Biomedical subjects

S A Carson

Publications and source records attributed to S A Carson.

At least 19 recordsLinked to original sources

PubMed1999

Efficacy of superovulation and intrauterine insemination in the treatment of infertility. National Cooperative Reproductive Medicine Network.

BACKGROUND: Induction of superovulation with gonadotropins and intrauterine insemination are frequently used to treat infertility. We conducted a large, randomized, controlled clinical trial of these treatments. METHODS: We studied 932 couples in which the woman had no identifiable infertility factor and the man had motile sperm. The couples were randomly assigned to receive intracervical insemination, intrauterine insemination, superovulation and intracervical insemination, or superovulation and intrauterine insemination. Treatment continued for four cycles unless pregnancy was achieved. RESULTS: The 231 couples in the group treated with superovulation and intrauterine insemination had a higher rate of pregnancy (33 percent) than the 234 couples in the intrauterine-insemination group (18 percent), the 234 couples in the group treated with superovulation and intracervical insemination (19 percent), or the 233 couples in the intracervical-insemination group (10 percent). Stratified, discrete-time Cox proportional-hazards analysis showed that the couples in the group treated with superovulation and intrauterine insemination were 3.2 times as likely to become pregnant as those in the intracervical-insemination group (95 percent confidence interval, 2.0 to 5.3) and 1.7 times as likely as those in the intrauterine-insemination group (95 percent confidence interval, 1.2 to 2.6). The couples in the intrauterine-insemination group and in the group treated with superovulation and intracervical insemination were nearly twice as likely to conceive as those in the intracervical-insemination group. CONCLUSIONS: Among infertile couples, treatment with induction of superovulation and intrauterine insemination is three times as likely to result in pregnancy as is intracervical insemination and twice as likely to result in pregnancy as is treatment with either superovulation and intracervical insemination or intrauterine insemination alone.

Abortion, Spontaneous↗

PubMed1998

Ectopic pregnancy.

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Chorionic Gonadotropin, beta Subunit, Human↗

PubMed1998

Lack of association between antiphospholipid antibodies and first-trimester spontaneous abortion: prospective study of pregnancies detected within 21 days of conception.

OBJECTIVE: To determine the role of antiphospholipid antibodies and anticardiolipin antibodies in first-trimester losses, addressing experimental pitfalls that preclude excluding the possibility that these antibodies reflect merely the selection bias of studying couples only after they have already experienced losses. DESIGN: Given that retrospective studies cannot exclude the possibility that such antibodies arise as a result of the fetal death, blood samples were obtained either before pregnancy or very early in pregnancy. Sera were obtained within 21 days of conception. SETTING: Multicenter university-based hospitals (National Institute of Child Health and Human Development collaborative study). PATIENT(S): Subjects for the current study were 93 women who later experienced pregnancy loss (48 diabetic; 45 nondiabetic), matched 2:1 with 190 controls (93 diabetic and 97 nondiabetic) who subsequently had normal live-born offspring. INTERVENTION(S): Sera from these 283 women were analyzed for antiphospholipid antibodies by enzyme immunoassay. In 260 of the 283 women (87 with pregnancy losses; 173 with live-born infants), sera were also available to perform assays for anticardiolipin antibodies by enzyme immunoassay. MAIN OUTCOME MEASURE(S): Pregnancy losses. RESULT(S): No association was observed between pregnancy loss and the presence of antiphospholipid antibodies or anticardiolipin antibodies. Levels of antiphospholipid antibodies were 6-19 PL/mL in 62.4% of the pregnancies that ended in losses and > or = 20 PL/mL in 5.4%; among pregnancies resulting in live-born infants, the percentages were 56.8% and 6.8%, respectively. Of the pregnancies that ended in a loss, 5.7% had anticardiolipin antibodies > or = 16 GPL/mL, compared with 5.2% of those ending in a live birth. CONCLUSION(S): This prospective study suggests that anticardiolipin antibodies and antiphospholipid antibodies are not associated with an increased risk for first-trimester pregnancy loss.

Abortion, Spontaneous↗

PubMed1998

Heterotopic abdominal pregnancy treated at laparoscopy.

