Abraham Lightman

Sperm motility index: a new parameter for human sperm evaluation

OBJECTIVEnThe study was performed to evaluate the correlation between sperm motility index, a novel parameter of semen quality, and routine semen analysis parameters by microscopic evaluation.nnnDESIGNnSperm motility index was measured by an electro-optical device, the Sperm Quality Analyzer (United Medical Systems Inc., Santa Ana, CA). Human semen samples covering the whole span of qualities were analyzed prospectively and simultaneously by both methods.nnnSETTINGnSamples were collected from patients referred to university hospital infertility clinics.nnnPATIENTS, PARTICIPANTSnNine hundred sixty-eight semen samples of 812 patients and healthy men were analyzed.nnnMAIN OUTCOME MEASURE(S)nSperm motility index is a measurement of optical density fluctuations caused by motile cells; therefore, a positive correlation was anticipated between its values and semen motility parameters.nnnRESULTSnSperm motility index values demonstrated statistically significant correlation with motile cell concentration, total cell concentration, and percent motile cells. They were also shown to reliably represent semen quality assessment obtained by two experienced andrologists.nnnCONCLUSIONSnThe sperm motility index provides a reliable and objective reflection of semen motility parameters and quality.

MALE GONADAL FUNCTION IN SURVIVORS OF CHILDHOOD HODGKIN AND NON-HODGKIN LYMPHOMA

The aim of this study was to investigate the impact of therapy on long-term gonadal function of young people cured of childhood lymphomas and to assess whether a prepubertal state during the treatment protects the gonads from chemotherapy and/or radiotherapy late effects. Clinical evaluation, semen analysis, and endocrine status were studied in 20 survivors of childhood lymphomas. Five patients received Inverted Y radiotherapy, 2320 cGy (1550-4000); all 20 received chemotherapy as follows: MOPP/ABVD protocol, 9 patients; COMP protocol, 5 patients; MOPP protocol, 3 patients; other protocols, 3 patients. Semen analysis results were as follows: normal values, 4/20 patients; oligospermia, 8/20 patients; azoospermia, 8/20 patients; FSH above normal level, 10/20 patients; 4/5 who received Inverted Y irradiation were azoospermic and 1 was severely oligospermic. Treatment damage to the testis involves tubular germinal elements. Radiotherapy and chemotherapy combinations that included nitrogen mustard or cyclophosphamide were associated with high rates of oligospermia and azoospermia. MOPP/ABVD combination did not have a significant better outcome of sperm counts compared to MOPP alone. Age at chemotherapy did not correlate with the sperm count; hence a prepubertal state did not protect the gonad from the late effects of treatment.

Zinc Concentration in Gravida’s Serum and Amniotic Fluid during Normal Pregnancy

Zinc concentration was determined in maternal serum and amniotic fluid during normal pregnancy. The nonpregnant zinc concentration in the serum of about 110 micrograms% decreases gradually during pregnancy to about half the normal level. Amniotic fluid zinc concentration shows a slight decrease and remains nearly constant until the 34th to 36th week of gestation, and then increases sharply (statistically significant) reaching the highest level at 40-42 weeks from the last menstrual period. The maternal-fetal metabolism of zinc, the various factors effecting zinc levels in maternal serum and amniotic fluid during pregnancy have been discussed in view of our results. These may serve as data base for further studies on the role of zinc in normal and pathological human pregnancies.

A prospective study of serum zinc concentration in children with celiac disease

Activation of human factor VII in plasma and m purified systems: Role of activated factor IX, Kallikrein and activated factor XII. J Clin Invest 64:1056, 1979. 7. Sardharwalla JB, Fowler B, Komrower GM: Homocystinuria: Cysteine levels in the plasma. In Bickel H, Stern J, editors: Inborn error of calcium and bone metabolism, Baltimore, 1976, University Park Press. 8. Radcliffe R, Bagdasarian A, Colman R, Ncmerson Y: Activation of bovine factor VII by Hageman factor fragments. Blood 50:6l 1, 1977. 9. Hilden M, Brandt N J, Nilsson IM, Schonheyder F: Investigations of coagulation and fibrinolysis in homocystinuria. Acta Med Scand 195:533, 1974, 10. Gershwin ME, Gude JK: Deep vein thrombosis and pulmonary embolism in congenital factor VII deficiency. N EngI J Med 288:141, 1973.

