Perspectives de l’analyse de la mobilité des spermatozoïdes

Several studies have shown a good correlation between sperm motility and fertility though the microscopic evaluation of the percentage of motile sperm is highly subjective by nature. Therefore in the last decade, various objectives methods have been proposed to overcome this problem. Two types of methods were developed: The methods based on the analysis of images obtained by microphotography, microcinematography and microvideography and the global, undirect methods based on physical principles. Several systems based on video and image analysis (Computer Aided Sperm Analysis, CASA) have been developed and are used in numerous laboratories of reproductive biology. CASA technology offers the possibility to analyse some characteristics of sperm motion which are related to the fertilization potential and to develop new parameters related to some important aspects of sperm behavior such as hyperactivation. However, there is a large amount of interactions between the operator and the CASA machine. CASA instruments are not “ready-to-use” robots: the reliability of CASA depends largely on the expertise and training of the user and the application of standardized procedures and quality control schemes. By contrast, there is only minimal interaction between the operator and the Sperm Quality Anlyser which is a new device measuring and index of sperm motility highly correlated to the concentration of progressively motile sperm. The device uses light passed through a small sample of semen introduced in a capillary tube to detect variations in optical density that result from moving particles. The reproducibility of the measurements is excellent, the device is easy to use and this is a potentially useful tool for field-work studies. Further investigations of this device in the managment of male infertility is warranted. Finally, both types of objectives approaches are complementary to the conventional analysis of sperm motility and they will not replace it. Standardized procedures have been proposed by the World Health Organization for the subjective evaluation of sperm motility. Such procedures are very useful to reduce significantly the intra- and interlaboratory variations but internal and external quality controls schemes indicate that they are not sufficient to achieve acceptable levels of variation and regular quality controls followed by the definition and the application of corrective procedures are required.     

Intérêt de l’analyse de la morphologie fine et de la qualité nucléaire des spermatozoïdes dans le cadre des techniques d’AMP

Routine semen examination does not identify minor malformations of the sperm nucleus and chromatin architectural defects, which may be associated with ART outcome and cannot be detected by the embryologist even at 1000x magnification. Recent publications have demonstrated the advantages, compared to routine analysis, of a new method of real-time detailed morphological evaluation of motile spermatozoa: motile sperm organellar morphology examination (MSOME). MSOME is performed with an inverted light microscope equipped with high-power differential interference contrast optics enhanced by digital imaging to achieve a magnification of 10000x. To be considered morphologically normal, a sperm nucleus must have both a normal shape and a normal chromatin content. The aim of the present study was to combine MSOME and sperm DNA fragmentation characteristics to assess reproductive outcome. The study population consisted of the male partners of 52 couples referred for conventional IVF or split cycles (half IVF-half ICSI cycles) and exhibiting normal routine sperm parameters. Spermatozoa were analysed by examining the fine nuclear morphology and DNA integrity using the sperm chromatin dispersion test (SCD test), based on the principle that the deproteinized nuclei of spermatozoa with nonfragmented DNA show extended halos of DNA dispersion that are either absent or only minimally present in sperm nuclei with fragmented DNA. Fertilization rates were significantly lower in the group showing less than 8% of normal spermatozoa according to MSOME criteria, but early embryo development was not affected. Fine sperm morphology correlated with DNA fragmentation rate. These results demonstrate that the assessment of sperm nuclear normality by MSOME analysis and SCD test improves characterization of the semen sample and should be evaluated as a tool for allocating patients to specific assisted reproduction treatments.     

L’analyse automatisée de la morphologie du spermatozoïde

Examination of sperm morphology is one factor of evaluation of sperm function, but it can also be considered as a biomarker of testicular function. All publications showed a high variability in observed results, in relation with different methods of staining slides and classifying sperm morphology, and a large subjectivity in the visual assessment. Automated sperm morphology analysis (ASMA) have the potential to provide more objective, accurate, and precise morphometric measurements of spermatozoa. Standardisation of the methods of slides preparation is first essential. Analysis of the sperm head morphometry appears the more accessible for the ASMA and could give selective parameters in the evaluation of fertility, in complement with motion sperm analysis. In the other hand automated analysis of all sperm abnormalities appears illusory with actual instruments, because the midpiece or the flagellum is a little structure weakly stained, and thus difficult to be identified by the computer. Until more rigorous and consistent definitions of sperm features can be developped, in relation with testicular function, the pronostic value of existing sperm abnormalities classifications is limited.     

