- Email: [email protected]
Persistence or reappearance of non-motile sperm after vasectomy: Does it have clinical consequences?
240
Citations from the literature /International
Journal of Gynecology & Obstetrics 57 (1997) 233-243
terization of images of Shorr-stained sperm. Zona pehucida selected sperm removed from re-inseminated oocytes that previously failed IVF. Setting: Academic research group associated with a tertiary infertility service. Patients: Semen samples from 51 infertile patients. Zntewentions: None. Main outcome measures: Differences in morphometric parameter means observed before and after swim-up and binding to zonae pellucidae. Results: Signi8cant differences between insemination and bound sperm were observed in 47 parameter means and 21 standard deviations. The sperm-zona pellucida binding process preferentially selects sperm beads with a large anterior region with relatively low optical density, as well as high axial symmetry and minimal neck anomalies. Bias against sperm with pyriform morphology was net observed. Conclusions: A causal Iii has been established between sperm head morphometry, particularly within the acrosomal region, and the ability of sperm to bind & the human zona pehucida. As sperm-zona binding is necessary for fertility, it is possible to derive a physiologically based assessment for clinical diagnosis of male infertility using the ‘zona-preferred’ morphometry results. Persistence or reappearance of non-motile sperm after vasectomy: Does it have clinical consequences? De Knijff D.W.W.; Vrijhof H.J.E.J.; Arends J.; Janknegt R.A. NLD FERTIL. STERIL. 1997 67/2 (332-335) Object&: To determine the percentage of patients with non-motile sperm 12 weeks after vasectomy, to estimate the time needed for eventual azoospermia in these patients, and to record the percentage of patients with recurrence of nonmotile sperm after initial azoospermia after vasectomy. Design: A review of the semen analysis of vasectomies performed in a 2-year period. Semen analysis in a group of volunteers from 4 months until 24 months after vasectomy. Setting: Vasectomies performed in an outpatient department of the University Hospital of Maastricht. Patients: Men referred by the general practitioner for a vasectomy. Interventions: Vasectomy. Main outcome measures: Amount and motility of sperm in post-vasectomy semen samples. Results: non-motile sperm was found in 33% of the patients 12 weeks after vasectomy. The mean time to azoospermia was 6.36 months. Non-motile sperm after initial azoospermia was found in 5 of 65 patients. Conclusions: Azoospennia as a criterion for sterility leads to unnecessary prolonged semen analysis in a large percentage of the vasectomized patients. Reappearance of non-motile sperm was found in an unexpectedly high percentage.
GYNECOLOGICAL
ENDOCRINOLOGY
Endothelin levels decrease after oral and non-oral estrogen in post-menopausal women with increased cardiovascular risk factors Wilcox J.G.; Stanczyk F.Z.; Hatch I.E.; Lobo R.A.; Gentzschein E. USA
FERTIL. STERIL. 1997 67/2 (273-277) Objectiue: To establish levels of plasma endothelin-1 in post-menopausal women with increased CV risk as compared with healthy premenopausal women and to measure the effects of different forms of estrogen replacement on plasma endothelin-1. Design: Prospective randomized study. Setting: University of Southern California Medical Center. Patients: We studied 18 post-menopausal women (mean age 53.4 f 4.9 years) with total cholesterol levels > 240 mg/dl divided into those with and without hypertension as well as in 10 healthy premenopausal women. Interventions: The post-menopausal women were randomized to receive oral e&one sulfate, transdermal E,, or placebo for 30 days. Main outcome measures: We measured the endothehn-1 levels and total cholesterol at baseline and after 30 days of estrogen treatment. Results: In the post-menopausal women, endothelin-1 was higher (4.58 f 0.46 pg/ml) compared with premenopausal levels (2.80 f 0.46 pg/mB. In hypertensive post-menopausal women, endothelin-1 was 5.56 f 0.44 pg/mI. After estrogen, plasma endothelin-1 values decreased from 5.38 f 0.66 to 4.82 * 0.9 pg/ml with oral estrone sulfate, 4.84 rt 0.25 to 4.54 f 0.49 pg/ml with transdermal E,, and did not change after placebo 4.76 f 0.71 to 4.81 + 0.46 pg/ml. In evaluating hypertensive women alone with estrogen therapy, plasma endothelin-1 showed the greatest decrement from 5.39 f 0.49 to 4.4 + 0.59 pg/ml (18.4%). The decrease in endothelin-1 with estrogen, which wasstatistitally significant for the entire group, did appear to be influenced by the route of administration. Baseline plasma endothelin-1 levels were correlated positively to plasma cholesterol levels with a correlation coefficient of 0.632. Condusions: These data provide another potential mechanism explaining the cardioprotective effects of hormone replacement therapy.
