人精子体外获能过程中活动和运动能力和动态变化与体外受精能力的…

通过６５例人精子在普通和高渗ＢＷＷ增基中获能３．６．１２、２４、３６、４８ｈ，观察其活动和运动能力并进行受精能力测定，试图利用常规参数的动力学变化指标评价其受精能力。结果显示：不同时项指标及不同时项的降低百分率均与受精率明显相关（Ｐ＜０．０５－０．０００１），不同分组下各指标的受精率有显著差异（Ｐ＜０．０５－０．０００５）；进一步分析了每小时平均降低百分率（ＡＤＲ）和递降百分率（ＧＤＲ）。报告了一     

精子核碱性蛋白转化与精子畸形及不明原因流产关系初探

本文探讨了精子核碱性蛋白转化与精子畸形及不明原因流产的关系。对８例有二次以上不明原因早期流产妇女的配偶（流产组）及１０个正常生育力的男性（对照组）作精子形态学检查，抽提精子核碱性蛋白，在酸－尿素聚丙烯酰胺凝胶（ａｃｉｄ－ｕｒｅａＰＡＧＥ）中电泳，测定组蛋白（Ｈ），中间型碱性蛋白（ＩＢＰ）及鱼精蛋白（ＨＰ１～３）各区带的相对含量，以（ＨＰ１～３）占总碱性蛋白（ＴＢＰ）的百分比表示碱性蛋白转化率。实验结果为：（１）碱性蛋白转化率与精子畸形率成直线负相关关系（ｒ＝－０．７５９Ｐ＜０．０１）；（２）流产组精子核碱性蛋白转化率低于对照组（Ｐ＜０．０５），ＩＢＰ／ＴＢＰ则高于对照组（Ｐ＜０．０５）。提示精子核碱性蛋白转化障碍致中间型碱性蛋白（ＩＢＰ）及组蛋白（Ｈ）在精子染色质中残留过多，是引起精子头部畸形的原因之一，且与不明原因流产有关。     

胰岛素样生长因子及其结合蛋白对体外精子活力的影响

精浆中含有胰岛素样生长因子（ＩＧＦｓ）、ＩＧＦ结合蛋白（ＩＧＦＢＰｓ）和ＩＧＦＢＰ 蛋白酶已被证实,但对它们的功能尚不了解。本文使用上泳法优选精子,并应用计算机辅助精子分析技术（ＣＡＳＡ）研究ＩＧＦｓ 和ＩＧＦＢＰｓ 对体外精子活动参数的影响,如：曲线速度（ＣＶ）、直线速度（ＰＶ）、直线性（Ｌｎ）、前向性（Ｓｔ）、精子头侧摆幅度（ＡＬＨ）和鞭毛摆动频率（ＢＦ）。用方差分析评价各试验组与对照组间随培育时间精子活动参数的变化。结果显示ＩＧＦⅠ使ＣＶ 和ＡＬＨ 显著减少（Ｐ＜ ０．０５）;而ＩＧＦ Ⅱ试验组精子活动参数没有变化。完整的ＩＧＦＢＰ ３使Ｌｎ、Ｓｔ、ＢＦ显著增加（Ｐ＜ ０．０５）,使ＡＬＨ 显著减少（Ｐ＜ ０．０５）;但ＩＧＦＢＰ ２对精子活动参数却没有显著的影响。当ＩＧＦ Ⅰ和ＩＧＦＢＰ ３同时被加到精子样品中培育时,未发现对精子活动参数有统计意义的改变。我们的结论是ＩＧＦ Ⅰ和完整的ＩＧＦＢＰ ３对体外精子活动参数有着不同、而且是相反的影响,这可能在生育调节方面有一定的功用。     

