Diagnosis and treatment of infertility in male great apes

Increased concern for maintenance of endangered species in captivity has prompted increased interest in monitoring the fertility of captive animals. This paper outlines methods for discrimination between lack of reproduction and infertility, and provides guidelines for identification of physiological causes of infertility. The role of environment in infertility is discussed, and suggestions are made for correction of environmental deficiencies. A brief review of the potential for infectious infertility is followed by an outline of appropriate treatments. It appears that a primary cause of physiological infertility in the gorilla is spermatogenic arrest, and it also appears possible that this defect may be corrected by alterations in environment and management. In summary, the outlook for continued breeding of great apes in captivity is bright, and efforts in the past few years to identify and alleviate potential causes for infertility and nonreproduction are beginning to yield good results.     

X-Y chromosome univalency in the testes of hyperthermic mice: II. Light and electron microscopic analysis of synaptonemal complexes

Hyperthermia-induced X-Y dissociation has been observed in diakinesis-metaphase I sper-matocytes but not in pachytene spermatocytes, which have been implicated as highly susceptible to heat stress. To determine X-Y dissociation in pachytene spermatocytes and to compare levels of dissociation between pachytene and diakinesis-metaphase I spermatocytes male ICR mice were exposed to 35°C ± 0.07°C and 65% ± 0.14% relative humidity for 2 or 4 days. Control mice were housed at 24°C ± 0.04°C and 43% ± 0.58% relative humidity. Mice were killed 0, 3, 5, 8, or 10 days after stress and the testes processed for meiotic chromosome display at diakinesis-metaphase I and synaptonemal complex display at pachynema. Twenty-five to thirty cells per mouse at both stages of meiosis were observed with light microscopy, and pachytene spreads with transmission electron microscopy to determine heat-stress effects on synaptonemal complex structure. Statistical analyses revealed significant linear increases in X-Y dissociation with prolonged exposure to heat at pachynema and diakinesis-metaphase I. Levels of pachytene dissociation were one-half the levels of dissociation at diakinesis-metaphase I. The resolvable structure of the lateral elements of the synaptonemal complex was not affected by heat stress.     

Selenium status of idiopathic infertile Nigerian males

Selenium concentration in the sera and seminal plasma of 60 infertile males (40 oligospermia and 20 azoospermia) and 40 males with proven evidence of fertility (normospermia; control group) were estimated using atomic absorption spectrophotometry. Results were correlated with spermatogram and hormonal levels in order to determine their relationship and significance in male infertility. The mean serum concentrations of selenium was found to be significantly increased in oligospermic compared to azoospermic subjects and controls (p<0.01), whereas the seminal plasma level was significantly higher in azoospermic compared to oligospermic subjects and controls (p<0.001). Thus, the ratio of serum selenium to seminal plasma selenium was 1∶1 in controls, 4∶1 in oligospermia, and 1∶2 in azoospermic subject. A significant inverse correlation was observed between serum selenium level and sperm count (p<0.01). Similarly, seminal plasma selenium correlated with spermatozoa motility, viability, and morphology. Serum selenium level shows positive correlation with the serum testosterone level (p<0.01). In conclusion, there appears to be a physiological balance in the distribution of selenium in serum and seminal plasma compartment of control males. A disturbance in this balance has a significant influence on spermatogenesis. Selenium appears to have a positive influence on Leydig cells, thus influencing the secretion of testosterone.     

Current knowledge of the human sperm proteome

The knowledge of the mature sperm proteome is undoubtedly the basis for understanding sperm function, the mechanisms responsible for fertilization, the reasons for infertility and possible treatments. The methods of sperm protein extraction depend mainly on the proteins of interest and the protein separation techniques that will be employed. The isolation of the membrane proteins appears to be most problematic step. Nevertheless, two-dimensional electrophoresis and mass spectrometry have become the main techniques used in human sperm protein analysis. We outline the present techniques used to examine the sperm proteome and data generated from studies on the human sperm and different types of male infertility. We present the most characteristic proteins that are involved in sperm function. Their value as biomarkers for diagnosis and treatment of infertility would require further validation. We focus on selected and critical studies of the human sperm proteome to present our subjective view of this fast-moving field.     