OBJECTIVE: To report a case of laparoscopic treatment of a heterotopic primary abdominal pregnancy after IVF with preservation of the concurrent intrauterine pregnancy. DESIGN: Case report. SETTING: University-based IVF program. PATIENT(S): A woman with a heterotopic abdominal pregnancy after IVF-ET. INTERVENTION(S): Pituitary down-regulation with luteal leuprolide acetate, ovulation induction with menotropins, IVF-ET, progesterone in oil for luteal support, laparoscopy, and resection of the abdominal gestation. MAIN OUTCOME MEASURE(S): Human chorionic gonadotropin levels, pelvic ultrasound examinations, and laparoscopic and pathologic findings. RESULT(S): A heterotopic abdominal pregnancy occurred after IVF-ET and was treated successfully with laparoscopy. The concurrent intrauterine pregnancy was delivered at term. CONCLUSION(S): Early diagnosis of an ectopic abdominal pregnancy allowed successful laparoscopic treatment, without sequelae to the intrauterine gestation.

Adult↗

PubMed1998

Postmenopausal dehydroepiandrosterone administration increases free insulin-like growth factor-I and decreases high-density lipoprotein: a six-month trial.

OBJECTIVE: To determine the effect of administering 6 months of oral postmenopausal DHEA therapy on serum DHEA, DHEAS, and T levels and on physiologic endpoints including lipoproteins and insulin-like growth factor-I (IGF-I). DESIGN: Randomized, double-blind, parallel trial. SETTING: Academic referral practice. PATIENT(S): Thirteen normal-weight or overweight, healthy, nonsmoking, postmenopausal women. INTERVENTION(S): Administration of oral micronized DHEA (25 mg/d). MAIN OUTCOME MEASURE(S): Monthly fasting 23 hours postdose levels of serum DHEA, DHEAS, T, lipoproteins, IGF-I, IGF binding protein-3 (IGFBP-3), and liver function tests. Morphometric indices by dual-energy x-ray absorptiometry scan (percent body fat; lean body mass), immune indices, and insulin sensitivity. RESULT(S): Levels of DHEA, DHEAS, and T all rose into premenopausal ranges, but after 6 months, levels of DHEA and T did not differ from baseline or placebo. At 3 months, the ratio of IGF-I to IGFBP-3 rose by 36.1% +/- 12.7%, but it fell to placebo values by 6 months. High-density lipoprotein and apolipoprotein A1 levels declined. CONCLUSION(S): Patients appeared to tolerate 6 months of DHEA therapy well. Given the small study size, no statistically significant differences in morphometric indices, immune indices, or insulin-sensitizing properties were observed, but significant attenuation of bioavailability occurred. Supplementation with DHEA increased IGF-I/IGFBP-3 levels at 3 months and decreased high-density lipoprotein and apolipoprotein A1 levels at 6 months.

Androgens↗

PubMed1998

Testosterone delivery systems for women: present status and future promise.

In women, testosterone (T) is increasingly recognized as a steroid with multiple non-reproductive effects. Testosterone deficiency in menopausal women is more common than appreciated, particularly in patients on hormone replacement or with surgical menopause. Replacement of T is an established therapy for male hypogonadism, and as a result innovative new delivery systems have evolved to optimize physiologic delivery. However, in women, modalities of T replacement remain underdeveloped and at present provide artificial and/or supraphysiologic androgen levels. This review discusses the androgen replacement modalities presently available for women, and those being developed for future use.

Adult↗

PubMed1997

New technologies permit safe abortion at less than six weeks' gestation and provide timely detection of ectopic gestation.

OBJECTIVE: The previously held dictum that elective abortion before 6 weeks' gestation carried greater risks than a later procedure was challenged by this protocol. STUDY DESIGN: This study evaluated a protocol for abortion before the customary 6 weeks' gestation. Patients willing to return to the clinic within 72 hours were given the option of elective abortion even when no gestational sac could be visualized with transvaginal ultrasonography. When no chorionic membrane with villi was seen in the curettings, postoperative serum levels of beta-human chorionic gonadotropin confirmed complete evacuation or diagnosed ectopic pregnancy. RESULTS: In 1530 abortion procedures at < 6 weeks' gestation by ultrasonographic criteria no serious complications occurred. In addition, 9 (0.67%) unsuspected ectopic pregnancies were diagnosed. CONCLUSIONS: Abortion before 6 weeks' gestation is safe, given close surveillance. Early termination combined with vaginal ultrasonography and follow-up with beta-human chorionic gonadotropin measurements allows diagnosis of early, unsuspected ectopic pregnancy. Ectopic pregnancy was found to be uncommon in women requesting early abortion.