黄体功能缺陷与子宫内膜效应不良患者的内分泌特征

目的：分析比较黄体功能缺陷（ＬＰＤ）和子宫内膜效应不良（ＩＥＲ）患者的内分泌特征。方法：采用放射免疫法和放射性配体饱和竞争、葡聚糖活性碳吸附分析法，测定ＬＰＤ、ＩＥＲ患者和月经周期正常者（对照组）的血清激素水平及同一月经周期子宫内膜组织中的雌、孕激素受体含量。结果：ＬＰＤ患者黄体期的雌、孕激素水平显著低于对照组（Ｐ＜０．００１），其子宫内膜雌、孕激素受体含量在整个月经周期中与对照组无差异（Ｐ＞０．１）；而ＩＥＲ患者整个月经周期的血清雌激素水平均低于对照组（Ｐ＜０．００１），但黄体期的血清孕激素水平与对照组无差异（Ｐ＞０．１），子宫内膜增生期的胞浆雌激素受体、胞核孕激素受体和整个月经周期的胞浆孕激素受体含量亦显著低于对照组（Ｐ＜０．００１，Ｐ＜０．００１，Ｐ＜０．０５）。结论：ＬＰＤ和ＩＥＲ是内分泌特征根本不同的两种情况，ＬＰＤ主要表现为黄体细胞分泌雌、孕激素功能下降，子宫内膜相应受体含量正常；ＩＥＲ则为整个周期的雌激素水平降低及相应受体合成障碍，而黄体分泌孕激素的功能正常。     

人类组织相容抗原免疫遗传与妊高征发病关系的探讨

选择４０对妊高征夫妇及正常对照组１００例，对其人类组织相容性抗原中与Ｄ区相关抗原（ＨＬＡ－ＤＲ）频率分布、纯合型频率及夫妇间ＨＬＡ－ＤＲ抗原共享进行了检测。结果显示：与正常对照组相比，妊高征患者ＨＬＡ－ＤＲ＿４频率有极显著的增加（Ｐ＜０．００１），妊高征患者夫妇ＨＬＡ－ＤＲ共享有明显提高（Ｐ＜０．０１），其中尤以ＤＲ＿４抗原共亨率最高（Ｐ＜０．０００１），然而，ＨＬＡ－ＤＲ及ＤＲ＿４纯、杂合型频率两组间无明显差异。结果表明，妊高征的遗传易感性可能与ＤＲ＿４有关，其相关性推测可能是由于ＤＲ＿４与妊高征的疾病易感基因间连锁不平衡所致，但ＤＲ＿４是否直接充当一种免疫缺陷基因尚不能确定。     

胰岛素样生长因子—Ⅰ对卵母细胞成熟度,受精力及卵裂力的影响

目的：探讨胰岛素样生长因子－Ⅰ（ＩＧＦ－Ⅰ）对卵巢功能的调节作用。方法：体外培养小白鼠未成熟卵母细胞、成熟卵母细胞和精子及受精卵。实验组加入不同浓度的ＩＧＦ－Ⅰ，对照组不加ＩＧＦ－Ⅰ。观察卵母细胞成熟度、受精率及卵裂率。结果：实验组小白鼠卵母细胞成熟度、受精率及卵裂率均大于对照组，差异有极显著性及显著性（Ｐ＜０．０１及Ｐ＜０．０５）。实验组及对照组受精卵均有不均匀分裂和细胞碎片出现，但在同一培养时间内，差异无显著性（Ｐ＞０．０５）。结论：ＩＧＦ－Ⅰ可促进体外培养的小白鼠卵母细胞成熟度及受精卵的卵裂过程，提高受精率；对受精卵和胚胎无明显不良影响。     

