William W. K. So

Predictive value of sperm morphology and movement characteristics in the outcome of in vitro fertilization of human oocytes

One hundred fourteen semen samples from Chinese males were analyzed for routine semen parameters including the semen volume, sperm count, percentage motility, and percentage normal morphology. Of these 114 samples, 54 also had movement characteristics of seminal and swim-up sperm evaluated by the computer image analyzer system (Cellsoft; Cryo Resources Co., New York). All semen samples were subjected to the swim-up procedure to harvest the motile sperm before inseminations of human oocytes. Fertilization was considered to have occurred when at least one oocyte was observed with two or more pronuclei. Semen samples were classified as infertile (0% fertilization rate;N=32) or fertile (>0% fertilization rate;N=82) before statistical analyses. There was a significant difference (P<0.005) in percentage normal morphology of seminal sperm between the fertile (mean±SE; 67.3±1.2%) and the infertile (59.3±2.2%) samples. The percentage normal morphology of seminal sperm correlated (r=0.3049;P<0.002) with the fertilization rate and this parameter was selected by the multivariate stepwise discriminant analysis as the discriminator capable of predicting the fertilization rate with 57.9% accuracy. Statistical analyses of samples where sperm movement was also evaluated demonstrated that there was significant differences (P<0.01) between the fertile (N=38) and the infertile (N=16) samples in percentage normal morphology of seminal sperm (67.8±1.8% vs 56.2±2.6%) and curvilinear velocity of swim-up sperm (89.2±3.5 vs 68.2±7.2 μm/sec). The fertilization rates correlated with the percentage normal morphology of seminal sperm (r=0.3868;P<0.005) and velocity of swim-up sperm (r=0.3842;P<0.005). Multivariate stepwise discriminant analysis demonstrated that these two sperm parameters in combination were capable of predicting the fertilization rate with 74.1% accuracy. Our results indicate that seminal sperm morphology, coupled with computerassisted image analysis of movement characteristics of swim-up sperm, can help to predict the outcome of in vitro fertilization of human oocytes.

Rapid recurrence of endometrioma after transvaginal ultrasound-guided aspiration

OBJECTIVE Ultrasound-guided aspiration is a less invasive management option for recurrent endometrioma. We postulated that the endometriotic tissue in the epithelial lining of endometrioma had undergone pressure atrophy after a period of observation, and resolution of the endometrioma can be achieved by aspiration of its content. STUDY DESIGN A prospective study was carried out in which patients with recurrent endometrioma that remain stationary in size for a period of at least 6 months were included. Ultrasound-guided aspiration of endometrioma was performed transvaginally under conscious sedation. Ultrasound scan examination was performed at 1, 3, 6, and 12 months after aspiration to detect recurrence. RESULTS Eight endometriomas were aspirated in six patients. The mean diameter and volume of endometrioma at aspiration were 31.0 mm (range, 18.0-46.3 mm) and 21.9 ml (range, 3.16-52.0 ml), respectively. There were no major complications. Cytological examination revealed hemosiderin-laden macrophages; neither malignant cells nor endometrial cells were detected in all cases. Six ovarian cysts recurred in five women (83.3%), all recurrence were detected within 3 months after aspiration. CONCLUSION We concluded that although transvaginal ultrasound-guided aspiration is a safe procedure, but the recurrence rate after aspiration is unacceptably high, and hence cannot be recommended as a treatment option for recurrent endometrioma.

Is There Any Difference in Pregnancy and Implantation Rates when Nurses Perform Embryo Transfer in an IVF-ET Program?

A retrospective analysis of fresh in vitro fertilization treatment cycles and frozen embryo transfer (FET) cycles from mid-1995 to December 31, 1998, was undertaken. Nurses performed embryo transfer (ET) for government-funded cycles, whereas doctors performed ET for self-funded cycles. During the study period, fresh ET was performed in 1,165 treatment cycles. There were no significant differences in demographic data, ovarian responses and the number of embryos replaced between ET cycles performed by nurses and doctors. Pregnancy rates for ETs performed by nurses and doctors were 16.7 and 15.8% per transfer, respectively, whereas the corresponding implantation rates were 8.3 and 6.9%, respectively. Similar pregnancy and implantation rates were encountered in FET cycles whether ET was performed by nurses or doctors.

Immunological studies in patients with oligospermia

Report of the study of the T-lymphocytes subsets, the serum autoantibodies and immune complex levels in 20 infertile men with idiopathic oligospermia to determine wether they are different from normal fertile men

A Prospective Randomized Control Study to Compare the Effect of Serum and a Commercial Serum Substitute (Plasmanate) on the Outcome of Assisted Reproduction Program

Objectives: To compare the effect of supplementation of serum and Plasmanate, a commercial serum substitute, to culture medium on the IVF outcome.