- Email: [email protected]
The use of the stimulated acrosome reaction test as a test of fertilizing ability in human spermatozoa
194
Citations from the Literature
FERTIL STERIL 1993 59/5 (1046-1054) Objective: To determine which factors relate to satisfaction with infertility treatment. Design: A prospective structured interview research design was used. Setting: In-person and telephone interviews were conducted. Participants: Wives and husbands from 185 couples in southeastern Michigan with primary infertility were studied. Main Outcome Measures: There were two main outcome measures: how satisfied people were with the infertility treatment they received and why they were satisfied. Results: Both men and women were satisfied with the infertility treatment they had received. The most frequently, mentioned reasons for satisfaction were the technical skills and the emotional support of infertility specialists. Both men and women advised infertility specialists to be compassionate and share information with their patients. Spouses’ satisfaction with treatment was the greatest predictor for both men and women. For men, using escape as a coping skill was a negative predictor for treatment satisfaction. For women, personal control and the number of infertility treatments received were other predictors for treatment satisfaction. Conclusions: As hypothesized, a variety of psychosocial factors were related to treatment satisfaction. Contrary to expectation, treatment costs and how long respondents had been trying to have a child were not related to treatment satisfaction. This study’s results suggest that physicians and their staff should pay particular attention to their patients’ emotional needs, to their patients’ understanding of procedures explained to them, to discussing adoption with their patients, to involving men more in the infertility treatment, and to assisting women to have more control over their course of treatment. Successful delivery after age Jo: A report of two cases as a result of oocyte donation Check J.H.; Nowroozi K.; Barnea E.R.; Shaw K.J.; Sauer M.V. USA OBSTET GYNECOL 1993 81/5 II SUPPL (835-836) Background: Because of donor oocyte programs, women who previously were considered too old to successfully achieve conception and delivery can now bear children. To our knowledge, there have been no previous reports of pregnancy outcome in women over age 50 who conceived using donor oocytes. This study presents the pregnancy and delivery data on two women who delivered at age 52. Cases: Case 1 was a 51year-old woman, gravida 3, para 3, whose three children had been conceived with her first husband more than 20 years previously. She had remarried 18 years before presentation and had been actively trying to conceive for the last 7 years. She was diagnosed as being in menopause based on elevated gonadotropins, amenorrhea, and failure to have progesteronewithdrawal menses. She conceived on her first embryo transfer cycle with embryos derived from donor oocytes and fertilized by her husband’s sperm (oocytes were donated by a woman who was undergoing retrieval for in vitro fertilization). During pregnancy she remained healthy, but had uterine prolapse at 20 weeks. She delivered a normal healthy male at 40.5 weeks; cesarean was performed because of a presumptive diagnosis of
Int J Gynecol Obstet 44
fetal distress after 3 h of labor, when monitoring revealed fetal heart decelerations. Case 2 was also a 51-year-old woman, gravida 6, para 4, who wished to conceive with her second husband’s sperm through the donor oocyte program. She had amenorrhea of 2 years’ duration and elevated gonadotropins. Conception occurred after fertilization of a donor oocyte by her husband’s sperm. She had an uneventful pregnancy, but labor was induced at 38 weeks’ gestation given the supposed high-risk status of this age group. Apgar scores were 8 and 9 at 1 and 5 min, respectively. Conclusion: Theoretically, the risks of pregnancy complications in older patients are magnified given the aging maternal cardiovascular system, which may predispose these women to placental insufficiency. These first two cases of donor oocyte pregnancies in women over age 50 found no maternal or fetal age-related complications. We hope these reports will encourage all researchers to share their findings so that prospective patients can make better, more informed decisions as to whether they want to participate in donor oocyte programs. The use of the stimulated acrosome reaction test as a test of fertilizing ability in human spermatozoa Pampiglione J.S.; Tan S.-L.; Campbell S. GBR FERTIL STERIL 1993 59/6 (1280-1284) Objective: To assess if patients who do not fertilize human oocytes in vitro can be identified by a lack of acrosomal response of their spermatozoa to stimulation by the calcium ionophore A23187. Design: The stimulated acrosomal response for all patients was calculated. Those not achieving fertilization were compared with a normogram constructed from donors and patients who achieved fertilization; the 0.5th centile (31.3% increase in the number of spermatozoa reacted) was used as a discriminant point. Patients: Fifty-four IVF patients and 15 fertile sperm donors. Setting: An outpatient based IVF program. Interventions: Acrosome reaction stimulated by 2 h incubation in a S-mol/l solution of the calcium ionophore A23187. Results: Patients who fertilized oocytes responded as donors. Eight of I6 patients failing to fertilize oocytes showed a minimal increase in the number of acrosome-reacted spermatozoa (mean [*SD] rise 6.3”/0 f 10.3%). An acrosomal response of < 31.3% predicts fertilization failure in lOO”/uof cases. Conclusions: Failure of the acrosome to react is responsible for some failure of IVF. Effect of platelet-activating factor, lyso-platelet-activating factor, and lysophosphatidylcholine on sperm motion: Importance of albumin for motility stimulation Jarvi K.; Roberts K.D.; Langlais J.; Gagnon C. CAN FERTIL STERIL 1993 5916 (1266- 1275) Objectives: To determine the effect of platelet-activating factor (PAF), the PAF derivative lyso-PAF. and lysophosphatidylcholine on in vitro sperm moti!iiy and to determine the role of albumin in this interaction. Design: Washed human spermatozoa were exposed to a range of PAF.
