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Plenary Session
Vol. 30, No.6, December 1978 Printed in U.S.A.
FERTILITY AND STERILITY Copyright" 1978 The American Fertility Society
SCIENTIFIC PAPERS TO BE PRESENTED AT THE THIRTY-FIFTH ANNUAL MEETING OF THE AMERICAN FERTILITY SOCIETY SAN FRANCISCO, CALIFORNIA FEBRUARY 5 TO 7, 1979 In order to provide Fertility and Sterility readers with descriptive information on the Annual Scientific Meeting of The American Fertility Society and in order to assist those planning to attend the Meeting in selecting sessions, abstracts of the papers to be delivered are presented here. Abstracts within each session are published in the order of their scheduled presentation. Abstracts of special lectures, correlated seminars, and prize award papers are not included.
macromolecular network, which is also regulated by the levels of circulating sex hormones. (Supported by United States Public Health Service Grant HD-03752 and Contract HD4-2826 from the National Institutes of Health.)
MONDAY, FEBRUARY 5 PLENARY SESSION 9:30 A.M. to 10:00 A.M. Moderator: WILLIAM C. ANDREWS, M.D. New Observations on the Structural Aspects of Bovine and Human Cervical Mucus. WYUE I.
An Objective Method for Analysis of Human Sperm Penetration into Cervical Mucus in Vitro. DAVID F. KATZ, PRD., JAMES W. OVERSTREET, M.D., PH.D., AND FREDERICK W. HANSON, M.D. Departments of Obstetrics and Gynecology and Human Anatomy, University of California, Davis, California.
LEE, PH.D., RICHARD J. BLANDAU, M.D., PH.D., PEDRO VERDUGO, M.D., AND P. GADDUM-ROSSE, PH.D. Department of Biological Structure and Center for Bioengineering, University of Washington, Seattle, Washington.
A new procedure is described for characterizing the penetration of human spermatozoa into cervical mucus in vitro. Semen is introduced to a prescribed volume of mucus contained in a flat capillary tube. The number of motile sperm and their swimming speeds are determined in both the semen and the mucus by hemocytometer counts and time-exposure photomicrography. Variation in penetrability of the mucus sample is taken into account by inclusion of a control test with donor semen. The assay compares the number of successful sperm entries into the mucus with the frequency of original sperm-mucus collisions. The clinical application of the method is described and sample results are presented.
Transport of spermatozoa through the cervix is important in fertility studies. The penetration of spermatozoa into cervical mucus is not only dependent on the sperm motility but also on the molecular structure of cervical mucus. We have used the technique of dynamic laser lightscattering to study the structure of cervical mucus by analyzing the molecular dynamics of the mucus. The autocorrelation function of the light scattered from estrous cow cervical mucus and human midcycle cervical mucus can best be fitted to a sum of two decaying exponentials. Our data suggest that the macroscopic structure of the mucus is an ensemble of entangled randomcoiled macromolecules rather than a fibrillar, cross-linked network as previously reported. This new structural model of cervical mucus can account not only for the observed viscoelastic properties of cervical mucus but also explains the pattern of sperm penetration into cervical mucus. The model suggests further that the cyclic changes in the physical properties of cervical mucus depend upon the degree of swelling of this entangled, ionic
Ultrastructural Study of the Ovarian Follicular Apex in Human Tissue. HITOSHI OKAMURA, M.D., AKIRA TAKENAKA, M.D., YASUO YAZlMA, M.D., AND TOSHIO
NISHIMURA, M.D. Department of Obstetrics and Gynecology, Kyoto University School of Medicine, Sayoku, Kyoto, Japan.
729
730
ABSTRACTS
To elucidate the mechanism offollicular rupture at ovulation in humans, stromal tissue and germinal epithelium in the follicular apex were studied ultrastructurally by focusing on the collagen and fibroblasts in the layers of theca externa and tunica albuginea. From 16 follicles at various stages of development, apical portions were excised and processed for electron microscopy. At the apex of growing follicles, fibroblasts with poor cytoplasm and abundant collagen fibers were observed in the layers of tunica albuginea and theca externa. In the preovulatory follicles, cytoplasm of fibroblasts is well-developed and rich in lysosomal granules and multivesicular structures. Intercellular collagen fibers are sparse. These lysosomal granules and multivesicular structures in the fibroblasts were most conspicuous in the theca external layer of pre- and postruptured follicles, and collagen fibers among these fibroblasts were almost nonexistent. These intercellular collagen fibers and ground substance seem to be digested by the content of lysosomal granules and multivesicular structures. In the germinal epithelium at the apical portion of preovulatory follicles, lysosomal granules were sparse. These ultrastructural observations are in agreement with our previous report of collagenolytic (collagenase and cathepsin B l ) activity in human follicular walls.