The Diagnostic Value of Serum Copper/Zinc Ratio in Gynecological Tumors

Abstract. Serum copper levels (SCu) and serum zinc levels (SZn) were determined on admission in 73 women hospitalized for suspected gynecological tumor. Twenty‐five of the women were subsequently found to have malignant tumor, while 48 had benign growths. The serum Cu/Zn ratio of the malignant group (2.13±0.53) was significantly (p<0.001) higher than that of the benign group (1.45±0.25). A good correlation was established between the Cu/Zn ratio and the stage of the malignant tumor. Serum copper level showed a linear correlation (R = 0.878) with serum ceruloplasmin values. These results indicate that the serum Cu/Zn ratio may be used as a valuable predictor of the presence of malignant gynecological tumor and its stage.

The presence of a sponsoring embryo in a batch of poor quality thawed embryos significantly increases pregnancy and implantation rate

OBJECTIVEnTo evaluate quantitatively the effect of one good-quality (sponsoring) embryo in a batch of low-quality thawed embryos on the implantation and pregnancy rates (PR).nnnDESIGNnRetrospective analysis of data.nnnSETTINGnTertiary care center IVF clinic affiliated with a university medical school.nnnPATIENT(S)nBetween March 1988 and April 1995, 392 IVF patients underwent a total of 440 thawing and ET cycles of 1,436 multicellular embryos.nnnMAIN OUTCOME MEASURE(S)nImplantation, clinical pregnancy, and multiple pregnancy rates.nnnRESULT(S)nIn the absence of sponsoring embryos in the thawed batch of embryos, a PR of 9.8% with an implantation rate of 3.1% was achieved. In the presence of a single sponsoring embryo, the PR nearly doubled (18.2%), with a significantly higher implantation rate of 7.0%. Only singleton pregnancies were achieved in the absence of sponsoring embryos compared with 21.7% multiple pregnancies in the single sponsoring embryo group.nnnCONCLUSION(S)nThe presence of a sponsoring embryo in a batch of poor quality thawed embryos is an important factor that significantly increased pregnancy and implantation rates. The optimal strategy for planning batches of multicellular frozen embryos is to include at least one sponsoring embryo in each batch when possible. We speculate that the sponsoring embryo may favorably influence the chances of low-quality embryos to undergo successful implantation.

Modulation of heart rate variability by estrogen in young women undergoing induction of ovulation

Estrogens are involved in the modulation of the cardiovascular system, yet their effects in young women remains largely unknown. Women who undergo ovulation induction treatments attain extremely high estrogen concentrations during a very short time period. The aim of the present study was to evaluate the effects of an acute increase in estrogens on the autonomic nervous system modulation of heart rate variability (HRV). A total of 27 women undergoing ovulation induction and 14 normally menstruating women were prospectively studied. HRV was assessed during nadir and peak estrogen using time domain and power spectral density analyses. A significant increase in high-frequency spectral power (243xa0±xa077 vs. 188xa0±xa073 ms2/Hz, Pxa0<xa00.01) with a significant decrease in the ratio of low to high-frequency power was observed during estrogen peak in women undergoing induction of ovulation. The acute increase in estrogen in women undergoing ovulation induction was associated with vagal activation and altered sympathovagal balance.

Ovarian stimulation in in vitro fertilization with or without the “long” gonadotropin-releasing hormone agonist protocol: effect on cycle duration and outcome

OBJECTIVEnTo study the correlation between stimulation duration of IVF cycles, with and without GnRH agonist (GnRH-a), and cycle outcome.nnnDESIGNnRetrospective analysis of data.nnnSETTINGnUniversity-affiliated IVF clinic.nnnPATIENT(S)n998 IVF cycles in which long GnRH-a protocol was used, and 155 cycles with hMG only.nnnINTERVENTION(S)nIVF cycles.nnnMAIN OUTCOME MEASURE(S)nCycle outcome in number of oocytes and embryos, and pregnancy rate.nnnRESULT(S)nThe mean stimulation duration (+/-SD) was 9.6+/-1.7 and 6.7+/-1.0 for the GnRH-a and the hMG-only cycles, respectively (P<0.01). In the GnRH-a group, no statistically significant correlation between cycle duration and pregnancy rate was found. Interestingly, the patients treated for 9 days had the highest number of oocytes retrieved and the highest pregnancy rate. Stimulation duration was not affected by age in either protocol. GnRH-a cycles yielded a significantly higher number of oocytes and embryos compared to cycles without GnRH-a. The pregnancy rate was similar in both groups.nnnCONCLUSION(S)nStimulation duration in the long GnRH-a protocol group was significantly longer than in the hMG-only group. Stimulation duration was not affected by age. No statistically significant correlation was found between stimulation duration and cycle outcome in the long protocol group.