E Oral1, A Arici, D L Olive, G Huszar. 1. Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut 06510-8063, USA.
Abstract
OBJECTIVE: To examine the mechanism of sperm motility inhibition by peritoneal fluid (PF) from women with endometriosis. DESIGN: Prospective, randomized study. SETTING: University-based andrology laboratory. PATIENTS: Women with and without endometriosis. INTERVENTIONS: Fresh semen or Percoll-purified sperm fractions were combined with PF from women with endometriosis (n = 20), from fertile women without endometriosis (n = 10), or withphysiological saline. MAIN OUTCOME MEASURE: Sperm motility parameters were determined with computer assisted semen analysis. Data were evaluated by the analysis of variance and the Student's t-test. RESULTS: Peritoneal fluid from women with minimal or mild endometriosis did not inhibit sperm motility in semen. Peritoneal fluid from women with moderate or severe endometriosis caused approximately 40%, 50%, and 80% declines in sperm motility and in percent progressive motile sperm after 4,7, and 24 hours, respectively. Sperm velocity was inhibited by approximately 30% and 60% after 7 and 24 hours, respectively. However, in the Percoll-purified sperm fractions the same PF did not inhibit sperm motility within the 4- to 7-hour time frame, and only a 17% to 42% inhibition occurred after the overnight incubation. Sperm velocity was not affected. CONCLUSION: Cellular components of seminal fluid appear to mediate the inhibitory action of PF. Assuming that the leukocyte components of semen and PF are common, the cell-mediated inhibition of sperm motility is a likely contributor to endometriosis related infertility.
RCT Entities:
OBJECTIVE: To examine the mechanism of sperm motility inhibition by peritoneal fluid (PF) from women with endometriosis. DESIGN: Prospective, randomized study. SETTING: University-based andrology laboratory. PATIENTS: Women with and without endometriosis. INTERVENTIONS: Fresh semen or Percoll-purified sperm fractions were combined with PF from women with endometriosis (n = 20), from fertile women without endometriosis (n = 10), or with physiological saline. MAIN OUTCOME MEASURE: Sperm motility parameters were determined with computer assisted semen analysis. Data were evaluated by the analysis of variance and the Student's t-test. RESULTS: Peritoneal fluid from women with minimal or mild endometriosis did not inhibit sperm motility in semen. Peritoneal fluid from women with moderate or severe endometriosis caused approximately 40%, 50%, and 80% declines in sperm motility and in percent progressive motile sperm after 4,7, and 24 hours, respectively. Sperm velocity was inhibited by approximately 30% and 60% after 7 and 24 hours, respectively. However, in the Percoll-purified sperm fractions the same PF did not inhibit sperm motility within the 4- to 7-hour time frame, and only a 17% to 42% inhibition occurred after the overnight incubation. Sperm velocity was not affected. CONCLUSION: Cellular components of seminal fluid appear to mediate the inhibitory action of PF. Assuming that the leukocyte components of semen and PF are common, the cell-mediated inhibition of sperm motility is a likely contributor to endometriosis related infertility.