Abortion, Induced↗

PubMed1997

Effect of sexual abstinence on the proportion of X-bearing sperm as assessed by multicolor fluorescent in situ hybridization.

OBJECTIVE: To document the relation between sexual abstinence and the proportion of X-bearing sperm in the ejaculate. DESIGN: Prospective cohort study. SETTING: Medical college. PATIENT(S): Ten normospermic men, aged 30 to 40 years, provided two semen samples: the first sample was obtained 1.0 to 1.5 days after ejaculation; the second, 7 to 10 days after ejaculation. INTERVENTION(S): Abstinence. MAIN OUTCOME MEASURE(S): Proportion of X- and Y-bearing sperm in two ejaculates. RESULT(S): Multicolor fluorescent in situ hybridization using directly labeled alpha-satellite probes specific for chromosomes 18, X and Y were used to analyze 40,273 sperm. After 1.0 to 1.5 days of abstinence, there were 47.6% +/- 1.7% (mean +/- SD) X-bearing sperm, and after 7 to 10 days of abstinence, there were 49.6% +/- 2.1% X-bearing sperm. The X:Y ratio increased marginally from 0.905 to 0.981. CONCLUSION(S): Sexual abstinence marginally increases the proportion of X-bearing sperm in the ejaculate as assessed by multicolor fluorescent in situ hybridization. This change of borderline statistical significance probably has little impact on the secondary sex ratio.

Adult↗

PubMed1997

Effect of postmenopausal estrogen replacement on circulating androgens.

OBJECTIVE: To determine the effect of estrogen replacement therapy (ERT) on serum androgen levels in postmenopausal women. METHODS: We measured serum dehydroepiandrosterone (DHEA), DHEA-sulfate, testosterone, estradiol (E2), LH, FSH, and sex hormone binding globulin in 8:00 AM fasting serum samples from a previous randomized, blinded, placebo-controlled crossover study in which 28 postmenopausal women (27 naturally menopausal) were given 2 mg/day of oral micronized estradiol. The treatment arms were 12 weeks with a 6-week washout. RESULTS: Estrogen replacement therapy raised mean (+/- standard error of the mean [SEM]) serum E2 from 8.7 +/- 1.0 to 117 +/- 18.7 pg/mL (P < .001 from baseline). Concurrently, mean (+/- SEM) DHEA-sulfate fell from 67.3 +/- 9.6 to 52.1 +/- 6.4 micrograms/dL (P < .001), and mean (+/- SEM) testosterone fell from 16.1 +/- 2.4 to 9.4 +/- 1.4 ng/dL (P = .006). Both FSH and LH declined significantly. Sex hormone binding globulin increased by 160% with ERT (P < .001). CONCLUSION: Menopausal ERT decreases serum androgen levels, decreasing DHEA-sulfate and testosterone by 23% and 42%, respectively. Whereas the decline in testosterone is likely due to decreased LH-driven ovarian stromal steroidogenesis, the declining levels of DHEA-sulfate also may imply a direct adrenal effect of estrogen. Bioavailable testosterone likely is reduced even more profoundly because sex hormone binding globulin is increased 160% by estrogen. Thus, menopausal ERT may induce relative ovarian and adrenal androgen deficiency, creating a rationale for concurrent physiologic androgen replacement.

Aged↗

PubMed1996

Delivery of dehydroepiandrosterone to premenopausal women: effects of micronization and nonoral administration.

OBJECTIVES: This single-dose study compares three dehydroepiandrosterone delivery methods (oral crystalline steroid, micronized steroid, and vaginal administration) to ascertain whether physiologic levels of circulating dehydroepiandrosterone and dehydroepiandrosterone sulfate can be obtained while increases in testosterone are minimized. STUDY DESIGN: Two randomized, double-blind, placebo-controlled single-dose comparisons were made. For oral micronized versus crystalline dehydroepiandrosterone 300 mg doses of micronized or crystalline dehydroepiandrosterone were administered, followed by 6 hours of blood sampling (n=7). Serum dehydroepiandrosterone, dehydroepiandrosterone sulfate, and testosterone levels were measured; areas under the curve and mean peak values were analyzed by Student-Newman-Keuls tests. For oral versus vaginal micronized dehydroepiandrosterone 150 mg oral or vaginal doses of micronized dehydroepiandrosterone were administered, followed by blood sampling over 12 hours (n=5). Data analysis was as described. RESULTS: Oral micronized and unmicronized dehydroepiandrosterone resulted in increases in serum dehydroepiandrosterone, dehydroepiandrosterone sulfate, and testosterone. Micronization increased the area-under-the-curve ratios for dehydroepiandrosterone sulfate/dehydroepiandrosterone and dehydroepiandrosterone sulfate/testosterone. Vaginal administration provided equivalent serum dehydroepiandrosterone; however, it failed to increase dehydroepiandrosterone sulfate or testosterone over placebo. CONCLUSION: Micronization of oral dehydroepiandrosterone diminishes bioconversion to testosterone. Vaginal dehydroepiandrosterone delivers equivalent dehydroepiandrosterone but substantially diminishes dehydroepiandrosterone bioconversion.