CD44V6、EGFR在卵巢上皮癌中的表达及临床意义

目的：探讨ＣＤ４４Ｖ６及ＥＧＦＲ在卵巢上皮癌中的表达及临床意义。方法： 以 ＳＰ免疫组织化学方法检测 ３３５例卵巢上皮癌, １８例卵巢上皮瘤和 １５例正常卵巢组织石蜡标本 ＣＤ４４Ｖ６及 ＥＧＦＲ的表达,并分析卵巢上皮癌的临床病理资料。结果：①正常卵巢组织 ＣＤ４４Ｖ６及 ＥＧＦＲ均呈阴性表达,卵巢上皮瘤及上皮癌中均有中ＣＤ４４Ｖ６及ＥＧＦＲ表达,正常卵巢与卵巢良恶性肿瘤之间的表达差异有高度显著性（Ｐ＜０．０１）,卵巢上皮癌与卵巢上皮瘤之间的表达差异无显著性（Ｐ＞０．０５）;（２）ＣＤ４４Ｖ６及ＥＧＦＲ的阳性表达与卵巢上皮癌的临床分期有关（Ｐ＜０．０５）,与组织分化程度及病理类型无关（Ｐ＞０．０５）;③ＣＤ４４Ｖ６及ＥＧＦＲ的阳性表达与卵巢上皮癌预后有关（Ｐ＜０．０５）;④ＣＤ４４Ｖ６及ＥＧＦＲ在卵巢上皮癌中的表达差异无显著性（Ｐ＞０．０５）,二者具有相关性（Ｐ＜０．０５）．结论：ＤＤ４４Ｖ６及ＥＧＦＲ可能是卵巢上皮癌发生的相关基因,与肿瘤的发展及转移有关。检测 ＣＤ４４Ｖ６及 ＥＧＦＲ可以估计卵巢上皮癌患者的预后,指导化疗。     

免不1号治疗79例抗精子抗体阳性不育症的临床研究

采用中药免不１号治疗抗精子抗体引起的免疫性不育症７９ 例，并设西药强的松３０例作对照。治疗结果：免不１号妊娠３１ 例，妊娠率３９．２％ ，强的松组妊娠３例，妊娠率１０％ ，两组比较有显著性差异（Ｐ＜ ０．０５）。治疗后，免不１ 号组精液复查，精子密度、存活率、前向精子活力等有明显改善（Ｐ＜ ０．０１），强的松组改善不明显（Ｐ＞ ０．０５）。免疫性不育症中医辨证分三型，其中脾肾两虚型经免不１ 号治疗后妊娠率最高（４２．１％ ）。     

流产患者外周血肿瘤坏死因子可溶性白细胞介素-2受体及T淋巴细胞亚群的测定

对８５例早期流产患者采用酶联免疫吸附法测定外周血肿瘤坏死因子（ＴＮＦ－α）、可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）以及采用流式细胞仪检测外周血Ｔ淋巴细胞亚群（总Ｔ淋巴细胞，ＣＤ３；Ｔ辅助，ＣＤ４；Ｔ抑制，ＣＤ８）。流产患者分为三组：２５例难免或不全流产（ＥＡ），先兆流产２０例治疗失败（ＴＡＦ）及３８例治疗成功（ＴＡＳ）。选择正常早孕妇女（ＮＰ）及非孕妇女（ＮＮＰ）各２０例为对照。结果：①血清ＴＮＦ－α、ｓＩＬ－２Ｒ水平在ＥＡ、ＴＡＦ、ＴＡＳ组分别明显高于ＮＰ组（Ｐ＜０．０５），且在ＥＡ、ＴＡＦ组较ＴＡＳ组明显升高（Ｐ＜０．０５）。血清ＴＮＦ－α、ｓＩＬ－２Ｒ水平在ＮＰ组与ＮＮＰ组没有明显差异（Ｐ＞０．０５）。②ＣＤ８细胞在ＥＡ、ＴＡＦ组分别明显低于ＴＡＳ、ＮＰ组（Ｐ＜０．０５），ＣＤ３、ＣＤ４在各组没有明显差异（Ｐ＞０．０５）。提示：自然流产可能与机体免疫异常有关。     

