Mick Abae

Endocrine Profiles and Semen Quality of Spinal Cord Injured Men

We characterized endocrine profiles and semen quality in spinal cord injury subjects using noninjured normal and infertile subjects as controls. Compared to normal controls, spinal cord injury subjects had lower serum levels of luteinizing hormone and follicle-stimulating hormone. Subjects with spinal cord injuries between the T8 and T10 levels had a higher incidence of hormone outliers compared to subjects with injuries at other levels. Sperm motility and per cent normal sperm morphology were lower in spinal cord injury subjects compared to normal controls but not to infertile control subjects. Spinal cord injury subjects with elevated follicle-stimulating hormone levels were azoospermic. We conclude that endocrine abnormalities are likely to accompany spinal cord injury but may not be the sole mechanism contributing to impairments in semen quality.

Treatment by assisted conception of severe male factor infertility due to spinal cord injury or other neurologic impairment

PurposeThis retrospective study evaluated the pregnancy rates of 23 couples with male factor infertility due to traumatic spinal cord injury (N = 21), multiple sclerosis (N = 1) or transverse myelitis (N = 1).MethodsOvulation induction by clomiphene citrate or gonadotropins was used in combination with intrauterine insemination as an initial approach for assisted conception in all but one couple.ResultsSix pregnancies occurred in 60 cycles of intrauterine insemination (mean of 2.6 cycles). In this group, the cumulative pregnancy rate was 26%. Six couples who failed after a total of 33 intrauterine insemination cycles (mean of 5.5 cycles), and 1 couple with no previous intrauterine insemination cycles, initiated 10 cycles of in vitro fertilization (mean of 1.4 cycles). In this group, five pregnancies occurred. The pregnancy rate was 71%.ConclusionWe conclude that ovulation induction in combination with intrauterine insemination offers an effective initial therapy of severe male factor infertility due to spinal cord injury.

Immunoreactive endothelin-1 concentrations in follicular fluid of women with and without endometriosis undergoing in vitro fertilization-embryo transfer

OBJECTIVE To determine the concentrations of immunoreactive (IR) endothelin-1 in human follicular fluid (FF) and whether IR-endothelin-1 levels are different in women with endometriosis-associated infertility. DESIGN Follicular fluid and plasma samples, obtained from women with and without endometriosis undergoing IVF-ET, were collected at the time of oocyte aspiration and analyzed for IR-endothelin-1 levels. SETTING Infertility clinic in an academic research environment. RESULTS Overall, 90% of FF samples and 60% of plasma samples contained IR-endothelin-1 detectable above the threshold of assay sensitivity. Immunoreactive endothelin-1 levels (mean +/- SEM) in FF samples from women with and without endometriosis-associated infertility were 74 +/- 12 and 37 +/- 6 pg/mL, respectively. There was no difference in IR-endothelin-1 levels in FF samples between controlled ovarian hyperstimulation cycles with or without leuprolide acetate. No significant differences were detected in plasma IR-endothelin-1 levels in women with endometriosis-associated infertility when compared with those without. CONCLUSIONS These results demonstrate the presence of IR-endothelin-1 in human FF obtained at the time of oocyte aspiration for IVF-ET and higher levels of IR-endothelin-1 in FF of women with endometriosis-associated infertility.