Semenology training programs : 8 years’ experience

OBJECTIVE: To evaluate the immediate effect of hands-on training on the quality of technical skills of laboratory technicians. DESIGN: Retrospective analytical study. SETTING: Academic institutions and private infertility clinics. PARTICIPANTS: One hundred and ten laboratory technicians. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): First, 110 participants from 16 African countries attended 5-day semenology workshops at Tygerberg Hospital. During these workshops the methodology as described by the World Health Organization manual for the analysis of human semen, namely, sperm concentration, motility, vitality, and morphology, formed part of the curriculum. Second, two experienced morphology readers from the Tygerberg group presented 23 1-day sperm morphology workshops in nine other countries. RESULT(S): The semenology workshops indicated a significant improvement in the evaluation of sperm concentration only, whereas pretraining and posttraining results for motility did not differ. Vitality reports did not differ from those of the experienced worker in the first place. Calculation by means of a linear regression model showed a significant decrease in the mean posttraining scores from the pretraining scores for the sperm morphology courses. CONCLUSION(S): Training improved technical skills for the evaluation of morphology and sperm concentration. The evaluation of graded sperm motility seems to be more difficult to teach over a short period

Treatment of male sperm autoimmunity by using the gamete intrafallopian transfer procedure with washed spermatozoa

CITATION: Van Der Merwe, J. P., et al. 1990. Treatment of male sperm autoimmunity by using the gamete intrafallopian transfer procedure with washed spermatozoa. Fertility and Sterility, 53(4):682–687, doi:10.1016/S0015-0282(16)53464-5.The original publication is available at http://www.fertstert.orgSixteen couples were diagnosed as having immunological infertility. To detect sperm-bound immunoglobulin (Ig), i.e., IgA, IgG, and IgM antibodies, the direct immunobead test (IBT) was used. In each individual patient, the direct IBT was ≥70% positive for either IgA of IgG or both. The indirect IBT was positive for IgA and IgG antibodies in the serum of all the patients. Semen was collected in 15 mL medium (Ham's F10 [Gibco, Grand Island, NY] + 10% whole blood serum) and prepared with the wash and swim-up method. Patients in the study group were treated for their immunological infertility problem by performing the gamete intrafallopian transfer (GIFT) procedure. An ongoing pregnancy was achieved in 7 of the 16 (43%) couples treated with the GIFT procedure with an ongoing pregnancy rate of 24.1% (7 of 29) per cycle. The GIFT procedure appears to be an effective and safe way of treating male immunological infertility.http://www.fertstert.org/article/S0015-0282(16)53464-5/abstractPost prin

Gamete intrafallopian transfer versus super-ovulation with intrauterine insemination for the treatment of infertility

CITATION: Abels, P. R. et al. 2007. Gamete intrafallopian transfer versus super-ovulation with intrauterine insemination for the treatment of infertility. South African Journal of Obstetrics and Gynaecology, 13(3):104-109.The original publication is available at http://www.sajog.org.zaBackground: A prospective randomised controlled trial comparing gamete intrafallopian transfer (GIFT) with intrauterine insemination (IUI) was undertaken at the Fertility and Reproductive Biology Unit of the Department of Obstetrics and Gynaecology, Tygerberg Hospital, between July 1999 and June 2000. Method. Eighty-five women were included in the study and were randomly allocated between the two groups after routine infertility investigations, 41 women to IUI and 44 women to GIFT. A combination of clomiphene citrate and human menopausal gonadotropin was administered to both groups to achieve ovulation. Results. Six (13.6%) of the 44 cycles in the IUI group and 24 (53.3%) of the 45 cycles in the GIFT group achieved conception. The mean number of cycles needed to achieve pregnancy in IUI was 7.3 (44/6) and in GIFT was 2.05 (45/24). The ongoing pregnancy rate of GIFT was 39.7% more effective than that of IUI (p=0.0001.The total ongoing pregnancy rate of GIFT was 30.8% superior to that of IUI (p=0.0021). When 2 follicles were obtained in an IUI cycle, GIFT was 41.6% more effective (p=0.0024), and when more than 2 follicles were obtained, GIFT was 28.3% more effective (p=0.0265). Conclusions. The number of mature follicles significantly increased the chance of pregnancy with IUI. In comparing the number of cycles needed to achieve a pregnancy, 1 GIFT cycle is equivalent to more than 3 IUI cycles. It is important to note that 4 IUI cycles will give equivalent or even better results if 2 - 3 follicles are recruited per cycle. In spite of the greater efficacy of GIFT, the authors conclude that at least 3 to 4 IUI cycles should be attempted before GIFT, on the basis that it is more cost effective and less invasive.http://www.sajog.org.za/index.php/SAJOG/article/view/92/167Publisher's versio