Anonymous or identity-registered sperm donors? A study of Dutch recipients' choices

BACKGROUND: The aim of the present study was to gain insight into parents' own donor preferences within a system offering the choice between an anonymous and identity-registered donor. A comparison was made between recipients choosing for an anonymous donor (AD choosers) and those choosing for an identifiable donor (ID choosers) with regard to their sexual orientation, demographic characteristics, disclosure issues and infertility distress. METHODS: Data from 105 couples (61% heterosexual, 39% lesbian) were registered on a standardized form during implication counselling sessions previous to treatment. RESULTS: Sixty-three per cent of the heterosexual couples and 98% of the lesbian couples had chosen an ID donor. Major differences between ID and AD choosers were identified. Among the ID choosers secrecy towards the child was no option, whereas 83% of the AD choosers did not intend to inform their child. Compared with heterosexual ID choosers, AD choosers were more distressed about their infertility and had a lower educational level. CONCLUSION: Legislation imposing ID donors appears to be acceptable for the majority of this study population. For a vulnerable group of heterosexual couples, who remained secretive about the use of a donor, adaptation to the new system is not self-evident.     

High rate of false positives in blood donor screening for antibodies to hepatitis C virus

Summary Anti-hepatitis C virus antibody screening of blood donors in different countries revealed prevalences ranging from 0,4–1,4%. These results were obtained with an enzyme immunoassay based on a recombinant hepatitis C virus antigen. We applied a specific inhibition assay (neutralization assay) and a recombinant immunoblot assay to determine the specificity of positive reactions in the enzyme immunoassay.Of 2836 blood donor sera tested, 10 (0,35%) were reactive in the enzyme immunoassay, however, only 3 sera (0,1%) proved to be specifically anti-HCV positive in the inhibition assay. The recombinant immunoblot assay gave similar results. The prevalence of anti-hepatitis C virus antibodies among blood donors has been overestimated in recent publications. Furthermore the high rate of false positives in the enzyme immunoassay may explain reports claiming that only a minor part of EIA positive blood units transmitted the hepatitis C virus to recipients.The inhibition assay was also applied to sera of haemophiliacs and of patients with hepatopathy which had reacted positively in the anti-hepatitis C virus antibody enzyme immunoassay. The antihepatitis C virus specificity was confirmed for all sera from the haemophiliacs group (100%) and for 77% of the hepatopathy patients group. Thus, the anti-hepatitis C virus enzyme immunoassay has a high predictive value when it is used to screen groups with high risks of parenteral hepatitis C virus infection, however, its predictive value is very low when it is used for blood donor screening.Abbreviations EIA enzyme immunoassay - HCV hepatitis C virus - RIBA recombinant immunoblot assay - SOD superoxide dismutase     

Psychological screening and the success of donor insemination

In a previous case series, a psychologist‘s rating ofcouples’ emotional adjustment and readiness for donorinsemination was predictive of pregnancy rates. We attemptedto replicate this finding with an extended series of 120 consecutivecouples in which each spouse filled out questionnaires whenevaluated for donor insemination. The Stress and InfertilityQuestionnaire measured specific attitudes and anxieties aboutdonor insemination. The Brief Symptom Inventory assessed psychologicaldistress. The Dyadic Adjustment Scale measured marital happiness.A psychologist used these questionnaires to rate the couple‘soverall adjustment in regard to donor insemination. Those couplesrated as distressed had a session of psychological counselling.Outcome was reviewed at a mean of 20 months after evaluation,with categories of pregnancy, continuing donor insemination,failure to begin the programme, or dropped out. For the 120couples overall, psychological factors did not predict pregnancyoutcome. Younger age of the wife did predict higher pregnancyrates     

Serum hepatitis B virus DNA in healthy HBsAg-negative Chinese adults evaluated by polymerase chain reaction

Serum hepatitis B virus (HBV) DNA was assayed using polymerase chain reaction, in 107 HBsAg-negative normal Chinese subjects. The results showed that eight subjects (7.5%) had HBV DNA. In the subgroup with antibody to hepatitis B surface antigen (anti-HBs) and to hepatitis B core antigen (anti-HBc), 7.3% (5/68) were positive for HBV DNA; HBV DNA was not detected in six individuals with anti-HBs only and in nine with anti-HBc only. In four persons with anti-HBc and anti-HBe, one had HBV DNA. In 20 subjects negative for all hepatitis B serological markers, two (10%) were found to have HBV DNA. This study indicates that serological markers are not adequate to rule out HBV infection, and it further implies that present blood donor screening methods may need improving.     

