Reassessment of the accuracy of traditional sperm characteristics and adenosine triphosphate (ATP) in estimating the fertilizing potential of human semen in vivo

Receiver operating characteristic curves and accuracy parameters were computed for traditional sperm characteristics (concentration, motility, morphology) and the number of peroxidase negative cells, and the concentration of adenosine triphosphate (ATP) in semen from populations of fertile and infertile men, and men who achieved a pregnancy after varicocele treatment. The percentage and concentration per millilitre of spermatozoa with rapid linear progressive motility, and the ATP concentration, provided the best discrimination between fertile and treated fertile from infertile men. The misclassification rate was higher for sperm morphology, total progressive motility and viability, whereas sperm concentration and the total sperm count per ejaculate had the worst discriminating power. The number of peroxidase negative cells per 100 spermatozoa was highly specific in identifying men who achieved pregnancy after varicocele treatment. The lower limit of normality of sperm characteristics was remarkably different between fertile men and men achieving pregnancy after treatment or during infertility work-up.     

Fetal habituation in high-risk pregnancies

Summary. Habituation is a basic form of learning and probably requires an intact central nervous system. Habituation in the behavioural response to vibration in 40 normal human fetuses was compared with that in a group of high-risk pregnancies with an increased risk of fetal neurological damage. Highly significant differences in habituation patterns between the high-risk groups and normal control subjects were found. This test may offer a method of assessing the integrity of the fetal central nervous system.     

INTRATHECAL SUFENTANIL AS A SUPPLEMENT TO SUBARACHNOID ANAESTHESIA WITH LIGNOCAINE

The combination of low-dose sufentanil with lignocaine for subarachnoidanaesthesia was studied in a double-blind comparative trialin 40 urological patients. Patients were allocated randomlyto two groups and received 5% heavy lignocaine 1.5 ml togetherwith either 1.5 ml of sufentanil 5 µg ml^–1, or physiologicalsaline 1.5 ml. No statistically significant differences wereobserved between the two groups with respect to analgesia oranaesthesia. The only clear benefit of the addition of a lowdose of sufentanil to lignocaine was the significantly longerperiod of postoperative analgesia. There was no significantdifference in the number of patients requiring supplementaryanalgesics. Side-effects were similar in both groups.