There are several mechanisms acting in synergism that can impair sperm characteristics of patients with accessory gland infection. In some cases, conventional sperm variables are disturbed with oligo and/or asthenozoospermia. In other patients, these sperm variables may appear normal, but the functional capacity of spermatozoa may be impaired. In particular, changes in the composition of the sperm membrane may result in reduced acrosome reactivity and capacity to fuse with the oolemma, and oxidative damage of the sperm DNA may induce mutagenesis. Changes in the biochemical make-up of seminal plasma can also reduce the in-vivo fertilizing capacity of spermatozoa, and infection-related disruption of the blood-testis barrier can induce the generation of anti-sperm antibodies and immunological infertility. Many of these functional abnormalities will not become evident upon 'basic semen analysis', which explains why some authors are unable to link infection of the accessory sex glands to subfertility. Also, functional and anatomical damage acquired as a result of infection is often permanent and not reversible by (antibiotic) treatment. Clearly, there are many more aspects of male accessory gland infection that require investigation. Available data should stimulate clinicians to place more emphasis on the prevention of infection-related infertility than on its treatment, as the latter is often unsuccessful.
The present study was undertaken to assess the relationship between the results of conventional semen analysis and the sperm motility index (SMI) as measured by the sperm quality analyser (SQA), and to evaluate these in relation to the fertilization and/or pregnancy outcome of assisted reproduction. SMI determinations and conventional semen analyses were performed on 223 samples from subfertile men in two laboratories in Leuven (n = 136) and Antwerp (n = 87), and on spermatozoa prepared on a Percoll gradient (n = 136) used for treatment of male factor infertility in 57 cycles of intrauterine insemination (IUI), 44 attempts at in vitro fertilization (IVF) and 31 attempts at intracytoplasmic sperm injection (ICSI). SMI values for native semen correlated significantly with sperm concentration, motility and morphology. Multiple regression analysis revealed sperm concentration after preparation, and the concentration of motile spermatozoa with normal morphology and SMI (before preparation) to be the independent determinants for SMI after preparation. SMI values were significantly higher after, than before, preparation (p < 0.0001). In regular IVF (n = 44) the percentage of fertilized oocytes correlated significantly (p < 0.05) with sperm motility (A + B%, r = 0.33), with the percentage of spermatozoa with normal morphology (r = 0.46) before preparation, with the values of SMI both before and after preparation (r = 0.54, r = 0.48), with sperm concentration (r = 0.34) and with the motile sperm concentration (r = 0.29) after preparation. For the occurrence of pregnancy (all treatment methods), comparison of areas under ROC curves (AURC) indicated motile sperm concentration after preparation, as well as SMI both before and after preparation, to have the highest AURC, with no significant difference between these values as far as predictive power was concerned. These results indicate that the SQA allows for rapid evaluation of sperm characteristics and of the effectiveness of sperm preparation techniques. However, it is not superior to conventional semen analysis in predicting the outcome of assisted reproduction.
Male fertility involves the capacity to obtain viable pregnancy and offspring after insemination. Currently, the most common way to measure bull fertility is through non-return rates (NRR) calculated after insemination of many females. However, this method is time-consuming and expensive. A number of biochemical molecules in sperm have been proposed as potential predictors of male fertility, e.g. platelet-activating factor (PAF). Platelet-activating factor (1-O-alkyl-2-O-acetyl-sn-glycero-3-phosphorylcholine) is a ubiquitous phospholipid that is implicated in the mediation of a wide variety of reproductive processes. The mechanism of PAF's action is a receptor-mediated event reported to affect intracellular calcium levels. Bull sperm contain PAF and its content has a positive relationship with motility. While the PAF-receptor has been reported in other species, it has not been demonstrated in bull sperm. Therefore, our objectives were to determine: 1. the relationship between PAF content in bull sperm and Estimated Relative Conception Rates (ERCR, a 3-year rolling average of NRR); and 2. the presence of the PAF-receptor in bull sperm. Sperm PAF content for bulls (n = 8) with different ERCR was determined by radioimmunoassay. PAF-receptor expression was determined as follows: total RNA was purified by acid phenol extraction and ethanol precipitation. Complementary DNAs were synthesized by reverse transcriptase with dNTPs and random primers at 37 • C, 60 min; followed by 65 • C, 5 min. Reverse transcription (cDNA) products were amplified with Taq polymerase, dNTP, and PAF receptor primer pair (upper, 5 -AATCCAGTCACCCTGGTTGTAG-3 ; lower, 5 -TGGACTCAGAGTTCCGATACAC-3 ) at 94 • C, 1 min; 55 • C, 1 min; 72 • C, 1 min for 35 cycles followed by 72 • C, 7 min. RT-PCR products were analyzed by 2% agarose gel electrophoresis. PAF-receptor protein was determined as follows: PBS-washed bull sperm was exposed to human PAF-receptor antibody at 4 • C for 3 h, washed in PBS, then exposed to fluorescein isothiocyanate-conjugated anti-IgG for 90 min at 37 • C, and again washed in PBS. Specimens were examined by epifluorescence microscopy at 400×. PAF content in bull sperm ranged from 1.39 ng/10 6 sperm cells to 13.68 ng/10 6 sperm cells. There was a positive correlation (P < 0.05) between PAF content and ERCR. Presence of PAF-receptors in bull sperm was confirmed by immunofluorescence. However, distribution of PAF-receptors in bull sperm was not uniform within or between specimens. A cDNA clone containing the coding region for PAF-receptor was isolated from bull sperm using a reverse transcription-polymerase chain reaction protocol. There is a positive correlation (R = 0.40; P < 0.05) between PAF content in sperm and in vivo fertility of individual bulls as determined by NRR. Molecular and immunofluorescence data confirm the presence of PAF-receptor (mRNA and protein) in bull sperm. Additional studies are warranted to elucidate the mechanism of PAF's action in sperm. Early selection for fertility in bulls represents a potentially v...
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