正常妊娠妇女外周血可溶性白细胞介素－2受体及淋巴细胞亚群的变化

测定了８７例妊娠晚期及２９例正常非孕妇女外周血可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）水平，同时对其中３６例孕妇及１０９例正常非孕妇女（正常对照）进行外周血淋巴细胞亚群检测。结果：妊娠晚期妇女ｓＩＬ－２Ｒ水平及Ｔｓ细胞（ＣＤ＿８）明显高于正常对照，分别为：２１４６００±７０４００Ｕ／Ｌ比１６２１００±８４１Ｄ０Ｕ／Ｌ，　Ｐ＜０．０１及３７．６％±５．３％比３１．３％±７．０％，Ｐ＜０．０１。妊娠妇女Ｔｈ细胞／Ｔｓ细胞（ＣＤ＿４／ＣＤ＿８）比例明显低于正常对照（１．２±０．２比１．５±０．５，Ｐ＜０．０１）。但总Ｔ淋巴细胞（ＣＤ＿３），ＣＤ＿４，细胞与正常对照相比，差异无显著性，分别为：６４．１％±７．３％比６６．０％±９．９％，Ｐ＞０．０５及４４．１％±５．８％比４３．８％±９．Ｏ％，Ｐ＞０．０５。相关分析表明孕妇ｓＩＬ－２Ｒ水平与ＣＤ＿３、ＣＤ＿４、ＣＤ＿８细胞及ＣＤ＿４／ＣＤ＿８均无显著相关性（ｒ分别为０．２０３２，０．２０７７，０．１０３７及０．１２１４，Ｐ均＞０．０５）。提示：孕妇外周血Ｔ淋巴细胞亚群及血清ｓＩＬ－２Ｒ的变化对维持正常妊娠有重要作用，ｓＩＬ－２Ｒ可能是促进胎儿正常生长的重要介质之一。     

Evaluation of a cut-off value for sperm motility after different hours of incubation to select the suitable reproductive technology (IVF or ICSI)

BACKGROUND: The aim of this study was to enhance the predictability of conventional semen parameters for in-vitro fertilization outcome. The utility of late sperm motility in presence of a cumulus-oocyte complex after different hours of incubation was investigated to predict the outcome of IVF in borderline and normal ejaculates (at least 5 x 10(6) motile sperm). METHODS: The study was done on 52 infertile couples undergoing conventional in-vitro fertilization and embryo transfer. Sperm were prepared by the Percoll cushion centrifugation with swim-down. Cocultures were established by inseminating the cumulus-oocyte complexes with 100000 motile spermatozoa and incubating them for 48 hours. Another 100000 spermatozoa were incubated in culture medium for 48 hours. Sperm motility (WHO a+b) was determined at 0, 4, 24 and 48 hours of incubation. RESULTS: The fertilization rate was 65.5% (42.9-88.1). The conventional semen parameters did not correlate with the fertilization rate. Sperm motility measured after different hours of incubation was found to be significantly positively correlated with the fertilizing ability of sperm in vitro in Spearman's rank correlation test: motility after 0 h (p<0.02), after 4 h (p=0.0025). after 24 h (n.s.) and after 48 h (p=0.0071). Cut-off values for late sperm motility were determined and differences in fertilization rates were calculated for these cut-off values after different hours of incubation. A cut-off value of 20% progressive motile spermatozoa after 48 hours gave the best statistical power (fertilization rate 71.7 vs. 50.2%, p<0.001). Significant differences in the fertilization rates were also observed for a cut-off value of 35% after 24 hours of incubation (70.1 vs. 46.2%, p=0.001) and for a cut-off point of 60% after 4 hours (72.4 vs. 51.5%, p=0.001). CONCLUSIONS: The predictive power of sperm motility after 48 h for fertilization outcome provides support in the decision-making process within the assisted reproduction setting. If less than 20% of sperm are motile after 48 h micromanipulatory techniques should be considered.     

常规IVF中受精失败相关因素及后续处理结果分析

目的:分析常规IVF受精失败原因,以进一步提高IVF受精率。方法:回顾性分析常规IVF中受精率低下或受精失败患者的各种因素及后续处理结果。结果:438个常规IVF取卵周期中,受精率≤25%的周期30个(A组)(6.85%)。其中12个周期第1日行补救性ICSI或重复IVF,最终共20个周期进行了胚胎移植,但均未获得临床妊娠。与受精率正常的周期(B组)相比,A组精子密度、活率、a级精子比例、前向运动精子比例(PMS)及分离后的精子活率、PMS比例、精子密度等均显著降低(P均<0.05)。组间的获卵数无明显差别,但A组MI期及GV期卵的数量明显高于B组(P<0.01)。其他受精失败因素包括对精子因素导致受精失败的7例在随后的周期进行ICSI,5例获得临床妊娠。结论:受精失败的原因是多方面的,但精液各参数下降及卵子发育不成熟是其主要原因;第1日行补救性ICSI或重复IVF的妊娠结局差;对于精子因素造成的受精失败,在以后的周期中行ICSI能获得理想的结果。     

