Gwo-Jang Wu

COMPARISON OF FOUR METHODS FOR SPERM PREPARATION FOR IUI

We compared the pregnancy rates and sperm characteristics of semen prepared by the albumin, Percoll, Puresperm, and swim-up methods. Semen analysis was performed by a computer-assisted system (CASA). The overall pregnancy rate was 14% per patient and 11% per cycle. The albumin and Percoll methods had the highest pregnancy rates, up to 12% per cycle. We then compared each method with the albumin method. The swim-up technique yielded the highest percentage of motile sperm. The Percoll method yielded statistically significant changes in average path velocity and straight-line velocity, while the Puresperm method revealed the same statistical changes in total concentration and hyperactive motile sperm percentage. After adjusting for age, methods, and CASA estimates, only straight-line velocity was significantly correlated with pregnancy. Although the Percoll method was associated with the best pregnancy rate, this product has been withdrawn from the market because of toxic contamination. Puresperm had replaced it in our laboratory but showed an unsatisfactory pregnancy rate. The swim-up method is the best choice for IUI.

Comparison of nitric oxide production motion characteristics of sperm after cryopreserved in three different preparations.

Three ml of semen collected from 20 volunteers were divided into three aliquots: a) semen cryopreserved for 48 hr then swim-up method; b) using swim-up method then cryopreserving for 48 h; and c) using 45%–90% two layers PureSperm to prepare sperm then cryopreserved for 48 h. Motility characteristics were evaluated before cryopreservation and after thawing. NO was measured using the chemiluminescence method after centrifugation. The recovery rate and motion parameters were the highest in the swim-up group. NO produced in the swim-up group was significantly lower than the PureSperm group, and the PureSperm group was lower than the semen treated with cryoprotectant group. Best semen quality was achieved due to the decreased NO production.

Boy born after gender preselection following successive gestational androgen excess of maternal luteoma and female disorders of sex development

OBJECTIVE To present male gender preselection after successive gestational hyperandrogenism and female pseudohermaphroditism by pregnancy luteomas. DESIGN Case report. SETTING University-based teaching hospital. PATIENT(S) We describe herein a gravida who presented two successive 46, XX disorders of sex development with apparent female genitalia with an enlarged clitoris due to maternal androgen excess from pregnancy luteoma. The maternal hyperandrogenemia returned to a normal level and bilateral luteoma regressed spontaneously postpartum. After gender preselection by Y-bearing spermatozoa for intrauterine insemination at the third gestation, a healthy boy was born in spite of the exaggerated maternal androgen production of pregnancy luteoma to avoid 46, XX disorders of sex development. INTERVENTION(S) Y-bearing spermatozoa for intrauterine insemination as male gender preselection. MAIN OUTCOME MEASURE(S) Boy born after gender preselection for intrauterine insemination and cesarean section. RESULT(S) Healthy boy born without disorder of sex development after antenatal maternal androgen excess of ovarian luteoma. CONCLUSION(S) Successive pregnancy luteomas associated with maternal hyperandrogenism may cause female disorders of sex development. Male preselection ameliorates the insult of external genitalia ambiguity by antenatal androgen excess in this matter of concern.

COMPARISON OF TIMING OF IUI IN OVARIAN STIMULATED CYCLES

This study was conducted to compare pregnancy rates following two different timings of intrauterine insemination (IUI) in ovarian stimulated cycles. This retrospective study included 135 couples undergoing treatment for infertility. IUI was performed at either 24 hr or 36 hr after hCG injection. Pregnancy rates did not differ between the two groups or in subgroups receiving different methods of ovarian stimulation. Pregnancy rates were similar when IUI was performed at either 24 or 36 hr after hCG injection in ovarian stimulated cycles.

OSR1 and SPAK cooperatively modulate Sertoli cell support of mouse spermatogenesis.

We investigated the role of oxidative stress-responsive kinase-1 (OSR1) and STE20 (sterile 20)/SPS1-related proline/alanine-rich kinase (SPAK), upstream regulators of the Na+-K+-2Cl− cotransporter (NKCC1)—essential for spermatogenesis—in mouse models of male fertility. Global OSR1+/− gene mutations, but not global SPAK−/− or Sertoli cell (SC)-specific OSR1 gene knockout (SC-OSR1−/−), cause subfertility with impaired sperm function and are associated with reduced abundance of phosphorylated (p)-NKCC1 but increased p-SPAK expression in testicular tissue and spermatozoa. To dissect further in a SC-specific manner the compensatory effect of OSR1 and SPAK in male fertility, we generated SC-OSR1−/− and SPAK−/− double knockout (DKO) male mice. These are infertile with defective spermatogenesis, presenting a SC-only-like syndrome. Disrupted meiotic progression and increased germ cell apoptosis occurred in the first wave of spermatogenesis. The abundance of total and p-NKCC1 was significantly decreased in the testicular tissues of DKO mice. These results indicate that OSR1 and SPAK cooperatively regulate NKCC1-dependent spermatogenesis in a SC-restricted manner.