necessary, but the amount of human CM is often inadequate. We examined estrous bovine CM as a substitute for human CM in the SPT. Preovulatory human CM and estrous bovine CM were collected and stored frozen at -20 degrees C until use. After being thawed at room temperature, the two CM samples were compared as to their pH, spinnbarkeit and ferning patterns, and it was found that they are quite similar. In Kremer's method of SPT, sperm penetration distance, density and motility were similar in human and bovine CM for 12 hours, but thereafter sperm motility became much lower in bovine CM than in human CM. The results of SPT with spermatozoa from patients with oligozoospermia were quite similar in both CMs. When spermatozoa pretreated with antisperm antibody were used for SPT, sperm penetration was completely blocked in human CM, but no inhibition was seen in bovine CM. From these results, we conclude that bovine CM can be substituted for human CM for some, but not all, purposes.

Animals↗

The fractional postcoital test: a reappraisal.

Postcoital tests (PCTs) were conducted following artificial insemination with either live or dead spermatozoa. The cervical mucus samples were analyzed for sperm counts and acid phosphatase activity. The results indicate that the final distribution of mucus and sperm in the PCT sampling catheter is not truly representative of their original distribution within the cervix. Moreover, PCTs done after insemination with semen containing only dead sperm yield unrealistically high sperm counts and high cervical mucus acid phosphatase levels. This is apparently due to the translocation of semen from the area of the external os into the mucus sample by the sampling catheter. This problem can be largely prevented by removing a plug of mucus from the external os prior to the catheter sampling procedure.

Acid Phosphatase↗

Naturally-occurring antisperm antibodies in men: interference with fertility and implications for treatment.

Naturally-occurring antisperm antibodies in men are a relative cause of infertility, being the fertility impairment related with the degree of sperm autoimmunization. The impairment of sperm penetration through the cervical mucus represents the best established mechanism of the antibody interference with fertility. Another mechanism may involve complement-mediated sperm injury and opsonizing effect through the female genital tract. Finally, sperm-bound antibodies can interfere with sperm functions involved in the fertilization process, mainly in the sperm-zona pellucida interaction. While some mechanisms of the antibody-interference with fertility depend only on the degree of sperm autoimmunization (e.g., inhibition of cervical mucus penetration), other mechanisms (e.g., interference with gametes interaction) could or could not occur depending on the relevance in the fertilization process of the specific antigen(s) recognized by antisperm antibodies, which are policlonal in nature. Intrauterine insemination is an effective treatment when sperm autoimmunization is low or moderate, mainly if combined with corticosteroid treatment and superovulated cycles. On the contrary, its effectiveness in cases of high degree of sperm autoimmunization is controversial. The resort to "high tech" procedures is mandatory when other less invasive approaches have failed or they may also be chosen as a first-choice method in cases of high degree of sperm autoimmunization. Since in most reports the fertilization rate with in vitro fertilization and embryo transfer (IVF-ET) was significantly lower in the presence of sperm-bound antibodies than in the case of other indications, the likelihood of fertilization is higher with intracytoplasmatic sperm injection (ICSI), where the reported fertilization rates are similar to those in other indications, or even higher.

Adrenal Cortex Hormones↗

[Fetal fibronectin and preterm birth].

OBJECTIVE: To determine whether fetal fibronectin is a sensitive test for the diagnosis and prediction of preterm birth. METHODS: Fetal fibronectin was measured by enzyme-labeled immunosorbent assay (ELISA) methods in sample of cervical secretion from 38 women with threatened preterm delivery (study group) and 43 normal pregnanty women with same gestational weeks (control group). RESULTS: The positive rate of fetal fibronectin in women with threatened preterm birth was significantly higher than that in the normal control group. CONCLUSION: Fetal fibronectin is an important marker. It can be used for diagnosis and prediction of preterm birth.

Adult↗

Timing of ovulation in spontaneous and induced cycles.

We studied 30 spontaneous cycles, 30 cycles induced with clomiphene citrate, and 30 cycles induced with human menopausal gonadotropin-human chorionic gonadotropin to evaluate the pattern of the following parameters and their predictive value in timing ovulation: basal body temperature; cervical mucus; mean follicular diameter; serum LH and 17-beta-estradiol; and urinary LH. Compared with the spontaneous cycles, in the cycles induced with clomiphene citrate the cervical score was significantly lower on the 4 days preceding ovulation, serum LH was higher in the early follicular phase, and serum 17-beta-estradiol was significantly higher in the pharmacologically treated cycles. The highest predictive values in all groups of cycles were obtained by considering the following combinations of parameters: serum 17-beta-estradiol and LH concentrations; mean follicular diameter as shown by ultrasonography and urinary LH as determined by a rapid method.

Adult↗

Autosperm antibodies in treated, pregnant and non-pregnant immunologically infertile patients.

Twenty-two immunologically infertile couples (male partners had proven autosperm antibodies-positive mixed antiglobulin reaction test [MAR] and direct immunobead test [d-IBT]) were treated with washed spermatozoa used either in the gamete intrafallopian tube transfer (GIFT) or artificial insemination (AIH) procedures. Sixteen of the 22 couples (72.2%) fell pregnant with an ongoing pregnancy rate of 54.5% (12/22). The pregnant and non-pregnant groups were compared with regards to the sperm antibodies detected on the spermatozoa (MAR, d-IBT and sperm cervical mucus contact [SCMC] test) and in the serum and seminal plasma of the male partners (tray agglutination test [TAT], indirect immunobead test [i-IBT], and enzyme-linked immunosorbent assay [ELISA]). The semen parameters, motility, forward progression, count/ml and normal morphological forms were also compared. Statistical analysis showed no difference between the two groups (pregnant and non-pregnant) with regards to the antibody tests performed on semen, serum and seminal plasma. No difference was also seen between the semen parameters of the two groups. The washing of spermatozoa for the GIFT or AIH procedures may therefore be a successful method of treatment for immunologically infertile couples. The results also indicate no difference in the fertility prognosis for the two groups since antibody levels and semen quality were not different between the pregnant and nonpregnant group.

Antibodies, Anti-Idiotypic↗