Objective: To examine whether a relationship exists between loss of mitochondrial transmembrane potential and plasma membrane translocation of phosphatidylserine (PS) in subpopulations of human spermatozoa ofmen consu...Objective: To examine whether a relationship exists between loss of mitochondrial transmembrane potential and plasma membrane translocation of phosphatidylserine (PS) in subpopulations of human spermatozoa ofmen consulting for infertility. Setting: A tertiary institutional research center. Design: Prospective observational study. Patient(s): Twelve infertile men and five fertile controls were compared. Intervention(s): Sperm subpopulations were compared after density gradient separation. Main Outcome Measure(s): Mitochondrial membrane potential was measured with a cationic dye, translocation of PS was evaluated with Annexin-V binding, and motion parameters were assessed manually. Result(s): In both the study and control groups and compared with the high-motility fraction, the low-motility fraction had significantly lower spermmotility and normal morphology,and significantly higher percentage of cells with disrupted mitochondrial membrane potential and plasma membrane PS translocation. There was a positive and significant correlation in both subfertile and control groups between the percentages of Annexin-V+live cells and cellswith mitochondrial membrane potential disruption (r = 0.82 and r = 0.85, respectively). Conclusion(s): The correlation of plasma membrane PS translocation and loss of mitochondrial membrane potential is suggestive of an early apoptosis phenotype, as is typically observed in somatic cells identified in sperm subpopulations with percentage of low-motile cells. We speculate that such changes might be used as diagnostic markers of sperm dysfunction(s) and that increased levels found in subfertile men might be indicators of reduced fertility potential.展开更多
Objective: The hemizona assay(HZA) is an established functional test that examines in vitro sperm-zona pellucida binding capacity with high predictive power for fertilization outcome in IVF. The objective of this stud...Objective: The hemizona assay(HZA) is an established functional test that examines in vitro sperm-zona pellucida binding capacity with high predictive power for fertilization outcome in IVF. The objective of this study was to evaluate the value of the HZA as a predictor of pregnancy in patients undergoing controlled ovarian hyperstimulation(COH) and intrauterine insemination(IUI). Design: Prospective clinical study. Setting: Academic center. Patient(s): Eighty-two couples with unexplained or male factor infertility that underwent 313 IUI cycles. Intervention(s): Basic semen analysis and HZA were performed within three months of starting COH/IUI therapy. Main Outcome Measure(s): Hemizona index(HZI) and clinical pregnancy. Result(s): Overall, patients with an HZI of < 30 had a significantly lower pregnancy rate compared to patients with an HZI of ≥30(11.1%vs. 40.6%, respectively; P < .05; relative risk for failure to conceive: 1.5[confidence interval 1.2-1.9]). In all patients combined, and in the range of HZI 0-60, the duration of infertility(P=.000) and the HZI(P=.004) were significant determinants of conception(receiver operating characteristics(ROC) analysis). In couples with male infertility, the average path velocity and HZI were significant predictors of conception(P=.001 and P=.005, respectively, ROC analysis). The negative and positive predictive values of the HZA for pregnancy were 93%and 69%, respectively. Logistic regression analysis provided models of HZI(P=.021) and duration of infertility(P=.037) with highest predictability of conception in male factor and unexplained infertility groups, respectively. Conclusion(s): TheHZA predicted pregnancy in the IUI setting with high sensitivity and negative predictive value in couples withmale infertility. Results of this spermfunction test are useful in counseling couples before allocating them into COH/IUI therapy.展开更多
文摘Objective: To examine whether a relationship exists between loss of mitochondrial transmembrane potential and plasma membrane translocation of phosphatidylserine (PS) in subpopulations of human spermatozoa ofmen consulting for infertility. Setting: A tertiary institutional research center. Design: Prospective observational study. Patient(s): Twelve infertile men and five fertile controls were compared. Intervention(s): Sperm subpopulations were compared after density gradient separation. Main Outcome Measure(s): Mitochondrial membrane potential was measured with a cationic dye, translocation of PS was evaluated with Annexin-V binding, and motion parameters were assessed manually. Result(s): In both the study and control groups and compared with the high-motility fraction, the low-motility fraction had significantly lower spermmotility and normal morphology,and significantly higher percentage of cells with disrupted mitochondrial membrane potential and plasma membrane PS translocation. There was a positive and significant correlation in both subfertile and control groups between the percentages of Annexin-V+live cells and cellswith mitochondrial membrane potential disruption (r = 0.82 and r = 0.85, respectively). Conclusion(s): The correlation of plasma membrane PS translocation and loss of mitochondrial membrane potential is suggestive of an early apoptosis phenotype, as is typically observed in somatic cells identified in sperm subpopulations with percentage of low-motile cells. We speculate that such changes might be used as diagnostic markers of sperm dysfunction(s) and that increased levels found in subfertile men might be indicators of reduced fertility potential.
文摘Objective: The hemizona assay(HZA) is an established functional test that examines in vitro sperm-zona pellucida binding capacity with high predictive power for fertilization outcome in IVF. The objective of this study was to evaluate the value of the HZA as a predictor of pregnancy in patients undergoing controlled ovarian hyperstimulation(COH) and intrauterine insemination(IUI). Design: Prospective clinical study. Setting: Academic center. Patient(s): Eighty-two couples with unexplained or male factor infertility that underwent 313 IUI cycles. Intervention(s): Basic semen analysis and HZA were performed within three months of starting COH/IUI therapy. Main Outcome Measure(s): Hemizona index(HZI) and clinical pregnancy. Result(s): Overall, patients with an HZI of < 30 had a significantly lower pregnancy rate compared to patients with an HZI of ≥30(11.1%vs. 40.6%, respectively; P < .05; relative risk for failure to conceive: 1.5[confidence interval 1.2-1.9]). In all patients combined, and in the range of HZI 0-60, the duration of infertility(P=.000) and the HZI(P=.004) were significant determinants of conception(receiver operating characteristics(ROC) analysis). In couples with male infertility, the average path velocity and HZI were significant predictors of conception(P=.001 and P=.005, respectively, ROC analysis). The negative and positive predictive values of the HZA for pregnancy were 93%and 69%, respectively. Logistic regression analysis provided models of HZI(P=.021) and duration of infertility(P=.037) with highest predictability of conception in male factor and unexplained infertility groups, respectively. Conclusion(s): TheHZA predicted pregnancy in the IUI setting with high sensitivity and negative predictive value in couples withmale infertility. Results of this spermfunction test are useful in counseling couples before allocating them into COH/IUI therapy.