大鼠肝移植排斥反应期一氧化氮合酶的动力学变化

目的 探讨供体特异性输血（DST）预处理后大鼠同种肝移植物一氧化氮合酶（NOS）的动力学变化。方法 观察同基因肝移植（Ⅰ组），同种肝移植（Ⅱ组），DST预处理的同种肝移植（Ⅲ组）术后NOS的表型及亚硝酸盐/硝酸盐，细胞因子的动态变化。结果 Ⅱ组血中亚硝酸盐/硝酸盐，INF-α，TNF-α浓度明显增高，免疫组化显示，Ⅱ组移植物中macNOS^ 及ED1^ ,ED2^ 细胞数明显增多，Northern blot分析，Ⅲ组移植物中IL-10和TGF-BmRNA呈高水平表达；Ⅱ组移植物的iNOS和IL-12mRNA水平明显高于其他组。结论 DST预处理的移植物处于免疫无应答状态，NOS被抑制与TH2及TH3类细胞因子高表达有关。     

一氧化氮供体和他汀对B组柯萨奇病毒感染的实验研究

目的研究硝酸酯类和他汀类等一氧化氮（NO）供体的抗柯萨奇病毒B组3型（CVB3）的作用及其特点和机制。方法用TCID50和空斑形成实验测定CVB3的毒力；MTT法确定NO供体药物的无毒性浓度；利用细胞病变效应（CPE）抑制实验和空斑形成抑制实验分析NO供体药物对CVB3在HeLa细胞和ECV．304细胞中增殖的抑制作用；并分析硝酸甘油（GRIN）不同给药次数、NO浓度变化以及NO浓度与GTN对CVB3抑制效应间的相关性。结果硝酸酯类药物GTN、硝酸异山梨酯可明显抑制CVB3所致的CPE及空斑形成（P〈0．05），他汀类药辛伐他汀、洛伐他汀均未显示抑制CVB3所致的CPE（P〉0．05）；CVB3接种前预先与GTN作用、CVB3接种同时加入GTN两种条件下CPE抑制率差异无统计学意义（P〉0．05）；CVB3攻击后多次给予GTN的组间CPE抑制率差异无统计学意义（P〉0．05），但在CVB3攻击前不同时间点给予GTN的组间CPE抑制率差异有统计学意义（P〈0．05）；NO浓度与不同时间点给予GrIN的CPE抑制结果呈正相关（r=0．97，P〈0．01）。结论NO供体类药物硝酸酯类具有明确的抗CVB3感染作用，其抗CVB3增殖的作用与NO浓度呈正相关；他汀类药物在本实验条件下未观察到抗CVB3增殖作用，原因可能是细胞类型与他汀不匹配。     

Evaluating plasma holds in the presence of multiple infections

To protect plasma supplies, donors are screened for infectiousdiseases. As an added measure of protection, donations are identifiedand stored for a period of time to allow future discard in theevent that an identified donor subsequently tests positive forsome screened disease. Previous models for evaluating such plasmaholds have only addressed the case of a single infectious disease.This paper extends the analysis to the case of multiple infections.Given knowledge of the marginal incidence rates for those infectionschecked, upper and lower bounds for important quantities suchas the probability of interdicting an infectious but undetecteddonation, the expected number of infections interdicted perdonation, and the net economic benefits of the holding policyare developed. Several examples are developed, illustratinghow the models can be used to evaluate the consequences of aplasma hold.     

活体亲属供肾肾移植的临床分析

目的　总结分析活体亲属供肾肾移植的手术和治疗经验 ,探讨其临床效果 .方法　回顾性分析 33例活体亲属供肾肾移植的临床资料 ,包括手术方法和创新、免疫抑制药物的用药方案及临床效果 .结果　本组全部切取左肾 ,经腹手术 ,手术顺利 ,移植肾在开放血液循环后 1～ 10分钟内分泌尿液 .供体肾功能在 1周内恢复正常 ,未出现严重并发症 .受者仅 2例出现急性排斥反应 .全部受者至今存活 ,肾功能良好 .结论　活体亲属供肾 ,移植效果明显优于尸体供肾肾移植 .排斥反应发生率低 ,恢复顺利     

The relationship between fertility potential measurements on cryobanked semen and fecundity of sperm donors

Sperm penetration assay (SPA) scores obtained from cryobanked semen were correlated with therapeutic insemination (TI) fecundity in a group of established sperm donors, thereby evaluating the efficacy of the SPA in screening donors for sperm banking. While the SPA has been used to separate fertile from infertile males, we altered assay conditions to use frozen semen and to distinguish performance among fertile donors. Three frozen ejaculates from 11 pregnancy-proven donors were analysed. Of 905 TI cycles, 275 recipients achieved 95 pregnancies. There were no significant relationships between fecundity and donor semen, washed sperm parameters, sperm recoveries or recipient age. A significant relationship was revealed between mean SPA scores (range 8.7-66.6 penetrations/ovum) and donor fecundity (range 0.04-0.16, P < 0.03). Sperm concentration was varied in an effort to establish the most sensitive test condition. Using 0.25x10(6) motile spermatozoa/ml, a highly significant relationship was observed (P < 0.002). The four donors with the lowest SPA scores achieved the four lowest fecundities. It is concluded that a modified SPA can be used on frozen donor semen to estimate donor fertility potential. If applied routinely in donor semen banking, poor quality applicants could be excluded, thereby increasing pregnancy rates while decreasing donor screening costs.