Le deuil de la fertilité dans l’insémination avec sperme de donneur (IAD)

In a sterile man, the practice of insemination with donor’s sperm paradoxically sets up a clamping of the bereavement of his fertility. The symptom of this is the setting of the conception of the child into secrecy. The psychological help required for the elaboration of the bereavement will allow lifting this secrecy, but that is not enough for this man to have access to fatherhood. By owning himself active and his child designer, he will have to confront the latent homosexuality inherent in the practice of insemination with donor’s sperm. Bringing the work of mourning to a successful issue will make the sterile man an authentic and peaceful father.     

L’AQS (Analyseur de la Qualité du Sperme): Evaluation de son intérêt pour l’analyse,la sélection et la congélation des spermatozoïdes

The sperm quality analyzer (SQA) is a device which has been recently proposed to make an objective measurement of human semen quality. It is based on a simple physical method: the measurement of optical density modifications induced by sperm movement. Optical density modification are measured though an electro-optical photoreceptor. Analogical signals produced are transformed in numerical signals and analysed by a microprocessor. The result of the analysis is given in a unique value called «sperm motility index» (SMI). In this study the reproducibility of the results got with the SQA has been measured and the interests of this new diagnostic technique for the andrological laboratory and for human sperm freezing have been evaluated. It can be conclude that SMI measurement is simple, well reproductive and very useful to evaluate the overall quality of a sample. The SMI allows a good prediction of the efficiency of the methods used to select spermatozoa so it can help to choose the best technique, in order to prepare the spermatozoa for a medically assisted procreation. Values of SMI after freezing and thawing of semen samples were also reproducible. They were well correlated to the number of motil sperm per straw as measured by conventional methods, SMI was more objective and accurate. From the value of SMI measured on fresh samples it was possible to predict the freezing tolerance. Therefore measurement of SMI could be very useful to check straws quality and in studies on human semen cryopreservation. Prospective studies are further needed to determine if the SMI could also predict “in vivo” fertility of IVF results and fertilizing ability of frozen thawed sperm.     

Données récentes sur la maturation des spermatozoïdes dans l'épididyme humain

Au cours de leur transit épididymaire, les spermatozo?des rencontrent un environnement varié, au regard des protéines avec lesquelles ils rentrent en contract. Dans la partie proximale de l'épididyme, ils sont soumis à l'action d'enzymes, et exposés à des protéines susceptibles de modifier les membranes. Dans la partie moyenne prédomine une autre catégorie de protéines et d'enzymes; celles associées au transport de stérols pourraient modifier les membranes spermatiques afin de permettre l'ancrage de protéines de liaison à la zone pellucide: P 34H et CD52. Dans la partie distale les spermatozo?des rencontrent des activités croissantes d'enzymes lytiques, des protéines impliquées à la fois dans la liaison à la zone pellucidé et la fusion ovocytaire, l'antigène de maturation CD 52, une activité anti-microbienne, et enfin des agents décapacitants qui facilitent leur survie avant l'éjaculation. L'adhérence des protéines aux différents domaines membranaires (comme la région antérieure ou le segment équatorial de l'acrosome) peut dépendre de la nature de la protéine, de la composition lipidique de la région membranaire concernée, et de l'environnement ionique dans la lumière épididymaire. La localisation des protéines sur le spermatozo?de, qu'il soit à acrosome intact (membrane acrosomique) ou acrosome-réagi (segment équatorial) pourra dicter leur r?le, concernant par exemple la fixation à la zona (P 34H), ou la liaison à l'ovocyte (gp 20). Les protéines comme les membranes peuvent être modifiées durant le transit épididymaire par des enzymes qui peuvent ajouter ou retirer des sucres et des peptides de la surface spermatique.     

L’apport de la scintigraphie dans la pathologie de l’appareil locomoteur de l’enfant et de l’adolescent. Regards croisés du clinicien et du scintigraphiste

This paper summarizes and clarifies the clinician's reasoning in front of a lesion of the musculoskeletal system and his appeal to the examinations of imaging and to his choices. It proposes an analysis of the criteria of choice of bone scanning in this arsenal of exploration. It details the keys of the dialogue between the clinician and the nuclear physician: firstly, the clinician determines the elements of his request and its areas of doubt and uncertainty, and his diagnosis of probability and, secondly, the nuclear physician adapts the nature of the examination according to the problem posed.     

