Biomedical subjects

B C Dunphy

Publications and source records attributed to B C Dunphy.

28 records · Page 2Linked to original sources

PubMed1989

The clinical value of conventional semen analysis.

The objectives of this study were, firstly, to relate semen variables to treatment independent conception rates by life-table analysis after having accounted for known female factors; secondly, to assess the relationship between the length of involuntary infertility before investigation and the predictive value of semen parameters; and thirdly, to examine the relationship between the type of progressive spermatozoal motility and fertility outcome. Laboratory error in the assessment of semen variables was minimized by using one consistent observer. Seven hundred thirty-nine subjects were recruited to the study over a 34-month period, and a 96.5% follow-up rate was achieved. Where the female partner had regular spontaneous ovulation, no pelvic pathology, and more than 48 months' preceding infertility, the Grade 2 motile sperm density (the concentration of spermatozoa exhibiting slow or sluggish linear or nonlinear motility) was the variable that best predicted fertility outcome (X1(2) = 20.24, P less than 0.0001). Where the Grade 2 motile sperm density was below 5 X 10(6)/ml in the latter group (19%), no conceptions were reported at 32 months' follow-up. Semen variables were not of predictive value where there were fewer than 48 months' infertility before investigation, or where the female partner had ovulatory dysfunction or pelvic pathology.

Cell Survival↗

PubMed1989

Is routine examination of the male partner of any prognostic value in the routine assessment of couples who complain of involuntary infertility?

The purpose of this study was to determine whether routine examination of the male partner is of value in assessing couples complaining of involuntary infertility. The relationship between male age, a previous paternity, male physical characteristics, and fertility outcome was examined. Life table analysis was performed after accounting for known female factors. Five hundred forty-four couples were recruited to the study. All conceptions were independent of treatment to either partner in which the female partner was found to be "normal" on investigation. Although male age and several physical characteristics were related to fertility outcome when all couples were examined, this was, by virtue of these variables, being related to female age and the length of involuntary infertility before investigation. When only those couples were examined in which the female partner was normal on investigation (n = 250), past paternity (x1(2) = 4.21, P = 0.040, RR = 1.81) was the only variable that retained a significant relationship to fertility outcome. It was concluded that routine examination of the male partner is of no prognostic value for couples complaining of involuntary infertility.

Adult↗

PubMed1989

The hypo-osmotic swelling test and the sperm mucus penetration test in determining fertilization of the human oocyte.

The usefulness of the hypo-osmotic swelling (HOS) test and the sperm mucus penetration (SMP) test as sperm function tests for in-vitro fertilization was analysed in 56 couples. Using logistic regression analysis only the SMP test was independently related to fertilization (P = 0.004), no false negative results were obtained, i.e. no fertilization if sperm from the ejaculate failed to penetrate mucus. The HOS test was of no predictive value. The results justify a further examination of the SMP test in other IVF centres.

Cervix Mucus↗

PubMed1989

Female age, the length of involuntary infertility prior to investigation and fertility outcome.

The objectives of this study were two-fold: firstly to determine whether female age exerts an influence on the fertility outcome of couples attending an infertility clinic, independent of demographic and clinical details; and secondly to examine the relationship between the length of involuntary infertility prior to investigation and the subsequent chance of conception. Seven-hundred-and-thirty-one subjects whose partner did not have azoospermia were recruited to the study. Female age ranged from 20 to 46 (mean = 31.1). The range of involuntary infertility prior to investigation was 12-216 (mean = 62) months. One-hundred-and-twenty-four women conceived. The following variables achieved the 5% level of significance when a stepwise analysis was performed on all cases; the concentration of spermatozoa exhibiting slow or sluggish linear or non-linear motility (chi 2(1) = 17.57, P less than 0.0001, RR = 1.67 per 50 x 10(6)), female age (chi 2(1) = 12.44, P = 0.0004, RR = 0.92 per annum), tubal status (chi 2(1) = 12.22, P = 0.0005, RR = 2.15), length of infertility before investigation (chi 2(1) = 11.22, P = 0.0008, RR = 0.87 per annum) and past paternity (chi 2(1) = 8.43, P = 0.0037, RR = 1.81). Female age was found to be positively correlated with the incidence and severity of ovulatory dysfunction, tubal occlusive disease, pelvic adhesions and endometriosis. Where the female partner was 'normal' on investigation, all conceptions were independent of treatment to either partner.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗

PubMedDate not supplied

Quality control during the conventional analysis of semen, an essential exercise.