The influence of seminal characteristics on the success rate of human in vitro fertilization

The relationship of conventional semen parameters and the limits of these parameters for fertilization in vitro were analyzed from data over a 3-year period (1980 to 1982). Sperm motility was the single most important parameter determining the fertilization rate. Fertilization failed when the initial and final motilities were less than 20% and 30%, respectively. The percentage of abnormal sperm forms was also significantly related to the fertilization rate; but even when there were greater than 60% abnormal spermatozoa, fertilization could be obtained. Sperm concentration in semen had no significant effect on the fertilization rate when the data were controlled for motility or abnormal sperm forms. The fertilization rate increased with reduced sperm numbers used for insemination in vitro but had no effect on the incidence of multiple pronuclei in oocytes.     

Relationship Between the Sperm Motility Index Assessed by the Sperm Quality Analyzer and the Outcome of Intracytoplasmic Sperm Injection

Purpose: Intracytoplasmic sperm injection (ICSI) has been validated as a useful treatment in severe male-factor patients who could not achieve fertilization and live births by conventional in vitro fertilization treatment. To examine the impact of male factors on ICSI outcome, clinical laboratory data were retrospectively analyzed. Methods: One hundred two cycles of ICSI treatment indicated by severe male-factor infertility were entered into this study. Sperm parameters including sperm motility, sperm concentration, and sperm motility index assessed by the Sperm Quality Analyzer were evaluated. Results: Five hundred seventy-six metaphase II oocytes retrieved were manipulated. The normal fertilization (2 PN) rate per oocyte was 64.9 ± 26.0% (mean ± SD). Of the 99 transfers, 31 clinical pregnancies were obtained, yielding an average pregnancy rate of 31.3% per transfer. The mean sperm motility, sperm concentration, and sperm motility index were 20.3 ± 16.1% (range, 0 to 50%), 18.2 ± 25.1 × 10 ⁶ /ml (range, <1 to 150 × 10 ⁶ /ml), and 31.2 ± 45.0 (range, 0 to 220), respectively. Sperm concentration did not have a significant impact on fertilization rate by ICSI. In four cases, ICSI was performed using totally immotile sperm and the fertilization rate was 43.5%, which was significantly lower than that of some of the other sperm motility groups, and no pregnancy could be achieved. In 14 cases in which the sperm motility index assessed by the Sperm Quality Analyzer was 0, the fertilization rate (50.0%) was significantly lower than in most of the other sperm motility index groups. Conclusions: These findings suggest that in severe malefactor cases with totally immotile sperm or a sperm motility index of 0, the selection of good-quality sperm should be verified before injection.     

Enhancement of human sperm motility and velocity in vitro: effects of calcium and creatine phosphate

Because of their roles in motility regulation and energy transport, calcium and creatine phosphate were examined for their effects on sperm motility and velocity in specimens of normal donors. Semen or migrated sperm fractions were incubated with of 1 mmol of calcium, 5 mmol magnesium, and 10 mmol of creatine phosphate (n = 28) or in the presence of 4 mumol of Verapamil, calcium, and creatine phosphate (n = 10). The samples were subjected to multiple exposure photography (four picture frames of two different drops) at 0, 1, 4, or 5 and at 10 hours and sperm motility and velocity were analyzed. In both calcium and calcium-creatine phosphate conditions, sperm motility and velocity were significantly increased, compared with control values (P = between less than 0.001 and 0.05). Sperm motility declined following Verapamil exposure, but the motility values remained at the level of the control in the presence of additional calcium or creatine phosphate. The effects of calcium and creatine phosphate take place rapidly; within 1 minute all improvements in sperm velocity and motility are fully achieved. There is no loading effect of calcium, and when the sperm is transferred into media without the additional calcium, the velocity decreased to that of the initial control value. Magnesium alone had no effect on motility or velocity. These experiments indicate that calcium or creatine phosphate can support sperm motility and velocity at a significantly increased level. Thus the addition of calcium or creatine phosphate to the insemination media may enhance the fertilizing capacity of sperm during in vitro fertilization or gamete intrafallopian transfer procedures.     

