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Biomedical subjects

D Katsoff

Publications and source records attributed to D Katsoff.

At least 19 recordsLinked to original sources
PubMed1997

Two methods of achieving pregnancies despite subnormal hypo-osmotic swelling test scores.

OBJECTIVE: To determine whether either the use of intracytoplasmic sperm injection (ICSI) or chymotrypsin-galactose pretreatment of sperm before IUI can improve pregnancy results in female partners of men with sperm with subnormal hypo-osmotic swelling test scores. DESIGN: Randomized controlled study. SETTING: University-based private practice of an infertility center and IVF center. PATIENT(S): Couples with infertility who presented during a specific time interval and in whom the male partner had a hypo-osmotic swelling score of < 50% in two consecutive cycles. INTERVENTION(S): Controls were treated by conventional IUI. Members of the treatment group were given an option of treatment of sperm with chymotrypsin-galactose before undergoing IUI or of undergoing IVF-ET with ICSI. MAIN OUTCOME MEASURE(S): Pregnancy rate (PR) per patient and per cycle. RESULT(S): None of the 14 control patients conceived despite 38 IUI cycles, whereas conception occurred for 4 (50%) of 8 couples in whom sperm was pretreated with chymotrypsin-galactose and for 2 (50%) of 4 couples who underwent ICSI. Patients who had enzymatic sperm treatment underwent 12 IUI cycles and 4 ICSI cycles; the PR per cycle was 33.3% in the former and 50% in the latter. CONCLUSION(S): These data suggest that treating sperm with chymotrypsin-galactose before IUI or injecting only one sperm into the oocyte overcomes to some degree the block to successful pregnancy seen in women whose male partners have subnormal hypo-osmotic swelling tests.

Chymotrypsin↗
PubMed1997

Evidence that oligoasthenozoospermia may be an etiologic factor for spontaneous abortion after in vitro fertilization-embryo transfer.

OBJECTIVE: To evaluate whether oligoasthenozoospermia may lead to a higher spontaneous abortion (SAB) rate once a pregnancy is established by IVF-ET. DESIGN: Retrospective clinical observational study. SETTING: University-based IVF program. PATIENT(S): Three hundred sixty-four couples with normal semen parameters who underwent IVF-ET with conventional sperm incubation; 70 couples with oligoasthenozoospermia but without marked abnormal sperm morphology (< 4% normal forms using strict criteria) who underwent ET after IVF with conventional sperm incubation; and 20 couples with oligoasthenozoospermia but without abnormal sperm morphology who underwent ET after IVF with intracytoplasmic sperm injection (ICSI). MAIN OUTCOME MEASURE(S): Implantation rate, clinical pregnancy rate, SAB rate, and delivery rate after IVF-ET. RESULT(S): Despite similar pregnancy and implantation rates per ET, as a result of a higher SAB rate (40.0% versus 11.7%), the delivery rates were lower in the female partners of men with oligoasthenozoospermia. Similar patients who used ICSI had a 0% SAB rate. CONCLUSION(S): Oligoasthenozoospermia should be considered a possible risk factor for SAB in IVF achieved pregnancies. Further studies are needed to determine whether ICSI reduces the risk of SAB associated with oligoasthenozoospermia.

Abortion, Spontaneous↗
PubMed1997

A challenge to the concept that the use of calcium channel blockers causes reversible male infertility.

The objective of this study was retrospectively to evaluate both in-vitro fertilization (IVF) and non-IVF cycles in which the male partner had been taking calcium channel blockers, either to confirm or refute previous data from another centre, suggesting that these drugs cause a severe but reversible subfertility problem in the male. These drugs were found to inhibit expression of mannose-ligand binding receptors, thus preventing spermatozoa from attaching to the zona pellucida; they were postulated to cause failed fertilization based on one case having this defect, in whom a return to normal was achieved after stopping the drug. However, the couple did not undergo a cycle with IVF to see if fertilization now occurred. The data presented here demonstrated fertilization in all patients having IVF who were taking calcium channel blockers. The subsequent pregnancy rate per transfer was 17.4%. Also, five out of 11 (45.4%) non-IVF patients conceived after correction of various female factors. Failure of the other six patients to conceive could be explained by other confounding factors, especially oligoasthenozoospermia. Taking into consideration other data suggesting poor fertilization when this mannose-ligand binding receptor abnormality was demonstrated, we propose the possibility that this defect, when not associated with calcium channel blockers, may be associated with some other cryptic factor that causes poor fertilization. According to our hypothesis, calcium channel blockers might cause the problem in mannose expression but also adversely affect some other factor that is deficient when non-drug related abnormalities in mannose-ligand binding expression are found.