A double-blind randomized controlled trial of the effects of medroxyprogesterone acetate on bone density of women taking oestrogen replacement therapy Adachi J.D.; Sargeant E.J.; Sagle M.A.; Lamont D.; Fawcett P.D.; Bensen W.G.; McQueen M.; Nazir D.J.; Goldsmith C.H. CAN BR. J. OBSTET. GYNAECOL. 1997 104/l (64-70) Objective: To assess the effects of medroxyprogesterone acetate on bone density in women who have had a hysterectomy. Design: Randomized, double-blind, placebo-controlled trial of medroxyprogesterone acetate 10 mg, 20 mg of placebo as an adjunct to oestrogen therapy. Participants: One hundred and twenty-three women, aged 18-45 years and currently receiving daily oestrogen, who presented at a university-based rheumatology practice. Interventions. The women were randomly assigned to receive either medroqprogesterone acetate 10 mg, 20 mg or placebo daily beginning on day 15 of each month for 1 year. Forty-one women were randomized into each group. Main outcome measures: The primary outcome measurement was the percentage of change from baseline in bone mineral density of the lumbar spine (L2-IA). Secondary outcome measures included differences in femoral neck bone density, cholesterol and triglyceride levels between groups.
Citations from the literature /International
Journal of Gynecology & Obstetrics 57 (1997) 233-243
terization of images of Shorr-stained sperm. Zona pehucida selected sperm removed from re-inseminated oocytes that previously failed IVF. Setting: Academic research group associated with a tertiary infertility service. Patients: Semen samples from 51 infertile patients. Zntewentions: None. Main outcome measures: Differences in morphometric parameter means observed before and after swim-up and binding to zonae pellucidae. Results: Signi8cant differences between insemination and bound sperm were observed in 47 parameter means and 21 standard deviations. The sperm-zona pellucida binding process preferentially selects sperm beads with a large anterior region with relatively low optical density, as well as high axial symmetry and minimal neck anomalies. Bias against sperm with pyriform morphology was net observed. Conclusions: A causal Iii has been established between sperm head morphometry, particularly within the acrosomal region, and the ability of sperm to bind & the human zona pehucida. As sperm-zona binding is necessary for fertility, it is possible to derive a physiologically based assessment for clinical diagnosis of male infertility using the ‘zona-preferred’ morphometry results. Persistence or reappearance of non-motile sperm after vasectomy: Does it have clinical consequences? De Knijff D.W.W.; Vrijhof H.J.E.J.; Arends J.; Janknegt R.A. NLD FERTIL. STERIL. 1997 67/2 (332-335) Object&: To determine the percentage of patients with non-motile sperm 12 weeks after vasectomy, to estimate the time needed for eventual azoospermia in these patients, and to record the percentage of patients with recurrence of nonmotile sperm after initial azoospermia after vasectomy. Design: A review of the semen analysis of vasectomies performed in a 2-year period. Semen analysis in a group of volunteers from 4 months until 24 months after vasectomy. Setting: Vasectomies performed in an outpatient department of the University Hospital of Maastricht. Patients: Men referred by the general practitioner for a vasectomy. Interventions: Vasectomy. Main outcome measures: Amount and motility of sperm in post-vasectomy semen samples. Results: non-motile sperm was found in 33% of the patients 12 weeks after vasectomy. The mean time to azoospermia was 6.36 months. Non-motile sperm after initial azoospermia was found in 5 of 65 patients. Conclusions: Azoospennia as a criterion for sterility leads to unnecessary prolonged semen analysis in a large percentage of the vasectomized patients. Reappearance of non-motile sperm was found in an unexpectedly high percentage.