Prediction of fertilization in vitro with human gametes: is there a litmus test?

OBJECTIVES: The objectives of this study were as follows: (1) to evaluate the relationships between sperm concentration, morphologic pattern, motion parameters, and sperm-zona pellucida binding capacity and (2) to assess their ability to predict fertilization outcome under in vitro fertilization conditions. STUDY DESIGN: Semen samples from 44 infertile men were prospectively evaluated for density, morphologic pattern (strict criteria), computerized motion parameters (motility, velocity, and linearity), and hemizona assay (outcome expressed as hemizona assay index), and results were correlated with fertilization outcomes of preovulatory oocytes during in vitro fertilization. RESULTS: Of all sperm parameters, morphologic pattern was the best predictor of the ability of the sperm to bind to the zona pellucida. Hemizona assay index was the best predictor of fertilization rate. Stepwise regression analysis provided a model of hemizona assay index plus motility with highest predictability (R2 = 53.4%). CONCLUSIONS: (1) The influence of sperm morphologic pattern as a prognosticator of fertilization outcome is established in major part as a determinant of sperm binding ability to the zona pellucida; (2) the hemizona assay provides a robust index that is highly predictive of the potential of human gametes to achieve fertilization and highlights its use in infertility and contraception testing.     

精浆松弛素对人精子运动及其相关参数的影响

目前一些学者认为内源性松弛素与精子运动率有关,但报道不尽一致。本实验采用RLx抗体中和精液RLx的方法,观察内源性RLx对精子运动率的影响。收集22例精液标本,13例为正常运动率精子,9例为低活动率精子,待液化后进行精液常规分析,作各项运动参数的测定,然后每例标本取精液0．38ml加入RLx抗血清（滴度为1：6000）0．02ml作为实验组,另取精液0．38ml加入正常血清0．02ml作为对照组,置37℃水浴孵育．分别在15min、30min、60min时再次测定精子运动的各项参数并进行对比。结果显示：实验组除2例正常运动率精子变化不明显外,其余均呈运动率的明显下降;其中尤以精子前向运动率的抑制最为显著。实验证明：内源性RLx在维持精子活动能力．特别是前向运动过程中起着重要作用。     

Effect of cryopreservation on quality and fertilization capacity of human sperm

OBJECTIVE: To analyze retrospectively the effect of cryopreservation on donor's sperm. STUDY DESIGN: Data were collected on 178 cryopreserved-thawed sperm specimens from 44 donors and 624 oocytes from 62 women, which underwent in vitro fertilization-embryo transfer (IVF-ET) treatments with donor's sperm. Data on fresh sperm, 175 sperm specimens from 76 couples which underwent IVF-ET treatments, were used as a control group. Semen analysis was done by cell concentration, percent of motility, and quality of motility according to the World Health Organization (WHO) recommendation. Sperm quality parameters which had the strongest impact on fertilization capacity were determined using the statistical response surface model and conjoint analysis. RESULTS: Passing sperm through Percoll column decreased sperm concentration, with no improvement in sperm motility but with a slight increase in quality of motility. Quality of motility of donor's sperm had the strongest impact on fertilization capacity. CONCLUSION: Current freezing-thawing protocols of sperm cause a decrease in sperm parameters without affecting fertilization capacity. Furthermore, quality of motility of frozen-thawed sperm seems to be a significant measure of sperm fertilization capacity.     