Mouvances des familles et réponses aux besoins des enfants II. L’autorité, la construction de l’identité et la sexualité

There are a lot of different models of family structures apart from the traditional nuclear family which is why they have been grouped together under the generic termrestructured families. Do they satisfactorily meet — to paraphrase Winnicott — the psychic needs of children that live inside them? The answer cannot be simplyyes or no as it is obviously impossible to study every individual case Like all human institutions, these families have to deal with specific failures and successes, which may be momentary during a crisis or a highly productive period while others may be more structural. In the second of these two articles, dedicated to this subject (Part 1 inPSN, vol. 1, 2003, n^o5, pp. 31–37), the issue of authority, the elaboration of the feeling of identity and some questions regarding sexuality will be discussed.     

Prise en charge de l’infécondité dans les troubles de l’éjaculation: avis conjoints de l’andrologue, du biologiste et du gynécologue

It is estimated that eighty percent of men who present ejaculatory disorders would like to procreate but only 5–10% from them can do it. Ejaculation can be achieved by assisted-techniques used in association with pharmacological treatment. In cases of failure of ejaculation and azoospermia, epididymal and testicular chirurgical sperm extraction allows obtaining spermatozoa. Less numerous than those obtained in ejaculated sperm, these chirurgical spermatozoa offer the advantage to be not infected by bacteria and by seminal plasma. The quality of sperm is evaluated by conventional spermiologic methods and it is important to analyze presence of spermatozoa in the urine together with that in ejaculated sperm. In ejaculatory disorders, the quality of sperm is often impaired and the mobility and vitality of spermatozoa are abnormal. Numerous bacteria and leucocytes are also present. These changes seem to be related to many factors located in the seminal plasma rather than central and testicular damages. As in fertile and infertile man, cryopreservation causes a decrease in conventional variables. However, taking into account the difficulty to obtain sperm, all patients with ejaculatory disorders would benefit from semen cryopreservation. In order to achieved successful pregnancy, several fertility treatment are available: home insemination with semen obtained by vibroejaculation, intrauterine insemination, in vitro fecondation, or intracytoplasmic sperm injection. Counselling couples undergoing such treatment program needs coordinated efforts of different specialities, which may involve andrology, biology and gynaecology.     

Recherches sur l'hérédité de la dilution et du blanchiment du pelage dans le genre cavia

Sans résuméTravail exécuté grâce à une subvention de la DonationGeorges etAntoine Claraz, instituta et curataJohannis Schinz professoris auspiciis Série zoologie n^o 66     

L’hermaphrodisme dans l’antiquité gréco-romaine: de la légende à la réalité

Since Antiquity, bisexual human beings have fascinated minds and excited the imagination. In this paper, the author discusses legends concerning the nativity of Hermaphrodite, the son of Hermes and Aphrodite, the social status of these bisexual beings and their fate in Ancient Rome and Greece.     

Etude du vieillissement d’Anagallis arvensis L.: Action régulatrice de la lumière,du saccharose et de l’acide indolyl-acétique sur la capacité rhizogènique des feuilles et des rameaux axillaires

The rooting capacity of leaves isolated from a vegetative clone ofAnagallis arvensis L. exposed to 9 hours of light (75 W m⁻²) at 22 °C and 15 hours of dark at 12 °C a day is significant only in F₁ young leaves and not in adult ones. The rooting capacity of the young leaves and of the vegetative shoots is greater in longer photoperiods. The leaves make roots even under weak (14 W m⁻²) irradiance. The rooting capacity of the leaves is diminished and even suppressed by exogenous sucrose (14,60 ×10⁻³M). This inhibition may be counteracted by IAA (10⁻⁶M). When leaves and shoots are taken from clones under long (16 h) photoperiods, or in constant irradiance, they progressively lose their rooting capacity during the treatment. Rooting capaoity is regained if the clones are returned again to “short day” (9 h) condition.      