GYNECOLOGICAL
ENDOCRINOLOGY
Endothelin levels decrease after oral and non-oral estrogen in post-menopausal women with increased cardiovascular risk factors Wilcox J.G.; Stanczyk F.Z.; Hatch I.E.; Lobo R.A.; Gentzschein E. USA
FERTIL. STERIL. 1997 67/2 (273-277) Objectiue: To establish levels of plasma endothelin-1 in post-menopausal women with increased CV risk as compared with healthy premenopausal women and to measure the effects of different forms of estrogen replacement on plasma endothelin-1. Design: Prospective randomized study. Setting: University of Southern California Medical Center. Patients: We studied 18 post-menopausal women (mean age 53.4 f 4.9 years) with total cholesterol levels > 240 mg/dl divided into those with and without hypertension as well as in 10 healthy premenopausal women. Interventions: The post-menopausal women were randomized to receive oral e&one sulfate, transdermal E,, or placebo for 30 days. Main outcome measures: We measured the endothehn-1 levels and total cholesterol at baseline and after 30 days of estrogen treatment. Results: In the post-menopausal women, endothelin-1 was higher (4.58 f 0.46 pg/ml) compared with premenopausal levels (2.80 f 0.46 pg/mB. In hypertensive post-menopausal women, endothelin-1 was 5.56 f 0.44 pg/mI. After estrogen, plasma endothelin-1 values decreased from 5.38 f 0.66 to 4.82 * 0.9 pg/ml with oral estrone sulfate, 4.84 rt 0.25 to 4.54 f 0.49 pg/ml with transdermal E,, and did not change after placebo 4.76 f 0.71 to 4.81 + 0.46 pg/ml. In evaluating hypertensive women alone with estrogen therapy, plasma endothelin-1 showed the greatest decrement from 5.39 f 0.49 to 4.4 + 0.59 pg/ml (18.4%). The decrease in endothelin-1 with estrogen, which wasstatistitally significant for the entire group, did appear to be influenced by the route of administration. Baseline plasma endothelin-1 levels were correlated positively to plasma cholesterol levels with a correlation coefficient of 0.632. Condusions: These data provide another potential mechanism explaining the cardioprotective effects of hormone replacement therapy.
A double-blind randomized controlled trial of the effects of medroxyprogesterone acetate on bone density of women taking oestrogen replacement therapy Adachi J.D.; Sargeant E.J.; Sagle M.A.; Lamont D.; Fawcett P.D.; Bensen W.G.; McQueen M.; Nazir D.J.; Goldsmith C.H. CAN BR. J. OBSTET. GYNAECOL. 1997 104/l (64-70) Objective: To assess the effects of medroxyprogesterone acetate on bone density in women who have had a hysterectomy. Design: Randomized, double-blind, placebo-controlled trial of medroxyprogesterone acetate 10 mg, 20 mg of placebo as an adjunct to oestrogen therapy. Participants: One hundred and twenty-three women, aged 18-45 years and currently receiving daily oestrogen, who presented at a university-based rheumatology practice. Interventions. The women were randomly assigned to receive either medroqprogesterone acetate 10 mg, 20 mg or placebo daily beginning on day 15 of each month for 1 year. Forty-one women were randomized into each group. Main outcome measures: The primary outcome measurement was the percentage of change from baseline in bone mineral density of the lumbar spine (L2-IA). Secondary outcome measures included differences in femoral neck bone density, cholesterol and triglyceride levels between groups.