Citations from the Literature
FERTIL STERIL 1993 59/5 (1046-1054) Objective: To determine which factors relate to satisfaction with infertility treatment. Design: A prospective structured interview research design was used. Setting: In-person and telephone interviews were conducted. Participants: Wives and husbands from 185 couples in southeastern Michigan with primary infertility were studied. Main Outcome Measures: There were two main outcome measures: how satisfied people were with the infertility treatment they received and why they were satisfied. Results: Both men and women were satisfied with the infertility treatment they had received. The most frequently, mentioned reasons for satisfaction were the technical skills and the emotional support of infertility specialists. Both men and women advised infertility specialists to be compassionate and share information with their patients. Spouses’ satisfaction with treatment was the greatest predictor for both men and women. For men, using escape as a coping skill was a negative predictor for treatment satisfaction. For women, personal control and the number of infertility treatments received were other predictors for treatment satisfaction. Conclusions: As hypothesized, a variety of psychosocial factors were related to treatment satisfaction. Contrary to expectation, treatment costs and how long respondents had been trying to have a child were not related to treatment satisfaction. This study’s results suggest that physicians and their staff should pay particular attention to their patients’ emotional needs, to their patients’ understanding of procedures explained to them, to discussing adoption with their patients, to involving men more in the infertility treatment, and to assisting women to have more control over their course of treatment. Successful delivery after age Jo: A report of two cases as a result of oocyte donation Check J.H.; Nowroozi K.; Barnea E.R.; Shaw K.J.; Sauer M.V. USA OBSTET GYNECOL 1993 81/5 II SUPPL (835-836) Background: Because of donor oocyte programs, women who previously were considered too old to successfully achieve conception and delivery can now bear children. To our knowledge, there have been no previous reports of pregnancy outcome in women over age 50 who conceived using donor oocytes. This study presents the pregnancy and delivery data on two women who delivered at age 52. Cases: Case 1 was a 51year-old woman, gravida 3, para 3, whose three children had been conceived with her first husband more than 20 years previously. She had remarried 18 years before presentation and had been actively trying to conceive for the last 7 years. She was diagnosed as being in menopause based on elevated gonadotropins, amenorrhea, and failure to have progesteronewithdrawal menses. She conceived on her first embryo transfer cycle with embryos derived from donor oocytes and fertilized by her husband’s sperm (oocytes were donated by a woman who was undergoing retrieval for in vitro fertilization). During pregnancy she remained healthy, but had uterine prolapse at 20 weeks. She delivered a normal healthy male at 40.5 weeks; cesarean was performed because of a presumptive diagnosis of
Int J Gynecol Obstet 44
fetal distress after 3 h of labor, when monitoring revealed fetal heart decelerations. Case 2 was also a 51-year-old woman, gravida 6, para 4, who wished to conceive with her second husband’s sperm through the donor oocyte program. She had amenorrhea of 2 years’ duration and elevated gonadotropins. Conception occurred after fertilization of a donor oocyte by her husband’s sperm. She had an uneventful pregnancy, but labor was induced at 38 weeks’ gestation given the supposed high-risk status of this age group. Apgar scores were 8 and 9 at 1 and 5 min, respectively. Conclusion: Theoretically, the risks of pregnancy complications in older patients are magnified given the aging maternal cardiovascular system, which may predispose these women to placental insufficiency. These first two cases of donor oocyte pregnancies in women over age 50 found no maternal or fetal age-related complications. We hope these reports will encourage all researchers to share their findings so that prospective patients can make better, more informed decisions as to whether they want to participate in donor oocyte programs. The use of the stimulated acrosome reaction test as a test of fertilizing ability in human spermatozoa Pampiglione J.S.; Tan S.-L.; Campbell S. GBR FERTIL STERIL 1993 59/6 (1280-1284) Objective: To assess if patients who do not fertilize human oocytes in vitro can be identified by a lack of acrosomal response of their spermatozoa to stimulation by the calcium ionophore A23187. Design: The stimulated acrosomal response for all patients was calculated. Those not achieving fertilization were compared with a normogram constructed from donors and patients who achieved fertilization; the 0.5th centile (31.3% increase in the number of spermatozoa reacted) was used as a discriminant point. Patients: Fifty-four IVF patients and 15 fertile sperm donors. Setting: An outpatient based IVF program. Interventions: Acrosome reaction stimulated by 2 h incubation in a S-mol/l solution of the calcium ionophore A23187. Results: Patients who fertilized oocytes responded as donors. Eight of I6 patients failing to fertilize oocytes showed a minimal increase in the number of acrosome-reacted spermatozoa (mean [*SD] rise 6.3”/0 f 10.3%). An acrosomal response of < 31.3% predicts fertilization failure in lOO”/uof cases. Conclusions: Failure of the acrosome to react is responsible for some failure of IVF. Effect of platelet-activating factor, lyso-platelet-activating factor, and lysophosphatidylcholine on sperm motion: Importance of albumin for motility stimulation Jarvi K.; Roberts K.D.; Langlais J.; Gagnon C. CAN FERTIL STERIL 1993 5916 (1266- 1275) Objectives: To determine the effect of platelet-activating factor (PAF), the PAF derivative lyso-PAF. and lysophosphatidylcholine on in vitro sperm moti!iiy and to determine the role of albumin in this interaction. Design: Washed human spermatozoa were exposed to a range of PAF.