Surgical repair of the lacerated cervix in the mare

Surgery was performed to repair lacerations which prevented cervical closure in thirteen mares. All lacerations involved the portion of the cervix that protrudes into the vagina. There did not appear to be a predisposition for lacerations to occur in any one position about the perimeter of the cervix. Nine mares had one laceration and four mares had two lacerations. Although the lacerations were presumed to have occurred at parturition, they apparently were not associated with dystocia. The method of surgical repair is described. Eight mares were bred after surgery, and five conceived.     

Affordable assisted reproductive technologies in developing countries: pros and cons

¹ Correspondence address. E-mail: akandewole{at}yahoo.com Infertility in developing countries is pervasive and a seriousconcern. In addition to the personal grief and suffering itcauses, the inability to have children especially in poor communitiescan create broader problems, particularly for the woman. Infertilityservices in developing countries span the spectrum from preventionto treatment. From a societal and public health standpoint,prevention is cost–effective and is considered by manygovernments and public health care providers to be a priorityfor service delivery. While prevention remains paramount, takenalone it ignores the plight of infertile couples, includingthose with non-infectious causes of infertility. Two key argumentsare frequently used to challenge the development of new reproductivetechnologies in developing countries: overpopulation and limitedresources. Evidence supports the conclusion that there is acompelling need for infertility treatment beyond prevention.In many instances, assisted reproductive technologies (ART)are the last hope or the only means to achieve a child for couples.In an effort to make much needed ART to developing countriesaccessible and affordable, developing countries should lookto public–private partnerships. Governments have a responsibilityto ensure safe and effective services including the controlof standards for clinical procedures and the regulation of professionalpractice.     

Inhibition of in vitro fertilization by mouse anti-mouse sperm sera and preliminary antigen identification

Antisperm antibodies are implicated as one causative factor of infertility, but the target antigens have not been identified. Immune responses to sperm antigens are qualitatively variable even within a single mouse strain. We took advantage of this variability and immunized individual female mice to allogeneic sperm to reflect their natural exposure during mating. We determined the ability of the individual sera to inhibit in vitro fertilization and to bind to sperm antigens separated by electrophoresis. Compared to preimmune sera, four of five immune sera significantly inhibited in vitro fertilization. The serum from individual mice bound variable panels of sperm antigens. By comparing the panels, we identified two polypeptides with molecular weights of 40,000 and 44,000 that were bound by all sera. We propose that these molecules may be good candidates for further investigation of the immunoprophylaxis of pregnancy.     

＂Micro-deletions＂ of the human Y chromosome and their relationship with male infertility