Administration, Intravaginal↗

PubMed1996

Prospective study showing that antisperm antibodies are not associated with pregnancy losses.

OBJECTIVE: To obtain prospective data on the relationship between presence of antisperm antibodies in maternal sera and first trimester pregnancy losses. DESIGN: First trimester sera obtained from diabetic and nondiabetic women recruited within 21 days of conception were analyzed using the indirect immunobead test for immunoglobulin (Ig)G, IgA, and IgM antisperm antibodies. Regional binding also was considered: sperm head, midpiece, and sperm tail. Results were correlated with pregnancy outcome. SETTING: Five university centers. PATIENTS: One hundred eleven women who experienced pregnancy loss (55 diabetic; 56 nondiabetic) were matched 2:1 with 104 diabetic and 116 nondiabetic women (controls) who subsequently had a normal liveborn infant. INTERVENTION: None. MAIN OUTCOME MEASURE: Pregnancy outcome (spontaneous abortion, liveborn) correlated with presence or absence of antisperm antibodies. RESULTS: Analyzing samples without knowledge of clinical status, no differences were observed with respect to IgG, IgA, and IgM binding when a positive test was defined as 50% of sperm showing antibody binding. Likewise, no association was found for IgG and IgM antisperm antibodies at 20% binding. The only positive finding was observed for IgA antisperm antibodies at 20% binding (Fisher's Exact test). This one positive finding merely could reflect multiple comparisons. No significant differences between groups were observed when analysis was stratified according to location of antibody binding (head, midpiece, tail tip, entire sperm). When the sample was stratified into those having and not having a prior loss, a relationship between antisperm antibodies and pregnancy loss still was not evident. CONCLUSION: Further work is necessary to determine whether IgA antisperm antibodies truly are associated with pregnancy loss or whether antisperm antibodies play any role in repetitive aborters. Findings in this study suggest that antisperm antibodies do not play a major role in pregnancy loss.

Abortion, Spontaneous↗

PubMed1996

Single serum progesterone as a screen for ectopic pregnancy: exchanging specificity and sensitivity to obtain optimal test performance.

OBJECTIVE: To investigate the diagnostic accuracy of screening serum P in diagnosis of ectopic pregnancy (EP) and to identify a cutoff value that provides the best compromise between test sensitivity and specificity. DESIGN: Retrospective analysis. SETTING: University hospital. INTERVENTIONS: Observation only. PATIENTS: First trimester pregnant women at risk for EP. MAIN OUTCOME MEASURE: Single P measurements were obtained from 3,674 pregnancies with outcomes defined as EP, viable intrauterine pregnancy (IUP), and spontaneous abortion (SAB). Diagnostic accuracy of the test was analyzed by generating receiver operating characteristic (ROC) curves, which quantify the ability of the test to distinguish EP and SAB from IUP. RESULTS: Diagnostic accuracy for EP versus IUP was 88.7% +/- 0.1% (mean +/- SEM); for SAB versus IUP, 93.8% +/- 0.4%; and for SAB + EP versus IUP, 92.8% +/- 0.4%. Diagnostic accuracy for SAB versus EP was only 39.4% +/- 0.2%. In the interval of 15.0 to 19.9 ng/mL (47.7 to 63.3 nmol/L), P missed 5.3% of the EPs and incorrectly included 84.3% of the viable IUPs; in the interval of 20.0 to 24.9 ng/mL (63.6 to 79.2 nmol/L), sensitivity improved in that only 3.5% of the EPs were missed but 88.8% of viable IUPs were included incorrectly. A cutoff value of > or = 17.5 ng/mL (55.7 nmol/L), the median point of the 15.0 to 19.9 ng/mL (47.7 to 63.3 nmol/L) interval, missed only 35 of 423 (8.3%) total EPs in the study. CONCLUSION: Analysis of ROC curves demonstrates that single serum P has high diagnostic accuracy for differentiating accidents of pregnancy (SAB and EP) from viable IUP, both individually (SAB versus IUP and EP versus IUP) and collectively (SAB + EP versus IUP); it cannot efficiently discriminate SAB versus EP. We conclude that for P > or = 17.5 ng/mL (55.7 nmol/L), patients thought to be at risk for EP may be followed reasonably without ultrasound or further invasive diagnostic studies.

