Ángela Cadavid

Assessment of sperm factors possibly involved in early recurrent pregnancy loss

OBJECTIVE To evaluate and compare standard sperm parameters, lipid peroxidation of sperm plasma membranes, antioxidant capacity of seminal plasma, and sperm chromatin integrity in ejaculates from men whose partners have a history of recurrent pregnancy loss and from a control group of men with recent fertility. DESIGN Descriptive study. SETTING Reproduction Program, University of Antioquia, Medellín, Colombia. PATIENT(S) Twenty-three couples with history of recurrent pregnancy loss and 11 men with recent fertility. INTERVENTION(S) Semen samples from control men and men whose partner had a history of recurrent pregnancy loss were examined for differences in semen parameters, lipid peroxidation, antioxidant capacity, DNA fragmentation index, and sperm preparation. MAIN OUTCOME MEASURE(S) Migration-sedimentation method was used to collect motile spermatozoa from fresh ejaculates for examination for semen parameters. RESULT(S) Men from the control group had spermatozoa with higher percentage of normal sperm morphology, concentration, progressive motility, and antioxidant capacity compared with men from the recurrent pregnancy loss group, who had spermatozoa with higher teratozoospermia and higher lipid peroxidation. Motile sperm fractions from both groups had spermatozoa with better sperm parameters compared with freshly ejaculated sperm. CONCLUSION(S) This study strengthens the current literature associating sperm quality with recurrent pregnancy loss, and emphasizes the importance of evaluating male factor by tests such as lipid peroxidation and measuring antioxidant capacity of seminal plasma in addition to conventional sperm parameters.

Role of male factor in early recurrent embryo loss: do antioxidants have any effect?

OBJECTIVE To evaluate whether increasing antioxidant intake in men with high levels of DNA damage or lipid peroxidation improves gestational results in couples with history of recurrent embryo loss. DESIGN Descriptive study (case series). SETTING Early recurrent embryo loss program at the University of Antioquia, Medellín, Colombia. PATIENT(S) Seventeen men whose spouses had a history of two or more embryo losses before 12 weeks of gestation. INTERVENTION(S) Male partners with increased DNA fragmentation index (%DFI) or high thiobarbituric acid reactive substances (TBARS) were instructed to consume a diet rich in antioxidants or commercial multivitamins containing beta-carotene, vitamin C, vitamin E, and zinc for at least 3 months. MAIN OUTCOME MEASURE(S) Pregnancy outcome was recorded in the spouses of men with increased %DFI or TBARS who received antioxidant supplementation. RESULTS Of the 17 men, 9 (53%) presented with an increased %DFI or TBARS. They were started on an antioxidant supplementation regimen. Of these nine men, six of their spouses became pregnant. All couples whose male partners accepted antioxidant supplementation achieved a successful pregnancy. CONCLUSIONS Our study demonstrates the benefits of an increased intake of antioxidant-rich food or antioxidant supplements by men who show high levels of sperm DNA fragmentation or lipid peroxidation, which could result in an improvement in gestational outcomes in couples with history of recurrent embryo losses.

Glomerular disturbances in preeclampsia: disruption between glomerular endothelium and podocyte symbiosis.

Background. Preeclampsia (PE) is the commonest cause of glomerular disease worldwide. Glomerular endotheliosis has been considered as the hallmark of PE, but this lesion is also found in non-proteinuric hypertensive pregnant women. Lately, podocyte alterations have been related to PE. Proposal. Although it has been demonstrated that glomerular endothelium and podocyte alterations are related to PE, we could locate no formal academic discussion that integrates these two phenomena. The demonstration that alterations of the expression of vascular endothelial growth factor (VEGF) by podocytes result in a dramatic endothelial phenotype and that induced production of endothelin-1 by glomerular endothelium provokes podocyte damage could indicate that glomerular lesions in PE result from disruption of the symbiosis between these cells rather than from events occurring independently. We shall try to describe a holistic way of viewing renal disease in PE women, in which the hypertensive emergency is produced by the effects of antiangiogenic proteins on the vascular endothelium, while renal lesion and proteinuria result from the effects of these proteins on both the glomerular endothelium and the podocyte. Conclusions. VEGF deficiency within the glomerulus in women with PE leads to the disruption of podocyte and glomerular endothelium symbiosis. The evidence demonstrating that exogenous VEGF administration in a rat model of PE could alleviate hypertension and proteinuria in these animals are encouraging in view of looking for therapeutic approaches in this direction, nonetheless further evidence should be provided in humans to directly demonstrate that VEGF supplementation could mitigate the symptoms of PE.