The Y chromosome evolves from an autochromosome and accumulates male-related genes including sex-determining region of Y-chromosome (SRY) and several spermatogenesis-related genes.The human Y chromosome (60 Mb long) is largely composed of repeti-tive sequences that give it a heterochromatic appearance,and it consists of pseudoautosomal,euchromatic,and heterochromatic regions.Located on the two extremities of the Y chromosome,pseudoautosomal regions 1 and 2 (PAR1 and PAR2,2.6 Mb and 320 bp long,re-spectively) are homologs with the termini of the X chromosome.The euchromatic region and some of the repeat-rich heterochromatic parts of the Y chromosome are called "male-specific Y" (MSY),which occupy more than 95% of the whole Y chromosome.After evolu-tion,the Y chromosome becomes the smallest in size with the least number of genes but with the most number of copies of genes that are mostly spermatogenesis-related.The Y chromosome is characterized by highly repetitive sequences (including direct repeats,inverted repeats,and palindromes) and high polymorphism.Several gene rearrangements on the Y chromosome occur during evolution owing to its specific gene structure.The consequences of such rearrangements are not only loss but also gain of specific genes.One hundred and fifty three haplotypes have been discovered in the human Y chromosome.The structure of the Y chromosome in the GenBank belongs to haplotype R1.There are 220 genes (104 coding genes,111 pseudogenes,and 5 other uncategorized genes) according to the most recent count.The 104 coding genes encode a total of about 48 proteins/protein families (including putative proteins/protein families).Among them,16 gene products have been discovered in the azoospermia factor region (AZF) and are related to spermatogenesis.It has been dis-covered that one subset of gene rearrangements on the Y chromosome,"micro-deletions",is a major cause of male infertility in some populations.However,controversies exist about different Y chromosome haplotypes.Six AZFs of the Y chromosome have been discov-ered including AZFa,AZFb,AZFc,and their combinations AZFbc,AZFabc,and partial AZFc called AZFc/gr/gr.Different deletions in AZF lead to different content spermatogenesis loss from teratozoospermia to infertility in different populations depending on their Y hap-lotypes.This article describes the structure of the human Y chromosome and investigates the causes of micro-deletions and their relation-ship with male infertility from the view of chromosome evolution.After analysis of the relationship between AZFc and male infertility,we concluded that spermatogenesis is controlled by a network of genes,which may locate on the Y chromosome,the autochromosomes,or even on the X chromosome.Further investigation of the molecular mechanisms underlying male fertility/infertifity will facilitate our knowledge of functional genomics.     

Introducing a second wife. A matrimonial aid in cases of a childless marriage

On the basis of the corpus of 2.727 answers to the questions contained in the archives of the Ethnological Atlas, Department of Ethnology, University of Zagreb, the author has tried to provide an answer to the question concerning reasons for introducing a second wife while the first wife is still alive. Attentive comparative analysis of the entire material (analized according to religion) leads to the incontestable conclusion that the first and basic consideration is the desire for children or the desire for male children. This makes the position of the infertile women tragic. The basic life credo of patriarchal societies is the production of children. Often a woman can establish her position in society only after she has borne a male child when she may have a place in the husband's family on the basis of blood ties. The author comes to the conclusion that in this respect, even among the Muslims, where more than one wife was allowed, it is less a matter of a second wife, or bigamy, in the true sense but of introducing a new wife as a matrimonial aid primarily in cases of a childless marriage.     

Non-reproduction in the honeybee mite Varroa jacobsoni

This study brings together the results of investigations into both the causes and subsequent consequences of mites which fail to produce viable female offspring. These showed that the premature death of the male offspring within the host cell leads to unfertilized adult female offspring emerging from the cell. These unfertilized mites cannot mate and so never produce viable offspring, although they do enter cells and attempt to reproduce. Therefore, virgin females cannot account for females which normally only produce male offspring, suggesting that these males are not produced parthenogenically. In the majority of mites, the type of reproductive behaviour does not change, i.e. once abnormal always abnormal. The possible role of premature male mite death in the resistance of (Africanized) bees is discussed.     

A transgenic insertion causing cryptorchidism in mice

A distinctive feature of gonadal maturation in mammals is the movement to an extraabdominal location. Testicular descent is a complex, multistage process whereby the embryonic gonads migrate from their initial abdominal position to the scrotum. Failure in this process results in cryptorchidism, a frequent congenital birth defect in humans. We report here a new mouse transgenic insertional mutation, cryptorchidism with white spotting (crsp). Males homozygous for crsp exhibit a high intraabdominal position of the testes, associated with complete sterility. Heterozygous males have a wild-type phenotype, and homozygous females are fertile. Surgically descended testes in crsp/crsp males show normal spermatogenesis. Using FISH and genetic analyses, the transgenic insert causing the crsp mutation has been mapped to the distal part of mouse chromosome 5. Transgene integration resulted in a 550-kb deletion located upstream of the Brca2 gene. A candidate gene encoding a novel G protein-coupled receptor (Great) with an expression pattern suggesting involvement in testicular descent has been identified.     