Abortion, Spontaneous↗

PubMed1996

Ovarian hyperstimulation augments adrenal dehydroepiandrosterone sulfate secretion.

OBJECTIVE: To determine if factor(s) secreted by the ovaries during hyperstimulation potentiate basal and ACTH-stimulated adrenal androgen secretion. DESIGN: Retrospective and prospective and prospective clinical study. SETTING: University tertiary care center infertility clinic. PARTICIPANTS: Two hundred thirteen hyperstimulation cycles in endocrinologically normal women were identified from 92 patients with ovulatory infertility, aged 25 to 45 years. Further, seven endocrinologically normal infertile women, aged 22 to 37 years, who were undergoing empiric ovarian hyperstimulation for infertility were identified and studied. INTERVENTIONS: In the previously performed cycles, basal and peak serum DHEAS and cortisol (F) levels were assayed and compared with each other and to the extant E2 levels. Additionally, at the baseline and the peak of ovarian hyperstimulation cycles, a standard ACTH test was performed and serum was assayed for DHEAS, DHEA, and F. MAIN OUTCOME MEASURE: Basal and ACTH-stimulated serum DHEAS, DHEA (prospective part only), and F concentrations. Where applicable, mean peak values were generated and compared between the baseline and the peak of stimulation with or without a correction for intrapatient variability in F secretion. RESULTS: Basal serum DHEAS levels rose with ovarian hyperstimulation independent of F. Post-ACTH mean peak value concentrations rose with ovarian hyperstimulation for DHEAS but not DHEA or F. CONCLUSIONS: Ovarian hyperstimulation potentiates basal and ACTH perturbed adrenal DHEAS secretion. This implies the existence of a humoral ovarian factor(s) that mediate this ovarian-adrenal cross-talk.

Adrenocorticotropic Hormone↗

PubMed1995

Ectopic pregnancy: new advances in diagnosis and treatment.

Recent reports affirm that ectopic pregnancy has become a medical rather than a surgical disease. Early diagnosis is the key to effective nonsurgical treatment. Diagnostic algorithms using serum progesterone, serial beta-human chorionic gonadotropin measurements, ultrasound, and office curettage now make definitive diagnosis possible without laparoscopy. Laparoscopic salpingostomy, the surgical gold standard, is an effective therapy but carries surgical complications and is expensive. Systemic variable dose methotrexate produces outcomes close to laparoscopic salpingostomy in similar patients. Single dose systemic methotrexate and intratubal methotrexate appear to be less effective. In many cases, ectopic pregnancies do not meet suitable medical criteria and still require surgery. The challenge today is identifying patients at risk and bringing them into the system during the early first trimester when treatment is simple.

Female↗

PubMed1995

Flow cytometry provides rapid and highly accurate detection of antisperm antibodies.

OBJECTIVE: Immunobead testing (IBT), the current standard for antisperm antibody detection, is time consuming and somewhat subjective. To overcome these limitations and maintain accuracy, we studied an immunofluorescent assay using flow cytometry. DESIGN: A validation study comparing flow cytometry to IBT in the detection of serum antisperm antibodies. SETTING: Flow cytometry laboratory. PATIENTS: Sera from 37 men after vasectomy (test) and sera from 35 fertile men (control). MAIN OUTCOME MEASURE: Test serum with and without immunoglobulin (Ig)G, IgA, and IgM antisperm antibodies as defined by IBT were analyzed by flow cytometry. Sensitivity and specificity of flow cytometry was calculated by defining the IBT as the true result. RESULTS: Flow cytometry identified 22 of 22 sera that were IgG positive (100% sensitivity), 12 of 14 sera that were IgA positive (86% sensitivity), and 4 of 4 sera that were IgM positive (100% sensitivity). Overall, 22 of 37 men were positive for antisperm antibodies. The flow cytometry correctly identified 71 of 71 negative sera (100% specificity). Fluorescence intensity values from the 37 study patients significantly correlated with immunobead binding to the head region and to the entire (more than one) region. CONCLUSIONS: Detection of IgG, IgA, and IgM antisperm antibodies by flow cytometry is highly sensitive and specific. In addition, flow cytometry is able to assess thousands of sperm rapidly and accurately, reducing sampling error and technical time.

