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Query: UMLS:C0848676 (male subfertility)
 265 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present the technique of in-vivo transperitoneal fertilization (IVTPF) as a first approach to infertility treatment in couples with male subfertility or unexplained factors. The technique is statistically less successful but also less invasive than either gamete intra-Fallopian transfer (GIFT) or in-vitro fertilization - embryo transfer (IVFET) and offers considerable advantages over intrauterine insemination (IUI). The IVTPF technique involves transperitoneal transfer of processed spermatozoa within the pouch of Douglas after induction of ovulation. We report our 4-year experience with IVTPF which includes 136 treatment cycles in 89 couples. Eight pregnancies were achieved in 89 patients (9%) and 136 treatment cycles (7%). Fifty-one patients (57%) received IVTPF for only one treatment cycle; seven of the eight IVTPF pregnancies occurred in this group. An ectopic pregnancy resulted in one of the eight IVTPF pregnancies (13%). The functional quality of the sperm in those couples who achieved pregnancy was statistically superior to those couples who did not conceive. However, pregnancy was also obtained in case of severe oligozoospermia. Based on our experience, we feel IVTPF to be a very reasonable first approach in patients with no pelvic pathology and with infertility secondary to male factors or unexplained causes.
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PMID:In-vivo transperitoneal fertilization. 255 20

The clomiphene or hMG to stimulate ovarian follicle maturation which we call "controlled ovarian stimulation (COS)", in vitro capacitation (IVC) of spermatozoa and artificial insemination of husband's sperm (AIH) were simultaneously given to refractory infertile couples. The following couples were studied in 5 groups, 1 male subfertility 27 cases, 2 functional infertility 25 cases, 3 ovulatory dysfunction due to central mechanism 8 cases, 4 cervical mucous insufficiency 3 cases, 5 endometriosis 6 cases. The pregnancy rate was 21.7% in total (15 of 69 cases): 25.9% in group 1, 16.0% in group 2, 25.0% in group 3, 33.3% in group 4 and 16.7% in group 5. The follicle size and serum estradiol were measured every day during the periovulatory phase to evaluate follicle maturation. The Percoll centrifugation method was compared with the washing-centrifugation method with respect to the recovery rate and the concentration rate of motile spermatozoa. The recovery rate was 67.9% with the Percoll centrifugation method, and 40.0% with the washing-centrifugation method. The concentration rate was 1.81 times in the Percoll centrifugation method, and 1.19 times in the washing-centrifugation method. The present studies indicated that the combination of COS and IVC methods for AIH in refractory infertile couples was very effective.
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PMID:[The study of the controlled ovarian stimulation and sperm capacitated AIH for the treatment of refractory infertility]. 312 75

344 couples with infertility unrelated to female organic pelvic disease underwent Direct Intraperitoneal Insemination (DIPI) for a total of a 429 DIPI cycles. Pregnancy per couple was 16.5% and per DIPI cycle 13.2%. DIPI was particularly effective in cases of infertility due to cervical mucus insufficiency and unexplained infertility with results respectively of 33.7% and 30.4% per couple and 30.7% and 28.7% per DIPI cycle. On the contrary, the results regarding male subfertility were 12.5% per couple and 10.5% per DIPI cycle. A significant difference was found (X2 A = 16.48, p less than 0.001) between these results and those of the group composed of cases of cervical mucus insufficiency and unexplained infertility. In cases of antisperm iso- and autoimmunization the results were on the whole poor, and were in any case influenced by corticosteroid pretreatment. The Pellet Swim-up Test (PST) proved to be a good prognostic sign for success of DIPI, since a significant difference was found between the PST group greater than or equal to 1.5 X 10(6)/ml (pregnancy per couple was 19.7% and per DIPI cycle 17.2%) and PST group less than 1.5 X 10(6)/ml (pregnancy per couple was 6.8% and per DIPI cycle was 4.5%) (X2 = 11.4. P less than 0.001).
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PMID:Direct intraperitoneal insemination (DIPI) for the treatment of refractory infertility unrelated to female organic pelvic disease. 322 94

In a preliminary study of the ejaculate of 93 men, changes in motility and hypo-osmotic swelling before and after sperm separation by discontinuous Percoll gradients were evaluated. Both parameters improved significantly (P less than 0.01) in Percoll-separated spermatozoa. In a second stage, 99 couples underwent intrauterine insemination of separated semen by Percoll gradients. The population had infertility for a mean of 5.6 years. In a 1-year period, a total of 344 intrauterine insemination cycles were completed. Failure was considered when conception did not occur within four treatment cycles. The mean number of cycles per successful couple before pregnancy was 1.52. An overall 21% pregnancy rate was achieved (16% for oligoasthenospermia and 24% for asthenospermia). Sperm separation in Percoll gradients is a useful technique for intrauterine insemination in some cases of male subfertility.
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PMID:Spermatozoa selection in discontinuous Percoll gradients for use in artificial insemination. 334 3