Selenium-vitamin E supplementation in infertile men

In order to verify the hypothesis that selenium (Se) and vitamin E (Vit E) could improve male fertility, nine oligoasthenoteratozoospermic men were supplemented for a period of 6 mo with Se and Vit E. Compared to the baseline period (presupplementation) of 4 mo, statistically significant increases were observed for Se and Vit E levels, sperm motility, percent live, and percent normal spermatozoa. These improvements are likely to be “supplementation-dependent,” since all of the parameters returned to baseline values during the posttreatment period. None of the couples reported a pregnancy during the study. The HPLC analysis conducted on the serum of one of the patients showed the existence of at least six different Se-containing peaks, whose Se content was affected by supplementation. The mechanism(s) involved in these improvements of semen parameters is presently under investigation.     

双歧杆菌微生态调节剂的人体服用效果实验

双歧杆菌微生态调节剂的人体服用效果实验中德联合研究院江西南昌３３００４７魏华付金衡佘世望江西乳品厂梅国和徐书升１材料与方法１．１菌种双歧杆菌ＢＤ－２,中德联合研究院生物工程室分离。１．２材料双歧杆菌试液（含１０９个／ｍｌ）;实验动物：１８－２２ｇ昆明...     

宫腹腔镜联合治疗输卵管性不孕的临床效果分析

目的:研究宫腔镜联合腹腔镜治疗输卵管性不孕的临床效果。方法:选择2014年8月~2015年6月我院收治的输卵管性不孕患者120例,根据患者的治疗术式将其平均分成两组,每组60例。其中,观察组以联合宫腹腔镜法诊治,而对照组仅给以腹腔镜进行诊治,随访和比较两组患者的治疗效果及术后妊娠状况。结果:观察组输卵管的再通率达97.39%,而对照组仅为78.57%,显著低于观察组(P0.05)。术后随访患者2年,均不曾接受其他辅助受孕技术,观察组在随访时间内妊娠率为58.33%,而对照组为38.33%,显著低于观察组(P0.05)。结论:相比单纯腹腔镜治疗,宫腹腔镜联合治疗输卵管性不孕的临床效果更好,值得在临床上推广。     

宫腔镜联合腹腔镜治疗输卵管性不孕的临床研究

目的:探讨宫腔镜联合腹腔镜治疗输卵管性不孕的临床效果,为临床治疗提供依据。方法:选择2011年1月~2013年1月因输卵管性不孕在我院妇产科就诊的患者共120例,依据手术方法平均分为A组(宫腔镜)、B组(腹腔镜)、C组(宫腔镜联合腹腔镜)和D组(开腹手术),对比各组患者手术情况(手术时间、术中出血量和住院天数)、术后输卵管再通率和术后妊娠率。结果:A、B、C、D组手术时间、术中出血量、及住院天数依次增加,差异均有统计学意义(均P0.05);C组患者术后输卵管再通率、妊娠率均显著高于A组、B组、D组(均P0.05)。结论:宫腔镜联合腹腔镜治疗输卵管性不孕,具有创伤小、术后恢复快、输卵管再通率、妊娠率高的优点,值得推广应用。     

不同禁欲时间对少精、弱精精液质量的影响

目的:了解不同禁欲时间对少精、弱精精液质量的影响,为临床治疗不育提供参考。方法:对正常精液、少精症、弱精症患者分别根据禁欲天数随机分成两组,禁欲2-4天为A组,禁欲5-7天为B组,对上述各组进行精液分析。结果:在正常组、少精组及弱精组中,A组的精液量、精子密度及精子总量低于B组,A组a b级精子百分率高于B组,差异有统计学意义。在少精组及弱精组中A组精子正常形态率高于B组,差异有统计学意义。结论:正常精液及弱精症患者禁欲2-4天的精液质量最好,少精症患者禁欲5-7天的精液质量最好。     