Antibodies↗

PubMed1994

Basal follicle stimulating hormone (FSH) predicts response to controlled ovarian hyperstimulation (COH)-intrauterine insemination (IUI) therapy.

PURPOSE: This work investigates the relationship of basal follicle stimulating hormone (FSH) measurements and age to ovarian responsiveness and pregnancy occurrence following controlled ovarian hyperstimulation and intrauterine insemination (COH-IUI). METHOD: Basal FSH was measured retrospectively in sera from infertility patients obtained on cycle day 2, 3, or 4 of a COH-IUI treatment cycle. Basal FSH was then correlated with COH response parameters and treatment outcome in ovulatory (n = 98) and anovulatory (n = 33) patients. Clinical data were collected from retrospective chart review. In the ovulatory group, increasing basal FSH was associated with fewer follicles (P = 0.01) and lower peak estradiol (P = 0.0001). RESULTS: No age related effects were detected in the anovulatory group. Also, there were no pregnancies in this group when basal FSH was > 22.1 mIU/ml. Increasing age in the ovulatory group was associated with fewer follicles (P = 0.0001), lower peak estradiol (P = 0.0001), and fewer pregnancies (P = 0.04). In the anovulatory group, basal FSH did not correlate with follicle numbers or peak estradiol, although more ampoules of hMG were used for stimulation (P = 0.03). CONCLUSIONS: Increasing basal FSH and patient age both correlated inversely with ovarian responsiveness to COH in ovulatory patients. Basal FSH can be used in clinically to identify patients undergoing COH who are unlikely to respond to superovulatory drugs and unlikely to become pregnant.

Adult↗

PubMed1994

Embryo survival after pronuclear microinjection and trophectoderm biopsy.

OBJECTIVE: Our purpose was to compare murine embryo development after pronuclear microinjection of a gene construct, followed by trophectoderm biopsy at the blastocyst state, with development after a single micromanipulation, and with cultured controls. STUDY DESIGN: alpha-Myosin heavy-chain gene sequence was microinjected into the murine embryo pronucleus and cultured to blastocyst. After trophectoderm biopsy the embryos were allowed to re-expand. Re-expanded embryos were transferred to pseudopregnant females; implantation and live birth rates were recorded. In this study group the rates were compared with three control groups of embryos simultaneously cultured after (1) pronuclear microinjection only, (2) trophectoderm biopsy only, and (3) non-micromanipulated, culture only. RESULTS: A total of 1222 embryos were divided among the four groups. In the study group 472 embryos underwent pronuclear microinjection and trophectoderm biopsy. Of these, 203 (43%) reached the blastocyst stage and underwent biopsy; 183 (38.8%) re-expanded after biopsy. Of 275 pronuclear microinjected only (control 1) embryos, 113 (41.1%) reached the blastocyst stage. Of 336 embryos 148 (44.0%) reached the blastocyst stage and underwent trophectoderm biopsy only (control 2); 129 (39.2%) survived biopsy. The cultured only group (control 3) consisted of 139 pronuclear embryos; 67 (48.2%) developed to the blastocyst stage. CONCLUSIONS: Murine embryos can survive two micro-manipulations, pronuclear microinjection followed by trophectoderm micro-biopsy. Although there is minimal effect of these procedures on embryonic development in vitro, the live birth rate is tenuous.

Animals↗

PubMed1994

Intrauterine insemination in fertile women delivers larger number of sperm to the peritoneal fluid than intracervical insemination.

Randomized IUI or intracervical insemination of eight fertile women with 50 x 10(6) sperm was performed to determine whether IUI delivers more spermatozoa to the peritoneal cavity. After IUI (n = 4), 2,053 to 29,450 sperm were recovered in the PF at laparoscopy. No sperm were found in the PF after intracervical insemination (n = 4). After IUI, CM contained 1.0 x 10(6) to 57.0 x 10(6) sperm/mL; after intracervical insemination, 0 to 1.2 x 10(3) sperm/mL were seen. One therapeutic mechanism for IUI is delivery of larger sperm numbers to the fertilization site by rapid (4 hours) transport. In addition, there is greater retrograde colonization of CM that may result in sustained release of sperm.

Cervix Uteri↗