<原著>性交後検査陰性例における精子不動化試験による治療法選択基準の検討
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概要
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Objective : ln immunologically infertile patient, a postcoital test (PCT) may be negative even when no abnormality is observed in general semen tests of the husband. A sperm immobilization test (SIT) was given to these patients, and the AIH pregnancy rates for positive and negative cases were compared to investigate criteria to determine the treatment of choice. Patients and Methods : Among 174 couples administered the PCT, no abnormalities were observed in general semen tests of the husbands, and test results for 32 couples were negative. These patients were enrolled in this study with informed consents. SIT was performed using fresh blood serum from PCT-negative patient, and AIH pregnancy rates for SIT-positive and- negative patients were compared. The serum of SIT-positive patient was used in a conventional test and the results were compared to SIT in which the patient's serum was inactivated and a complement added. Results and Discussion : No difference was observed in the results of SIT using with fresh serum, which were obtained from antisperm antibody positive cases, and conventional SIT results. Among 32 patients whose serum was used in SIT, 18 were positive and abnormalities were observed. When the SIT result and semen observations were compared, it was found that the possibility of AIH pregnancy was dependent on the sperm mobilization rate among SIT-positive cases, and the fertility index (sperm concentration × mobility rate/10^6) in negative cases. From the beginning, IVF was selected in cases in which SIT showed complete sperm immobilization within 12 hr. Although the treatment choice is under for PCT-negative cases, the outlook for AIH pregnancy is favorable for SIT-positive cases who generally have a sperm mobility rate srreater than 45% after 6 hr, and SIT-negative cases who have a fertility index greater than 125. When fresh serum is used, similar results are conveniently obtained without inactivation and adding a complement to the culture medium, and SIT can be performed for more patients and immunologically infertile patients can receive appropriate treatment.
- 愛知医科大学の論文
- 2003-03-15