Calcium Channel Blockers↗
PubMed1996

Transfer of cryopreserved embryos improved pregnancy rates in patients with damage to the functional integrity of the sperm membrane as measured by the hypo-osmotic swelling test.

OBJECTIVE: To compare the pregnancy rates (PRs) after transfer of cryopreserved embryos in patients who have damage to the functional integrity of the sperm membrane as measured by the hypo-osmotic swelling test to those without this defect. DESIGN: Prospective clinical study. SETTING: University-associated IVF center. PATIENTS: Fifty-four patients enrolled in a matched prospective study to evaluate the effects of low HOS scores (<50%) on PRs after IVF-ET were followed to determine the PR after transfer of cryopreserved embryos. MAIN OUTCOME MEASURE: Clinical PRs and implantation rates. RESULTS: Fourteen patients with low hypo-osmotic swelling test scores underwent 21 frozen ET cycles, achieved for clinical pregnancies for a PR per cycle of 19.0% and an implantation rate of 7.1%. Twelve patients with normal hypo-osmotic swelling test scores underwent 21 frozen ET cycles, achieved five preganancies for a clinical PR per cycle of 23.8% and an implantation rate of 9.3%. CONCLUSION: Previous studies have demonstrated an adverse effect of low hypo-osmotic swelling test scores on PRs after IVF-ET despite normal fertilization. This adverse effect was not found in the transfer of cryopreserved embryos from males with hypo-osmotic swelling test scores. Further investigation is required to determine how cryopreservation improves the chances of implantation of these embryos.

Cell Membrane↗
PubMed1995

Chymotrypsin-galactose treatment of sperm with antisperm antibodies results in improved pregnancy rates following in vitro fertilization.

PROBLEM: To determine if chymotrypsin-galactose (CG) treatment of sperm bound with antisperm antibodies (ASA) improves pregnancy rates (PRs) following in vitro fertilization (IVF). METHOD: Patients with > 50% ASA who failed to conceive despite six intrauterine insemination (IUI) cycles were included. Initially the sperm treatments were randomized with CG vs culture medium; subsequently only CG treatment was used. RESULTS: There was a significantly lower fertilization rate in those patients inseminated with sperm incubated in culture medium vs CG (27% vs 47%, P < .05 t-test). Similarly, a higher percentage of patients receiving culture medium treatment of sperm had failed fertilization (45%) compared to CG (11%). Though the clinical PRs were higher with CG (21%) tham medium (9.5%), there was no statistical difference. CONCLUSIONS: Though the percentage of sperm bound with antibodies are not reduced, we hypothesize that the CG treatment improves fertility by possibly mitigating the antagonistic action of these antibodies.

Autoantibodies↗
PubMed1995

The effect of sera antisperm antibodies in the female partner on in vivo and in vitro pregnancy and spontaneous abortion rates.

PROBLEM: To determine the incidence of antisperm antibodies (ASA) in female sera from infertile couples or those suffering from recurrent abortions. Also to determine if the pregnancy and/or abortion rates are any higher in those positive versus those negative for ASA. METHOD: All registered patients had sera drawn and ASA measured by indirect immunobead test on initial study. Pregnancy and abortion rates were determined for patients undergoing in vivo or in vitro therapy. RESULTS: There was a low incidence of ASA in patients having in vivo or in vitro treatment. There was no decrease in pregnancy rates (PRs) or increase in spontaneous abortions (SAB) in those positive for ASA. CONCLUSION: Antisperm antibodies in female sera do not seem to be etiologic in causing infertility or SAB. Future studies might consider changing the antigen source from donor sperm to husband's sperm.

Abortion, Habitual↗
PubMed1994

The use of chymotrypsin/galactose to treat spermatozoa bound with anti-sperm antibodies prior to intra-uterine insemination.