腹腔镜与宫腔镜联合治疗输卵管性不孕症患者的疗效观察

目的：探讨腹腔镜与宫腔镜联合治疗输卵管性不孕症的临床效果。方法：收集2012 年1 月-2014年1 月我院收治的68 例输 卵管性不孕症患者,按照随机字数表法将患者随机分为观察组（腹腔镜联合宫腔镜治疗）与对照组（单纯宫腔镜治疗）各34例。对 比两组临床指标及术后一年输卵管再通率、妊娠率及并发症发生率。结果：两组各临床指标对比,差异无统计学意义（P>0.05）;观 察组输卵管再通率和妊娠率分别为91.17%,85.29%,显著高于对照组的73.53%、52.94%,而并发症发生率为11.76%,低于对照组 的32.35%,差异均有统计学意义（均P<0.05）。结论：腹腔镜联合宫腔镜治疗输卵管性不孕症切口小,术后恢复快,能有效提高卵管 再通率和妊娠率,减少术后并发症,值得临床推广。     

全氟显4D-HyCoSy与3D-HyCoSy对输卵管性不孕症患者的诊断效果评价

摘要 目的：探讨与评价全氟显子宫输卵管四维超声造影（4D-HyCoSy）与经阴道三维超声输卵管造影（3D-HyCoSy）对输卵管性不孕症患者的诊断效果。方法：选择2018年8月到2021年11月选择在本院诊治的女性不孕症患者84例作为研究对象,都给予全氟显4D-HyCoSy与3D-HyCoSy诊断,记录图像质量与不良反应发生情况。金标准为腹腔镜检查,判断诊断效果。结果：在84例患者中,全氟显4D-HyCoSy的图像质量优良率为100.0 %,高于3D-HyCoSy的92.9 %（P<0.05）。全氟显4D-HyCoSy诊断为输卵管通畅14例,输卵管通而不畅23例,输卵管阻塞47例。3D-HyCoSy诊断：22例输卵管通畅,21例输卵管通而不畅,41例输卵管阻塞。腹腔镜诊断：15例输卵管通畅,21例输卵管通而不畅,48例输卵管阻塞。全氟显4D-HyCoSy、3D-HyCoSy对输卵管性不孕症患者的诊断敏感性为100.0 %（36/36）、97.2 %（35/36）,特异性为97.9 %（47/48）、83.3 %（40/48）。84例患者在全氟显4D-HyCoSy、3D-HyCoSy检查期间发生的不良反应主要为阴道出血、恶心呕吐、腹部疼痛等,不良反应发生率对比无差异（P>0.05）。全氟显4D-HyCoSy对输卵管性不孕症患者的诊断敏感性与3D-HyCoSy对比无差异（P>0.05）,诊断特异性高于3D-HyCoSy（P<0.05）。结论：相对于3D-HyCoSy,全氟显4D-HyCoSy在输卵管性不孕症患者的应用能提高图像质量优良率,具有很好的安全性,还具有更好的诊断特异性。     

非梗阻性无精子症的遗传学基础及研究进展

非梗阻性无精子症(non-obstructive azoospermia,NOA)是导致男性不育的重要原因,影响着约0.6%的男性或10%的不育男性.NOA是一种由多因素引起的具有高度遗传异质性和表型异质性的复杂疾病,其中遗传学病因包括染色体异常、Y染色体微缺失、基因突变以及表观遗传修饰等.目前临床上针对NOA患者的遗传学检测,还仅限于结合附睾和睾丸穿刺活检的核型分析及Y染色体微缺失检测,而且一直缺乏理想的治疗方案.因此,深入解析NOA的具体分子机理,对阐明NOA的病因、提高男性不育的临床诊断和治疗具有重要意义.本综述将从NOA的遗传学基础、NOA的病理特征、临床诊断及治疗等方面进行系统的探讨.