MONDAY, FEBRUARY 5 GENETICS 10:30 A.M. to 11:00 A.M. Moderator: MITCHELL S. GoLBUS, M.D. Gonadal Dysgenesis and Sexual Function. ROBERT G. SATTERFIELD, M.D., RAJESH MATHUR, PH.D., AND H. OLIVER WILLIAMSON, M.D. Department
of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina. This study was designed to ascertain the depth of sexual experience among a group of gonadal dysgenesis patients. Examination of several varieties of gonadal dysgenesis revealed differences of external genitalia and vaginal capacity. Differences were to some degree related to karyotype and previous hormonal therapy. A discussion was held with each patient relative to her sexual exposure after knowledge of her
December 1978 anatomy had been obtained. Sexual enjoyment was correlated with presence or absence of adequate vaginal size. Gonadotropins (luteinizing hormone and follicle-stimulating hormone), androgens (dehydroepiandrosterone, androstenedione, testosterone, and dehydrotestosterone) and estrogens (estriol and estradiol) were measured in the majority of patients, and hormonal levels were correlated with the desire for sexual activity and enjoyment thereof. It is believed that sexual counseling should be part of the total care of gonadal dysgenesis patients and can only be rendered after knowledge is obtained of the individual's anatomy. Furthermore, hormonal treatment may cause anatomical changes for some patients, so continued observation and counseling are essential.
Evaluation of Reproductive Failure in 101 Couples. PAUL G. MCDONOUGH, M.D., PHUNG THI THO, M.D., AND J. ROGERS BYRD, PH.D. Departments of Obstetrics, Gynecology, and Endocrinology, Medical College of Georgia, Augusta, Georgia. One hundred and one couples with two or more consecutive abortions were studied over a period of 10 years. All couples had peripheral blood karyotypes, hysterograms, luteal evaluation by endometrial biopsy, and thyroid biochemistries. The discernible etiologies in this group of patients included (1) genetic abnormalities, 25; (2) Mullerian malformations, 16; (3) endocrinologic abnormalities, 24; (4) immunologic disorders, 2; and (5) unknown causes, 34. Further evaluation of the results indicate that (1) cytogenetic abnormalities were identified in 9.5% of the couples having abortions with or without a phenotypically normal child; (2) cytogenetic abnormalities were identified in 23% of the couples whose reproductive history consisted of abortions and malformed offspring; (3) the most common Mullerian anomaly was uterus subseptus; and (4) in those couples in whom cytogenetic carrier states and Mullerian malformations were excluded, the over-all success rate for subsequent pregnancy was 73%. All patients within the endocrine group were treated with pure progesterone and the success rate for subsequent pregnancy was 87%. It is concluded from this study that if one eliminates the two well-defined causes of recurrent abortion, namely cytogenetic carrier states and
FERTILITY AND STERILITY Copyright" 1978 The American Fertility Society
SCIENTIFIC PAPERS TO BE PRESENTED AT THE THIRTY-FIFTH ANNUAL MEETING OF THE AMERICAN FERTILITY SOCIETY SAN FRANCISCO, CALIFORNIA FEBRUARY 5 TO 7, 1979 In order to provide Fertility and Sterility readers with descriptive information on the Annual Scientific Meeting of The American Fertility Society and in order to assist those planning to attend the Meeting in selecting sessions, abstracts of the papers to be delivered are presented here. Abstracts within each session are published in the order of their scheduled presentation. Abstracts of special lectures, correlated seminars, and prize award papers are not included.
macromolecular network, which is also regulated by the levels of circulating sex hormones. (Supported by United States Public Health Service Grant HD-03752 and Contract HD4-2826 from the National Institutes of Health.)
MONDAY, FEBRUARY 5 PLENARY SESSION 9:30 A.M. to 10:00 A.M. Moderator: WILLIAM C. ANDREWS, M.D. New Observations on the Structural Aspects of Bovine and Human Cervical Mucus. WYUE I.
An Objective Method for Analysis of Human Sperm Penetration into Cervical Mucus in Vitro. DAVID F. KATZ, PRD., JAMES W. OVERSTREET, M.D., PH.D., AND FREDERICK W. HANSON, M.D. Departments of Obstetrics and Gynecology and Human Anatomy, University of California, Davis, California.
LEE, PH.D., RICHARD J. BLANDAU, M.D., PH.D., PEDRO VERDUGO, M.D., AND P. GADDUM-ROSSE, PH.D. Department of Biological Structure and Center for Bioengineering, University of Washington, Seattle, Washington.
A new procedure is described for characterizing the penetration of human spermatozoa into cervical mucus in vitro. Semen is introduced to a prescribed volume of mucus contained in a flat capillary tube. The number of motile sperm and their swimming speeds are determined in both the semen and the mucus by hemocytometer counts and time-exposure photomicrography. Variation in penetrability of the mucus sample is taken into account by inclusion of a control test with donor semen. The assay compares the number of successful sperm entries into the mucus with the frequency of original sperm-mucus collisions. The clinical application of the method is described and sample results are presented.