Anti-sperm antibodies in semen have been associated with a decrease in fertility potential. The question arises as to whether intra-uterine insemination (IUI) can improve pregnancy rates by merely allowing earlier capacitation and close timing to ovulation, or whether certain treatments of the spermatozoa add extra benefit. The study presented herein was designed to compare IUI using Percoll density separation with an albumin treatment versus chymotrypsin/galactose treatment. Sixteen patients were evaluated where IUI was randomized between both sperm treatments. Pregnancy rates/cycle were 25% (eight of 32) with chymotrypsin/galactose-treated spermatozoa compared to only 3% (one of 33) cycles with albumin-treated spermatozoa (P < 0.01). Since it has been reported that the proportions of spermatozoa showing immunobead binding for specific antibodies after chymotrypsin/galactose treatment remain unchanged, the exact mechanism for improvement is unknown; possibly chymotrypsin/galactose interferes with the function of the antibodies.

Autoantibodies↗
PubMed1994

The frequency of antisperm antibodies in the cervical mucus of women with poor postcoital tests and their effect on pregnancy rates.

PROBLEM: To determine the impact of the presence of antisperm antibodies (ASAs) in the cervical mucus of female partners in couples with unexplained poor postcoital tests (PCT). Furthermore, the efficacy of intrauterine insemination (IUI) in these same patients was determined by pregnancy rates (PRs). METHOD: Pregnancy rates following IUI in patients with infertility and poor postcoital tests, whether the cervical mucus was positive or negative for ASAs, were evaluated. RESULTS: The 6-month PRs were similar in the ASA negative (40.5%) versus the positive (42.4%) group. CONCLUSIONS: It appears that the antifertility effect of ASA may be mainly the immobilization of sperm in the cervical mucus, and thus, performing IUI may effectively correct the problem.

Antibodies↗
PubMed1993

A prospective study to evaluate the efficacy of modified swim-up preparation for male sex selection.

A previously published study reporting the use of a modified swim-up technique for sperm preparation prior to insemination which resulted in a high percentage of male births has been criticized for its lack of controls. The present prospective study was initiated to investigate further the efficacy of modified swim-up preparation for male sex-selection when applied in a properly defined control group. Our results showed that the proportion of males born in singleton pregnancies was approximately 50% in the group inseminated following sperm preparation with Percoll and in the control group with no sperm preparation compared with 88.5% in the group treated with the modified method of swim-up sperm preparation prior to insemination. This high rate of males in the group treated with modified swim-up was also observed in singleton pregnancies of women taking ovulation inducing drugs (primarily clomiphene citrate). This contrasts with previous publications in which a higher rate of females was found in clomiphene citrate patients using the albumin separation technique. How the mechanism of the swim-up procedure may result in a high male birth rate remains unclear. A high percentage of y enriched semen was found using fluorochrome quinacrine mustard staining but this procedure may falsely stain autosomal chromosomes. If analysis using sensitive DNA probes fails to confirm the y enrichment of the spermatozoa, one must hypothesize that the modified swim-up procedure damages the x-spermatozoa.

Female↗
PubMed1993

Effects of Percoll discontinuous density gradients vs SpermPrep II vs Sephadex G-50 gel filtration on semen parameters.

There are various methods of separating sperm from seminal plasma for subsequent intrauterine insemination (IUI) and for in vitro fertilization (IVF). The purpose of the present study was to assess and compare semen parameters following Sephadex, Percoll and SpermPrep II separation techniques. The SpermPrep II is also a Sephadex preparation but uses a different bead size, less Sephadex and is a quicker method. The specimens (n = 16) were initially evaluated for count, (C; x 10(6)/ml)% motility (MO), grade of motility (GR; %), and HOS test scores. Each specimen was then divided into 3 equal aliquots and prepared as follows: 1) layered onto a modified Percoll discontinuous density gradient column; 2) processed using SpermPrep II; and 3) filtered through a Sephadex gel filtration column (G-50). The results show all 3 treatments yielded lower (p < 0.01) counts as compared to control values but no differences were noted among them. Percoll and SpermPrep II increased MO (p < 0.01) where Sephadex reduced it (p = NS). Percoll and SpermPrep II improved the % of best quality sperm but not Sephadex with SpermPrep II being higher than Percoll. There were increases (p < 0.05) in HOS values in all experimental treatments with SpermPrep II being the best. However, this study did not show as many males with HOS scores below 50% as noted in other studies. Finally, Percoll and SpermPrep II seem equally effective methods for producing high quality sperm for IUI or IVF although SpermPrep II is quite faster.

Centrifugation, Density Gradient↗
PubMed1992

Effect of swim-up, Percoll and Sephadex sperm separation methods on the hypo-osmotic swelling test.