The Role of Mannose Receptor on HIV‐1 Entry into Human Spermatozoa

In this opinion article we consider the possibility that human spermatozoa have receptors for human immunodeficiency virus‐1 (HIV‐1). It is clear that sperm cells have the potential for transmitting HIV‐1, but the mechanisms responsible for spreading or the virus by this vector are not known. In contrast to the traditional HIV‐1 target cells, spermatozoa do not express CD4 receptors or the CCR5/CXCR4 co‐receptors. Recent evidence indicates that astrocytes, which also do not express these molecules, can be infected with HIV‐1 through the mannose receptor. Furthermore, a 160‐kDa sperm receptor that interacts with the HIV gp 120 has been described. Therefore, we hypothesize that the mannose receptor, of 165–175 kDa, is the receptor that HIV‐1 uses to invade spermatozoa, which could lead to both vertical and horizontal transmission of HIV‐1.

Comparación de la concentración espermática usando la cámara de Makler y la cámara de Neubauer

Resumen Comparacion de la concentracion espermatica usando la camara de makler y la camara de neubauer Objetivo Determinar la concordancia entre el conteo de espermatozoides obtenido usando camara de Makler y de Neubauer, en eyaculados de individuos fertiles Diseno Estudio prospectivo realizado en el Grupo Reproduccion de la Universidad de Antioquia, Medellin-Colombia Metodos 112 eyaculados provenientes de individuos fertiles fueron analizados en el presente estudio. El recuento espermatico se realizo en la camara de Makler y en la camara de Neubauer; la comparacion entre ellas se determino con la prueba Bland-Altman plot Resultados El promedio de las concentraciones fue 107,8 y 106,2 x 106 espermatozoides/mL usando la camara de Makler y de Neubauer, respectivamente. Se encontro concordancia entre ambos metodos Conclusion Nuestros resultados muestran que la determinacion de la concentracion espermatica mediante la camara de Makler es tan exacta como la realizada con la camara de Neubauear y que ambas pueden ser usadas en el analisis rutinario de semen

Evaluación de los parámetros funcionales espermáticos en individuos infértiles normozooespérmicos

OBJECTIVE This study evaluated the integrity of the chromatin structure, reactive oxygen species (ROS) levels, mitochondrial membrane potential (MMP), DNA damage and lipid peroxidation of semen samples from infertile men classified as unexplained infertility. METHODS Between February 2010 and July 2011 semen parameters and functional tests were evaluated in 10 subjects with proven fertility, 10 that belong to general population and 8 with idiopathic infertility. In addition to the conventional semen analysis, the following unconventional seminal analysis were conducted: evaluation of ROS, MMP, sperm chromatin structure assay (SCSA) by flow cytometry, assessment of sperm membrane lipid peroxidation by spectrophotometry, and alkaline comet assay by electrophoresis. RESULTS We observed a significant increase (P<.05) in the production of ROS and the fragmentation or sperm DNA damage in the population of infertile men. There were no statistically significant differences (P>.05) in the analysis of sperm membrane integrity between the groups. Moreover, we observed significant correlations (P<.05) between SCSA and comet assay (r=0.86) and the production of intracellular ROS (r=-0.588). CONCLUSION The sperm from individuals with idiopathic infertility showed high levels of intracellular ROS and increased levels of DNA fragmentation in the sperm. These results suggest that these two parameters are related to unexplained infertility and therefore have clinical importance as a possible diagnostic and prognostic tool in the evaluation of idiopathic male infertility.