Intra- and inter-technician variability in assessing sperm motility by the methods recently advocated by the World Health Organization (WHO) were studied. The intra- and inter-technician variability in estimating sperm concentration and the intra-technician variability in assessing sperm morphology were also examined. Intra-technician variability in assessing sperm motility appeared to be related to the natural ability and/or training of the observer. Although in general the intra-technician variability was low, there were marked and clinically significant differences between observers when assessing the same semen sample. There was no significant difference between observers in the assessment of sperm concentration, and intra-technician variability was low. When assessing sperm morphology, the intra-technician variability was potentially large (above a level of 20% morphologically ideal spermatozoa). Technicians should be recruited who have natural ability as observers. Quality control appears to be an essential exercise for any center that plans to relate semen parameters to fertility outcome.

Evaluation Studies as Topic↗

PubMedDate not supplied

Semen characteristics of 49 fertile males.

We examined the semen characteristics of 49 men whose partners had conceived within the last 16 weeks. There was considerable variation in the semen results. The % of morphologically ideal forms and the absence of sperm bound antibodies appeared to be the two most important semen characteristics when assessing the fertilising potential of the samples. A large proportion of samples (70%) when compared to the WHO standards of normality, were classed abnormal, however, only 25% of the samples had greater than 2 abnormal characteristics. It is diagnostically more relevant to determine the number of abnormalities within a sample rather than categorising the sample as "normal" or "abnormal".

Adult↗

PubMedDate not supplied

Postcoital test: which form of spermatozoal motility is associated with a good fertility outcome?

The objectives of this study were to examine the predictive value of the PCT in relation to treatment-independent conception rates, to determine which cutoff point best predicted fertility outcome, and which form of spermatozoal motility on PCT is most significantly related to fertility outcome. A prospective study was undertaken of couples referred for the investigation of "unexplained" infertility. One hundred and twenty six couples were recruited between July 1984 and April 1986. On further investigation female infertility factors were identified in 32 (25%) of couples, who were therefore excluded from the study. All conceptions were treatment independent. The relationship between the result of the postcoital test and the chance of conception was studied using a modification of Cox's regression model of life table analysis. The mean length of involuntary infertility prior to referral was 75 months (range = 18-192, SD = 39.2). The mean length of follow-up was 18 months (range = 1-34, SD = 8.4). A 98% follow-up rate was achieved. Eighteen women conceived, giving a 32-month treatment-independent conception rate of 22%. A cutoff point of one spermatozoon exhibiting sluggish motility per HPF was the most effective method of classifying the results of the postcoital test (X2(1) = 4.28, P = 0.037, RR = 4.7. This would suggest that the most efficient form of spermatozoal motion in cervical mucus is slow or sluggish motility.

Adult↗

PubMedDate not supplied

The importance of employing stringent methods to recruit fertile male controls.

Two methods of recruiting fertile male controls were evaluated and compared. The first group was recruited from the partners of women attending an antenatal clinic without obtaining details of their reproductive history. The second group was recruited after obtaining a detailed reproductive history from the couple and employing stringent entry criteria. Entry criteria for the second group included a length of exposure to the risk of pregnancy of not more than 12 months and no previous episode of involuntary infertility for either partner. There were significant differences between the distributions of semen parameters obtained from the two groups, indicating that the selection criteria for "fertile" men significantly influence results obtained and therefore that it is important to employ stringent criteria for the recruitment of fertile male controls. The group which was recruited by stringent criteria (mean length of exposure to the risk of pregnancy of 3 months) was characterised by a significantly higher median concentration of spermatozoa which exhibited slow linear or nonlinear motility. This confirms the findings of a previous study which suggested that slow linear or nonlinear motility are superior forms of spermatozoal motion.

Adult↗

PubMedDate not supplied

Male alcohol consumption and fecundity in couples attending an infertility clinic.

The relationship between male alcohol intake and fertility was studied for 258 couples attending an infertility clinic. 21% consumed less than 1 unit per week on average, 10% consumed between 1 and 5 units per week, 23% consumed between 6 and 10 units per week, 27% consumed 11 to 20 units per week and 19% consumed more than 20 units per week. There was no significant association between alcohol consumption and any semen parameter. 110 men had a female partner who was apparently normal. There was no significant difference in the alcohol intake between the 'normal' and 'abnormal' female groups. Couples were followed-up for up to 32 months. Sixteen women had a treatment independent conception within the 'normal' female group. There was no significant association between the amount of alcohol consumed per week and the fertility outcome.

Adult↗

PubMedDate not supplied

Male cigarette smoking and fecundity in couples attending an infertility clinic.

The relationship between male cigarette smoking and fertility was studied for 330 couples attending an infertility clinic. 59% did not smoke, 10% smoked between 1 and 5 per day, 8% smoked between 6 and 10 per day, 16% smoked 11-20 per day and 7% smoked more than 20 per day. There was no significant association between smoking and any semen parameter. 138 men had a female partner who was apparently normal. There was no significant difference in smoking habits between the 'normal' and 'abnormal' female groups. Couples were followed-up for up to 32 months. Nineteen women had a treatment independent conception within the 'normal' female group. There was no significant association between the number of cigarettes smoked and the fertility outcome.

Adult↗