Chemotactic Responsiveness of Human Spermatozoa to Follicular Fluid Is Enhanced by Capacitation but Is Impaired in Dyspermic Semen

Purpose: Our purpose was to study the chemotactic responsiveness of human spermatozoa from normal and pathological semen samples to follicular fluid (FF), as well as the effect exerted by capacitation on sperm chemotaxis.Methods: The chemotactic responsiveness of human spermatozoa to FF was tested by an accumulation assay chamber in which they were allowed to migrate through a microporous membrane and accumulate in a compartment filled with FF or control medium. The percentage of cells with hyperactivated motility among migrated sperm was objectively assessed by CASA and its relationship to the accumulation rate was studied. Single FFs were tested with single normospermic or dyspermic semen samples; the same FF was tested with different semen specimens. The influence of capacitation onto the chemotactic responsiveness to FF was investigated by comparing the accumulation rate of spermatozoa from normal and pathological samples after incubation under capacitating conditions for 1 or 6 hr.Results: Some FFs (active FFs) effectively attracted human spermatozoa from normospermic samples up to a dilution factor of 1:500 (v:v) with control medium. A wide range of responses was observed when the same FF was tested with different normal semen samples. A longer time under capacitating conditions increased both the chemotactic responsiveness of normal semen and its ability to undergo the acrosome reaction (AR) in response to A23187. Pathological semen had an impaired chemotactic responsiveness to active FF that was not enhanced by increasing the time spent under capacitating conditions. Dyspermic semen was also less responsive to A23187, a finding suggesting incomplete capacitation.Conclusions: Chemotactic responsiveness to FF is acquired in parallel to or as part of the capacitation process. Dyspermic semen samples have an impaired capacity to achieve both capacitation and chemotactic responsiveness to follicular factors.     

Timing of sperm capacitation appears to be programmed according to egg availability in the female genital tract

The time course of the level of A23187-induced acrosome reaction between human and rabbit spermatozoa was compared. It was extended in the former (a periodic ovulator) and short in the latter (an induced ovulator). This finding suggests that the capacitated state is programmed to maximize the prospects that an ovulated egg will meet spermatozoa in the best functional state.     

尿激酶型纤溶酶原激活因子在小鼠精-卵接触前通讯和体外受精中作用初探

目的:探讨尿激酶型纤溶酶原激活因子(uPA)在雄性促生育中的作用机制。方法:通过检测精子在毛细管内聚集数量的变化来测试小鼠精子体外对uPA和卵细胞的趋化性,以及将卵细胞分别经uPA、uPA抑制剂(PAI-1)以及抗-uPAR抗体预处理后,检测其趋化诱导精子的能力,来反应uPA在精-卵接触前通讯中的作用。其次观察精子经uPA预处理后其受精能力的变化。结果:精子在递减uPA浓度梯度中的聚集数量明显低于等浓度内的(P<0.05);经uPA预处理的卵细胞其聚集精子的能力显著强于未经处理的卵细胞(P<0.05),而用PAI-1预处理卵细胞后,卵细胞聚集精子的能力显著下降(P<0.05);用抗-uPAR抗体预处理卵细胞并不影响卵细胞对精子的聚集作用;uPA处理后的精子与卵细胞共孵育后其受精卵数目多于未经处理的(P<0.05)。结论:精子在体外对uPA和卵细胞均有趋化性;uPA能增加卵细胞对精子的趋化作用,增进精-卵接触前通讯,促进受精。本实验在一定程度上探讨了uPA促男性生育的机制,并为其在临床上的应用提供一定的理论依据。     

Pregnancy in a woman with a continent appendicovesicostomy: a case report

BACKGROUND: Few cases of pregnancy following the Mitrofanoff procedure (continent appendicovesicostomy) have been reported, but in those cases there was an increased rate of cesarean delivery with no long-term consequences to renal function or to the urinary diversion. CASE: A 15-year-old primagravida with a prior nephrectomy for a dysplastic kidney and prior continent appendicovesicostomy for urinary retention due to spina bifida occulta and neurogenic bladder had a pregnancy complicated by preterm premature rupture of membranes, preterm labor, breech presentation and cesarean delivery with the assistance of a urologist. The patient had a minimal decline in renal function, and she and the infant did well. CONCLUSION: Cesarean delivery should be reserved for obstetric indications. Surgical assistance by a urologist at the time of cesarean delivery may be helpful.     

Laparoscopic management of a 20-cm ovarian cyst in a patient with a BMI of 70: a case report

A woman in her mid-40s with a body mass index (BMI) of 70 presented with lower abdominal pain of 24-h duration. The trans-abdominal scan revealed a large cystic ovarian mass. Laparoscopic salpingo-oophrectomy was performed by placing six ports in the upper abdomen; initial Verres needle entry and pneumoperitoneum were established through the left upper quadrant. A low CA-125 and the benign appearance of the ovary allowed the operation to continue laparoscopically with fewer perioperative complications. The histology of the specimen demonstrated a benign epithelial serous cystadenoma of the ovary with torsion.