Aspirin‐Triggered Lipoxin Prevents Antiphospholipid Antibody Effects on Human Trophoblast Migration and Endothelial Cell Interactions

Antiphospholipid antibodies (aPL) interfere with several physiologic functions of human trophoblasts, including reducing their ability to migrate, decreasing their production of angiogenic factors, and inducing an inflammatory response. This may provide the underlying mechanism by which aPL responses lead to recurrent pregnancy loss or preeclampsia in women with obstetric antiphospholipid syndrome (APS). Although treatment with heparin may reduce the rate of recurrent pregnancy loss, the risk of preeclampsia remains high. Therefore, alternative treatments are needed for the management of pregnant patients with APS. Since aspirin‐triggered lipoxins (ATLs) have immune and angiogenic modulatory properties, the objective of this study was to determine the effects of the ATL 15‐epi‐lipoxin A4 on the function of aPL‐altered human trophoblasts in the first trimester of pregnancy.

Presence of HIV-1 DNA in spermatozoa from HIV-positive patients: changes in the semen parameters.

Although very inefficient, sexual transmission of HIV-1 is responsible for more than 80% of infections worldwide. Yet, the presence of HIV in spermatozoa has been a matter of debate. The aim of this study was to evaluate the presence of HIV nucleic acids and the distribution of mannose receptors in sperm cells, and to determine the semen parameters and cytokine levels in ejaculates from HIV-positive patients. The presence of non-seminal cells in purified sperm was revealed by light microscopy, flow cytometry and RT-PCR. HIV nucleic acids were evaluated by nested PCR; the distributions of mannose receptors on the surface of the sperm and cytokine levels in ejaculates were determined by fluorescence microscopy and flow cytometry respectively. Sperm characteristics were determined by conventional methods. HIV DNA was detected in 69.2% of purified sperm from HIV-positive men; in contrast all purified sperm were negative for HIV RNA. The distribution of mannose receptors and cytokine levels in HIV-1-positive men were similar to uninfected individuals. Using the Principal Component Analysis (PCA) method, it was possible to determine that semen parameters of HIV-positive men exhibit different distributions compared to HIV-negative individuals. Finally, these results indicate that viral DNA is present in purified sperm from HIV-positive men and that HIV infection of spermatozoa could be associated with lower seminal parameters as demonstrated by the PCA method. The similar distribution of mannose receptors between infected and uninfected individuals suggests that sperm cells from infected individuals interact normally with oocytes.

Human Spermicidal Activity of Passiflora edulis Extract

Objective To evaluate the spermicidal activity of Passiflora edulis extract on human spermatozoa. Methods Human spermatozoa were incubated with P. edulis extracts and their motility and viability were evaluated; additionally, the cytotoxic effect of the extracts was evaluated by the tetrazolium bromide (MTT) reduction assay. Results The motility and viability were decreased immediately after treatment with a 21% dilution of the supernatant of the extract of P. edulis (P Conclusion These results may open the way for the use of P. edulis as a spermicidal product with less adverse effects.

Nuevas opciones en anticoncepción: posible uso espermicida de plantas colombianas

COLOMBIAN PLANTS WITH SPERMICIDAL ACTIVITY, NEW OPTIONS IN ANTICONCEPTION: BRIEF REVIEW Currently there exists increasing preoccupation concerning sexual and reproductive health among teenagers; in spite of the availability of different contraceptive methods, the number of undesired pregnancies is steadily increasing. Among the products presently available for birth control, spermicides are a means that can be totally controlled by the woman and are very reliable compared to other contraceptives in common use. However, they cause irritation in the vaginal epithelium due to their tensoactive effect on cellular membranes which might enhance the risk of acquiring sexually transmissible diseases. In searching for new alternatives, it was observed that a wide variety of plants have spermicidal activity. Hence it is interesting to consider potential contraceptives of vegetable origin, as they may constitute a key tool to prevent undesired pregnancies in general, and in particular in vulnerable groups such as teenagers and young women.