Which isolated sperm abnormality is most related to sperm DNA damage in men presenting for infertility evaluation

Background

Sperm DNA damage is common in infertile men and is associated with poor semen parameters but the impact of an isolated sperm abnormality on sperm DNA damage has not been studied.

Objective

To evaluate sperm DNA damage in a large cohort of infertile men with isolated sperm defects.

Design, setting and participants

Retrospective study of 1084 consecutive, non-azoospermic infertile men with an isolated sperm defect: isolated oligozoospermia (iOligo), isolated asthenozoospermia (iAstheno) or isolated teratozoospermia (iTerato).

Outcome measurements and statistical analysis

We examined and compared clinical parameters, conventional semen parameters and %sperm DNA fragmentation (%SDF, assessed by flow cytometry-based Terminal deoxynucleotidyl transferase-mediated dUTP Nick End-Labeling assay) in the three groups of men.

Results and limitations

The mean (±SD) %SDF was significantly higher in the iAstheno compared to the iOligo and iTerato groups (25.0 ± 14.0 vs. 19.2 ± 11.6 and 20.7 ± 12.1 %, respectively, P < 0.0001). Similarly, the proportion of men with high %SDF (>30 %) was significantly higher in the iAstheno compared to the iOligo and iTerato groups (31 % vs. 18 % and 19 %, respectively, P < 0.0001). In the group of 713 men with iAstheno, %SDF was positively correlated with paternal age (r = 0.20, P < 0.0001) and inversely correlated with %progressive motility (r = −0.18, P < 0.0001). In the subset of 218 men with iTerato, %SDF was also positively correlated with paternal age (r = 0.15, P = 0.018) and inversely correlated with %progressive motility (r = −0.26, P = 0.0001).

Conclusions

In this large cohort of infertile men with isolated sperm abnormalities, we have found that the sperm DNA fragmentation level is highest in the men with sperm motility defects and that 31 % of these men have high levels of sperm DNA fragmentation. The data indicate that poor motility is the sperm parameter abnormality most closely related to sperm DNA damage.     

Predictive value of sperm morphology and movement characteristics in the outcome of in vitro fertilization of human oocytes

One hundred fourteen semen samples from Chinese males were analyzed for routine semen parameters including the semen volume, sperm count, percentage motility, and percentage normal morphology. Of these 114 samples, 54 also had movement characteristics of seminal and swim-up sperm evaluated by the computer image analyzer system (Cellsoft; Cryo Resources Co., New York). All semen samples were subjected to the swim-up procedure to harvest the motile sperm before inseminations of human oocytes. Fertilization was considered to have occurred when at least one oocyte was observed with two or more pronuclei. Semen samples were classified as infertile (0% fertilization rate;N=32) or fertile (>0% fertilization rate;N=82) before statistical analyses. There was a significant difference (P<0.005) in percentage normal morphology of seminal sperm between the fertile (mean±SE; 67.3±1.2%) and the infertile (59.3±2.2%) samples. The percentage normal morphology of seminal sperm correlated (r=0.3049;P<0.002) with the fertilization rate and this parameter was selected by the multivariate stepwise discriminant analysis as the discriminator capable of predicting the fertilization rate with 57.9% accuracy. Statistical analyses of samples where sperm movement was also evaluated demonstrated that there was significant differences (P<0.01) between the fertile (N=38) and the infertile (N=16) samples in percentage normal morphology of seminal sperm (67.8±1.8% vs 56.2±2.6%) and curvilinear velocity of swim-up sperm (89.2±3.5 vs 68.2±7.2 m/sec). The fertilization rates correlated with the percentage normal morphology of seminal sperm (r=0.3868;P<0.005) and velocity of swim-up sperm (r=0.3842;P<0.005). Multivariate stepwise discriminant analysis demonstrated that these two sperm parameters in combination were capable of predicting the fertilization rate with 74.1% accuracy. Our results indicate that seminal sperm morphology, coupled with computerassisted image analysis of movement characteristics of swim-up sperm, can help to predict the outcome of in vitro fertilization of human oocytes.