12 couples, with infertility due to male subfertility, female antisperm isoimmunization, male antisperm autoimmunization, cervical mucus insufficiency or unexplained infertility underwent intrauterine A.I.H. with capacitated sperm and controlled ovarian stimulation. The pregnancy percentage was of 41.6% per woman treated and of 31.2% per treatment cycle; five pregnancies were obtained, of which two resulted in abortions. Five cases of oligoasthenospermia were treated, three severe and two moderate; two pregnancies occurred in the former and one in the latter. S.I.T. and S.I.T.-cap. were performed on the serum, and Micro-S.I.T. and Micro-S.I.T.-cap. on the cervical mucus in order to exclude the possibility that intrauterine A.I.H. with capacitated sperm might have caused capacitated or non-capacitated antisperm immunization. Intrauterine A.I.H. would seem to be a useful alternative to G.I.F.T. and to I.V.F./E.T. or at least a technique which should be performed before these two in cases of infertility not caused by female organic pelvic disease; it is cheap, simple and extremely well-accepted by the patient.
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PMID:In vitro sperm capacitation and intrauterine insemination (IVC-Insem): a simple technique for the treatment of refractory infertility unrelated to female organic pelvic disease. Clinical results and immunological effects: a preliminary report. 357 97

6 couples, (4 with male subfertility, 1 with cervical mucus insufficiency, 1 with unexplained infertility), underwent direct intraperitoneal insemination of capacitated sperm in combination with induced and timed ovulation. 2 pregnancies were obtained, both of them in couples with male subfertility.
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PMID:Intraperitoneal insemination (IPI) in couples with infertility unrelated to female organic pelvic disease. 357 4

The association between in vitro fertilization (IVF) and the zona-free hamster egg sperm penetration assay (SPA) was studied in 134 couples. The indications for IVF were tubal disease in 82 couples, unexplained infertility in 23, male infertility in 10, and combined mechanical and male factors in 19. In general, a positive SPA was a good predictor of subsequent IVF (91 of 107 couples). Specificity (number of couples with fertilization in vitro divided by the number of couples with a positive SPA times 100) was 94% for tubal infertility, 76% for unexplained infertility, and 46% for male infertility. A negative SPA predicted an overall fertilization failure of 78% (21 of 27 couples). Sensitivity of the test (number of couples with IVF failure divided by the number of couples with a negative SPA times 100) was 100% for tubal and unexplained infertility but only 63% for male infertility. The high predictive value of the SPA for subsequent IVF outcome in tubal infertility and unexplained infertility warrants its routine use for prescreening in IVF programs. Because of the lack of association between SPA and IVF in oligoasthenospermia, the bioassay should not be relied upon for predicting IVF outcome in male subfertility. The overall high association between the animal model and human IVF reinforces the use of the SPA for both basic research and clinical decision-making.
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PMID:Correlation between the zona-free hamster egg sperm penetration assay and human in vitro fertilization. 369 71

The management of varicocele is still controversial in spite of its high incidence (15%) in prepubertal boys and young adults and although it is believed to represent a major contributing factor to male subfertility. Fifty boys between 6 and 14 years of age were operated on for left varicocele, and a long segment of the left internal spermatic vein was excised. Thirty-four of them underwent preoperative retrograde left renal venography and pressure readings in both renal veins and inferior vena cava. In all 50 patients, intraoperative antegrade (via internal spermatic vein) left renal venography was performed. This examination revealed impaired renal venous drainage in 38 patients (group A) and normal venous return through the left renal vein in 12 patients (group B). In all 34 patients (from both groups) on whom retrograde venography was performed, there was marked renospermatic reflux. The pressure readings in the left renal vein were significantly increased in group A only. Our data strongly suggest that left varicocele is caused by renospermatic venous reflux and that this condition is probably irreversible. The reflux in group A is explained by the impaired venous drainage through the left renal vein. In group B, it is our impression that the reflux is a result of a congenitally valveless left internal spermatic vein. If varicocele is indeed a major cause for infertility, then our data logically point toward surgery.
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PMID:Varicocele in children: "to treat or not to treat"--venographic and manometric studies. 379 68

Fourteen couples with long-standing infertility, associated with cervical mucus insufficiency, male subfertility, or unexplained infertility, participated in a therapeutic trial. The female partners, who were all ovulatory, were given human menopausal gonadotropin from day 2 of the menstrual cycle (controlled ovarian hyperstimulation). When plasma estradiol concentrations reached 1000 to 2000 pg/ml, human chorionic gonadotropin was given. Approximately 32 hours and again 70 hours thereafter, a masturbation specimen of the husband's sperm was capacitated in vitro and inseminated transcervically into the uterine cavity. Five women (35%) conceived following a single cycle of treatment. Four of the pregnancies are currently progressing normally; one ended in a spontaneous miscarriage in the early first trimester. The potential role of in vitro sperm capacitation and transcervical intrauterine insemination in the treatment of refractory infertility unrelated to female organic pelvic disease is discussed.
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PMID:In vitro sperm capacitation and transcervical intrauterine insemination for the treatment of refractory infertility: phase I. 642 23

Varicocele is a common and treatable cause of male subfertility. The authors describe a new technique for varicocele detection using radionuclide blood-pool imaging of the scrotum. Of 83 patients studied, 29 had a clinically palpable varicocele of various sizes, and 26 of them were demonstrated by this technique. Two of the false negatives were bilateral varicoceles. In the 41 patients with no clinically detectable varicocele, there were 10 positive and 10 marginally asymmetric studies. The results indicate that this technique detects unilateral varicoceles with high sensitivity, including some which are subclinical. There may be significant implications for treatment of infertility.
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PMID:Detection of varicocele by radionuclide blood-pool scanning. 742 50


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