The separation of spermatozoa from the seminal plasma is required to prepare the spermatozoa for intrauterine insemination, in-vitro fertilization and sex selection. This study evaluated the effects of sperm preparation techniques on the functional integrity of the sperm membrane, as measured by the hypo-osmotic swelling test (HOS). Thirty-four semen specimens obtained from the male partner of infertile couples were evaluated. A semen analysis and HOS test were performed on each specimen. The remainder of the specimen was divided into three equal aliquots, the first prepared using Percoll, the second using a swim-up method and the third using a Sephadex column. After the preparation, a semen analysis and HOS test was performed on each aliquot. The mean and standard deviation for the HOS test was 72.9 +/- 8.5% initially, 71.2 +/- 13.1 after Percoll, 75.2 +/- 15.1 after swim-up and 62.4 +/- 14.5 after Sephadex. Analysis of variance showed that the mean HOS score was the same after Percoll and swim-up as it was initially but significantly lower after preparation with Sephadex. There was also a higher proportion of abnormal semen specimens (HOS less than 50%) after preparation with Sephadex than after the other preparation methods. We recommend the use of the HOS test as part of a screening panel for sperm separation.

Cell Membrane↗
PubMed1990

Evaluation and treatment of a male factor component to unexplained infertility.

The standard semen analysis frequently fails to identify subfertile males even when findings are normal and conversely often fails to identify fertile males with subnormal semen analyses. This has created the need to produce other tests of sperm physiology that will better distinguish a fertile from a subfertile specimen. Understanding more about the nature of the sperm defect should lead to the establishment of more specific and effective therapies. Until that time, it would still be reasonable to try some of the available empirical therapies even though they may work merely by a placebo mechanism.

Ascorbic Acid↗
PubMedDate not supplied

Hypoosmotic swelling: evaluation of sperm tails using strict criteria in cases of globozoospermia.

The semen from two men with globozoospermia was evaluated for hypoosmotic swelling changes and morphologic evaluation of the tail using strict criteria. No abnormalities were noted. Globozoospermia is due to a genetic defect that results in the absence of acrosomal structures. The acrosomal vesicle in the Golgi region does not develop in close contact to the nucleus, which results in the formation of globe-shape heads. Although some semen parameters were abnormal in both cases, they were different types, suggesting no association with round-headed sperm.

Adult↗
PubMedDate not supplied

Effects of Percoll discontinuous density gradients vs SpermPrep II vs Sephadex G-50 gel infiltration on semen parameters.

There are various methods of separating sperm from seminal plasma for subsequent intrauterine insemination. Some of these same techniques have been employed for female sex selection. The purpose of the present study was to assess and compare semen parameters following Sephadex, Percoll, and SpermPrepII separation techniques. The SpermPrepII is also a Sephadex preparation but uses a different bead size, less Sephadex, and is a slightly quicker method. The specimens (n = 16) were initially evaluated for count, (C; x 10(6)/mL), percent motility (MO), grade of motility (GR; percent) and hypoosmotic swelling (HOS) test scores. Each specimen was then divided into three equal aliquots and prepared as follows: (1) layered onto a modified Percoll discontinuous density gradient column; (2) processed using SpermPrepII; and (3) filtered through a Sephadex gel filtration column (G-50). The results show all three treatments yielded lower (P < 0.01) counts as compared to control values, but no differences were noted among them. Percoll SpermPrepII increased MO (P < 0.01) whereas Sephadex reduced it (P = NS). Percoll and SpermPrepII improved the percentage of better quality sperm but not Sephadex; SpermPrepII was slightly higher than Percoll, but the difference was not significant. There were increases (P < 0.05) in HOS values in all experimental treatments, with SpermPrepII having the highest scores. However, this study did not show as many males with HOS scores below 50% as noted in other studies. Percoll and SpermPrepII seem to be equally effective methods for producing high-quality sperm for intrauterine insemination or in vitro fertilization.

Cell Separation↗
PubMedDate not supplied

Comparison of direct swim-up, mini-Percoll, and Sephadex G10 separation procedures.

A comparison was made of three sperm separation techniques--direct swim-up, mini-Percoll, and Sephadex G-10--on semen parameters, including count, % motility, forward progression, and hypoosmotic swelling (HOS) test scores. Overall, the best quality sperm (less debris, best % and quality motility, and best HOS scores) were noted with the direct swim-up procedure. Mini-Percoll resulted in the highest count, but the worst HOS score. Sephadex G-10 resulted in quality of semen specimen almost as good as the direct swim-up procedure, but did allow some noncellular debris and bacteria to filter through the column.

Cell Separation↗