Objective To observe the sperm penetration rate among treated but 'unsuccessful' infertile men with varicocele Material & Methods Twenty nine infertile males with II°(n=17) or III°(n=12) var...Objective To observe the sperm penetration rate among treated but 'unsuccessful' infertile men with varicocele Material & Methods Twenty nine infertile males with II°(n=17) or III°(n=12) varicocele were enrolled into this study. They underwent a varicolectomy, but their spouses had not achieved a pregnancy after 1.5~2 years of treatment. The sperm zona-free hamster oocyte penetration assay (SPA) was used to compare the sperm penetration rate (PR) before treatment and 1.5~2 years after treatment. Results After varicolectomy, enhanced PR were observed in 7 cases of the II°group and in 1 case of the III°group. However, the PR values of these 8 cases were still below 20% PR-level. Conclusion Among the treated but 'unsuccessful' men, some patients could obtain improvements on PR after varicolectomy. But PRs of men with III°grade varicele would still remain a low PR-level which indicate varicolectomy is ineffective in increasing PR among part of sever varicocele patients. SPA is a useful test for evaluating the fertilizing potential of treated infertile males with varicocele.展开更多
This was a cohort study of in vitro fertilization(IVF)subjects at the University of Utah,Salt Lake City(UT,USA)utilizing partner sperm.Cycles where both the hamster egg penetration test(HEPT)and semen analysis were pe...This was a cohort study of in vitro fertilization(IVF)subjects at the University of Utah,Salt Lake City(UT,USA)utilizing partner sperm.Cycles where both the hamster egg penetration test(HEPT)and semen analysis were performed within 2 years prior to IVF cycles were stratified into four groups based on a normal or an abnormal HEPT and morphology.The mean conventional and intracytoplasmic sperm injection(ICSI)fertilization rates were calculated in each group.We performed a univariate analysis on the primary outcome comparing clinically interesting subjects.We performed a cost-effectiveness analysis of a policy of HEPT versus universal ICSI in couples with an abnormal morphology.Among patients with a normal HEPT,there was no difference in the mean conventional fertilization rates between those with a normal and an abnormal morphology.There was no difference in the mean conventional fertilization rates between subjects with a normal morphology without a hamster test and those with a normal HEPT without a morphology assessment.In 1000 simulated cycles with an abnormal morphology,a policy of HEPT was cost saving compared to universal ICSI,yet produced similar fertilization rates.The HEPT is similar to the World Health Organization edition 5(WHO-5)morphology in predicting successful conventional fertilization while allowing decreased utilization of ICSI.A policy of HEPT for males with abnormal morphology saves cost in selecting couples for a fertilization method.展开更多
基金This study was supported by the Natural Science Foundation of Guangdong Province
文摘Objective To observe the sperm penetration rate among treated but 'unsuccessful' infertile men with varicocele Material & Methods Twenty nine infertile males with II°(n=17) or III°(n=12) varicocele were enrolled into this study. They underwent a varicolectomy, but their spouses had not achieved a pregnancy after 1.5~2 years of treatment. The sperm zona-free hamster oocyte penetration assay (SPA) was used to compare the sperm penetration rate (PR) before treatment and 1.5~2 years after treatment. Results After varicolectomy, enhanced PR were observed in 7 cases of the II°group and in 1 case of the III°group. However, the PR values of these 8 cases were still below 20% PR-level. Conclusion Among the treated but 'unsuccessful' men, some patients could obtain improvements on PR after varicolectomy. But PRs of men with III°grade varicele would still remain a low PR-level which indicate varicolectomy is ineffective in increasing PR among part of sever varicocele patients. SPA is a useful test for evaluating the fertilizing potential of treated infertile males with varicocele.
文摘This was a cohort study of in vitro fertilization(IVF)subjects at the University of Utah,Salt Lake City(UT,USA)utilizing partner sperm.Cycles where both the hamster egg penetration test(HEPT)and semen analysis were performed within 2 years prior to IVF cycles were stratified into four groups based on a normal or an abnormal HEPT and morphology.The mean conventional and intracytoplasmic sperm injection(ICSI)fertilization rates were calculated in each group.We performed a univariate analysis on the primary outcome comparing clinically interesting subjects.We performed a cost-effectiveness analysis of a policy of HEPT versus universal ICSI in couples with an abnormal morphology.Among patients with a normal HEPT,there was no difference in the mean conventional fertilization rates between those with a normal and an abnormal morphology.There was no difference in the mean conventional fertilization rates between subjects with a normal morphology without a hamster test and those with a normal HEPT without a morphology assessment.In 1000 simulated cycles with an abnormal morphology,a policy of HEPT was cost saving compared to universal ICSI,yet produced similar fertilization rates.The HEPT is similar to the World Health Organization edition 5(WHO-5)morphology in predicting successful conventional fertilization while allowing decreased utilization of ICSI.A policy of HEPT for males with abnormal morphology saves cost in selecting couples for a fertilization method.