Transport of spermatozoa through the cervix is important in fertility studies. The penetration of spermatozoa into cervical mucus is not only dependent on the sperm motility but also on the molecular structure of cervical mucus. We have used the technique of dynamic laser lightscattering to study the structure of cervical mucus by analyzing the molecular dynamics of the mucus. The autocorrelation function of the light scattered from estrous cow cervical mucus and human midcycle cervical mucus can best be fitted to a sum of two decaying exponentials. Our data suggest that the macroscopic structure of the mucus is an ensemble of entangled randomcoiled macromolecules rather than a fibrillar, cross-linked network as previously reported. This new structural model of cervical mucus can account not only for the observed viscoelastic properties of cervical mucus but also explains the pattern of sperm penetration into cervical mucus. The model suggests further that the cyclic changes in the physical properties of cervical mucus depend upon the degree of swelling of this entangled, ionic
Ultrastructural Study of the Ovarian Follicular Apex in Human Tissue. HITOSHI OKAMURA, M.D., AKIRA TAKENAKA, M.D., YASUO YAZlMA, M.D., AND TOSHIO
NISHIMURA, M.D. Department of Obstetrics and Gynecology, Kyoto University School of Medicine, Sayoku, Kyoto, Japan.
729
730
ABSTRACTS
To elucidate the mechanism offollicular rupture at ovulation in humans, stromal tissue and germinal epithelium in the follicular apex were studied ultrastructurally by focusing on the collagen and fibroblasts in the layers of theca externa and tunica albuginea. From 16 follicles at various stages of development, apical portions were excised and processed for electron microscopy. At the apex of growing follicles, fibroblasts with poor cytoplasm and abundant collagen fibers were observed in the layers of tunica albuginea and theca externa. In the preovulatory follicles, cytoplasm of fibroblasts is well-developed and rich in lysosomal granules and multivesicular structures. Intercellular collagen fibers are sparse. These lysosomal granules and multivesicular structures in the fibroblasts were most conspicuous in the theca external layer of pre- and postruptured follicles, and collagen fibers among these fibroblasts were almost nonexistent. These intercellular collagen fibers and ground substance seem to be digested by the content of lysosomal granules and multivesicular structures. In the germinal epithelium at the apical portion of preovulatory follicles, lysosomal granules were sparse. These ultrastructural observations are in agreement with our previous report of collagenolytic (collagenase and cathepsin B l ) activity in human follicular walls.
MONDAY, FEBRUARY 5 GENETICS 10:30 A.M. to 11:00 A.M. Moderator: MITCHELL S. GoLBUS, M.D. Gonadal Dysgenesis and Sexual Function. ROBERT G. SATTERFIELD, M.D., RAJESH MATHUR, PH.D., AND H. OLIVER WILLIAMSON, M.D. Department
of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina. This study was designed to ascertain the depth of sexual experience among a group of gonadal dysgenesis patients. Examination of several varieties of gonadal dysgenesis revealed differences of external genitalia and vaginal capacity. Differences were to some degree related to karyotype and previous hormonal therapy. A discussion was held with each patient relative to her sexual exposure after knowledge of her
December 1978 anatomy had been obtained. Sexual enjoyment was correlated with presence or absence of adequate vaginal size. Gonadotropins (luteinizing hormone and follicle-stimulating hormone), androgens (dehydroepiandrosterone, androstenedione, testosterone, and dehydrotestosterone) and estrogens (estriol and estradiol) were measured in the majority of patients, and hormonal levels were correlated with the desire for sexual activity and enjoyment thereof. It is believed that sexual counseling should be part of the total care of gonadal dysgenesis patients and can only be rendered after knowledge is obtained of the individual's anatomy. Furthermore, hormonal treatment may cause anatomical changes for some patients, so continued observation and counseling are essential.
Evaluation of Reproductive Failure in 101 Couples. PAUL G. MCDONOUGH, M.D., PHUNG THI THO, M.D., AND J. ROGERS BYRD, PH.D. Departments of Obstetrics, Gynecology, and Endocrinology, Medical College of Georgia, Augusta, Georgia. One hundred and one couples with two or more consecutive abortions were studied over a period of 10 years. All couples had peripheral blood karyotypes, hysterograms, luteal evaluation by endometrial biopsy, and thyroid biochemistries. The discernible etiologies in this group of patients included (1) genetic abnormalities, 25; (2) Mullerian malformations, 16; (3) endocrinologic abnormalities, 24; (4) immunologic disorders, 2; and (5) unknown causes, 34. Further evaluation of the results indicate that (1) cytogenetic abnormalities were identified in 9.5% of the couples having abortions with or without a phenotypically normal child; (2) cytogenetic abnormalities were identified in 23% of the couples whose reproductive history consisted of abortions and malformed offspring; (3) the most common Mullerian anomaly was uterus subseptus; and (4) in those couples in whom cytogenetic carrier states and Mullerian malformations were excluded, the over-all success rate for subsequent pregnancy was 73%. All patients within the endocrine group were treated with pure progesterone and the success rate for subsequent pregnancy was 87%. It is concluded from this study that if one eliminates the two well-defined causes of recurrent abortion, namely cytogenetic carrier states and