Criblage de nouveaux gènes cibles des récepteurs nucléairesdes oxystérols LXRs impliqués dans le maintien de l’épithélium épididymaire et la maturation des spermatozoïdes dans l’épididyme

Liver X receptors (LXRs) are involved in cholesterol homeostasis and lipid metabolism.Ixr knock-out mice for the two isoformsIxra andIxrb exhibit severe disruption of the structure of caput epididymidis segment 1 and 2 epithelium and increased sperm fragility. These defects generate infertility in 10-month-old male mice. The role of LXRs in the epididymis have not yet been investigated. A cell line obtained from mouse caput epididymidis (B2 cells) was used to screen for LXR epididymal target genesin vitro. The presence of one isoform of LXR (LXRα) was detected by immunocytochemistry and the capacity of B2 cells to respond to a synthetic agonist of LXRs (T0901317) was verified. These results validated the use of B2 cells as a model. Bidimensional electrophoresis was performed on B2 cells treated with T0901317. Eight proteins up-regulated by LXRs were isolated. Only one protein has been identified: polyubiquitin, which has already been reported to be involved in cellular cholesterol homeostasis.     

Effets des différentes fractions du gradient de Percoll discontinu sur la mobilité des spermatozoides humains

The centrifugation on discontinued Percoll gradient is a technique of sperm preparation, which has enabled better success of in-vitro fertilization. In this work, we have analysed the movements of spermatozoa separated in different Percoll fractions after 4 hours of incubation at 37°C and under 5% of CO₂. These measures are made by computer assisted videomicrography (Cell Soft). From this study, we notice that the more the Percoll concentration increases, the greater is the curvilinear velocity, the linearity and the lateral amplitude of the head. The 100% and 90% Percoll fractions help to get spermatozoa with good movement features, indicating the use of this technique in medically assisted procreation.     

L’anonymat dans l’insémination avec don de sperme: un regard éthique

Which is the link between secret and anonymity in the case of donor insemination? Do we need to know the name of our donor in order to understand our own personal history? What does the term origin mean? This article aims to analyze such questions from a philosophical point of view, in order to show the difference existing between secret — which concerns conception — and anonymity, which deals with the name of the sperm donor.     

Place de l’imagerie dans l’évaluation de l’efficacité des traitements dans le cancer du sein

This paper describes, from the current literature, the role of various imaging methods to assess the response to therapy in breast cancer. Two different clinical situations are considered: neoadjuvant chemotherapy of locally advanced breast cancer and the metastastic breast cancer. Significant clinical data are available for three criteria: the volume of the tumour, the uptake of fluorodeoxyglucose using PET and the perfusion of the tumor evaluated either by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) or by PET using ¹⁵O water. ¹⁸F FDG PET allows prediction of the response after one or two cycles of neoadjuvant chemotherapy. New approaches will offer opportunities to refine the role of imaging in monitoring the response to chemotherapy. PET using thymidine as biomarker is promising in assessing the tissular proliferation. Estrogen analogs could be used to predict hormonally responsive breast cancer. Many other approaches, although less developed, might offer new insights in the response to therapy of breast cancer like magnetic resonance spectroscopy or optical imaging of hemoglobin oxygenation. Imaging also offers potential of monitoring the down-regulation of specialized receptors of the cell membrane in response to treatment: the most studied receptor in preclinical model has been the human epidermal growth factor receptor type 2 (HER2). Integrin, a family of cell adhesion receptor, is also an important target for imaging. Apoptosis, multidrug resistance and hypoxia can also be studied using appropriate biomarkers. To allow reliable multicenter trials of new drugs, these different imaging approaches still require an improved standardization of image acquisition and processing.     

L’apport de l’imagerie hybride TEMP/TDM dans la prise en charge du cancer différencié de la thyroïde

IntroductionSingle photon emission computed tomography combined with a low dose computed tomography (SPECT/CT), is a hybrid imaging integrating functional and anatomical data. The purpose of our study was to evaluate the contribution of the SPECT/CT over traditional planar imaging of patients with differentiated thyroid carcinoma (DTC).MethodsPost-therapy iodine 131 (¹³¹I) whole-body scan followed by cervico-thoracic SPECT/CT, were performed in 100 patients with DTC.ResultsAmong these 100 patients followed for a predominantly papillary DTC, planar imaging and SPECT/CT, were perfectly concordant in 70% of patients and discordant in the remaining 30%. The use of fusion imaging SPECT/CT compared to conventional planar imaging allowed us to correct our therapeutic approach in 27% (27/100 patients), according to the protocols of therapeutic management of our institute.ConclusionSPECT/CT is a hybrid imaging modality which provides better identification and more correct anatomic localization of the foci of radioiodine uptake with impact on therapeutic management.