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Aim: The correct diagnosis of the functional capacity of human sperm is limited. The Sperm Quality Analyzer (SQA) with the visualization system (SQA V, Medical Electronic System, Hatavorzo, Israel), an upgraded version of SQA, was recently developed to provide a rapid and low‐cost quantitative evaluation of sperm quality as well as sperm velocity assessment. The aim of the present study was to evaluate whether the SQA V's new parameters correlate with computer‐aided sperm analysis (CASA) estimates.

Background and Aim: The factors that affect sperm immobilizing antibody production in some women are not fully understood. This study was performed to investigate if production of sperm immobilizing antibodies in women is associated with their husbands’ sperm count.

There is a need to improve our understanding of the cut-off value of the direct immunobead test (D-IBT).The subjects were 26 D-IBT-positive and 140 D-IBT-negative males. The results of post coital tests (PCTs) for each subject were examined.A significant difference was observed in abnormal PCTs between values20 % and those ≥20 % (A cut-off value of 20 % was correlated with the possibility of conception on treatment with IUI. The D-IBT is a screening test, and the value of 20 % initially suggested by Bronson et al. seems to be more appropriate than that of 50 % in the criteria defined by the World Health Organization.

Aims It has been shown that supplementation of patients’ sera that contains sperm-immobilizing antibodies results in failure of fertilization and embryo developmentin vitro. The present study was carried out to investigate if exposing retrieved eggs to a high number of sperm-immobilizing antibodies in the follicular fluid (FF)in vivo affected subsequent fertilization and embryo developmentin vitro, even if they were washed with an antibody-free culture medium.

The presence of antisperm antibodies (ASA) can reduce fecundity in both males and females. The present review describes a strategy, established by investigations of the diverse inhibitory effects of ASA on fertility, for the appropriate diagnosis and treatment of infertile males with ASA. For infertile males with ASA, diagnosis using the direct-immunobead test (D-IBT), the postcoital test (PCT) and the hemizona assay (HZA) should be carried out as the basis for decision-making. If the patient with ASA has an abnormal hemizona index, it seems reasonable to advise selecting intracytoplasmic sperm injection-embryo transfer (ICSI-ET) as a primary treatment. However, it has been shown that some immunologically infertile males with normal fertilizing ability established pregnancy by timed intercourse (TI) or intrauterine insemination (IUI). In such patients with ASA having normal hemizona index, TI or IUI can be selected based on the PCT result. Therefore, the treatment strategy for males with ASA is similar to that for infertile males with oligozoospermia or asthenozoospermia. In conclusion, it should be emphasized that a diversity of ASA exists and their effects on fertility in infertile males. Although there is an argument that routine testing for ASA in males is not always necessary, one should be aware that in some cases of failed IUI or IVF, ICSI is selected afterward because of the diagnosis of ASA. (Reprod Med Biol 2005; 4: 133-141).

It is well known that Chlamydia trachomatis causes acute and chronic pelvic inflammatory disease including salpingitis. We describe a case of successful pregnancy following conservative treatment of massive ascites associated with acute Chlamydia trachomatis peritonitis. In this present case, we conservatively treated a woman with acute chlamydial salpingitis accompanied with marked ascites and an adnexal mass that simulated a malignant neoplasm. Elevated CA125 and CA19-9 also suggested a malignancy at the time of diagnosis, however following treatment they decreased to below the cut-off value, and were useful in identifying the efficacy of medical treatment. The patient subsequently became pregnant after infertility treatment and underwent a normal vaginal delivery. We conclude that the possibility of Chlamydia trachomatis peritonitis should be considered when a patient presents with ascites and an adnexal mass in sexually active women.

Aim The correct diagnosis of the functional capacity of human sperm is limited. The Sperm Quality Analyzer (SQA) with the visualization system (SQA V, Medical Electronic System, Hatavorzo, Israel), an upgraded version of SQA, was recently developed to provide a rapid and low-cost quantitative evaluation of sperm quality as well as sperm velocity assessment. The aim of the present study was to evaluate whether the SQA V’s new parameters correlate with computer-aided sperm analysis (CASA) estimates.

To investigate the change pattern of leptin duringin vitro fertilization and embryo transfer (IVF-ET) treatment with controlled ovarian hyperstimulation (COH) and at the stages of very early pregnancy. The serum leptin concentration was investigated in 65 patients treated with assisted reproductive technology (ART) in five different periods (ART-1: on the first day of ovarian stimulation with follicle-stimulating hormone; ART-2: at human chorionic gonadotropin administration before oocyte retrieval; ART-3: 7 days after oocyte retrieval; ART-4: 14 days after oocyte retrieval and ART-5: 21 days after oocyte retrieval). The leptin concentration showed significant lower values in the pregnancy group than the non-pregnancy group at ART-3 and ART-4 (P < 0.05). In the pregnancy group, leptin concentration increased from ART-1 (13.5 ±8.2 ng/mL) to ART-2 (23.0 ±15.1 ng/mL) (P < 0.001). The values significantly decrease at 7 days after oocyte retrieval, from ART-2 to ART-3 (18.1 ± 12.0 ng/mL) (P < 0.01), and then showed no remarkable change until 21 days after oocyte retrieval. In the non-pregnancy groups, leptin concentration increased from ART-1 (17.3 ± 11.5 ng/mL) to ART-2 (25.7 ± 12.1 ng/mL) (P < 0.0001). There was no remarkable change in leptin concentration until 14 days after oocyte retrieval, followed by a significant decrease in leptin concentration at ART-4 (21.9 ± 11.9 ng/mL) to ART-5 (18.1 ± 11.8 ng/mL) (P < 0.05). The serum leptin concentration increases during COH in the pregnancy and non-pregnacy groups. In the pregnancy group, leptin concentration showed a fall of leptin values at early luteal phase. These findings might be useful to elucidate the role of leptin in the IVF-ET patients.

The factors that affect sperm immobilizing antibody production in some women are not fully understood. This study was performed to investigate if production of sperm immobilizing antibodies in women is associated with their husbands’ sperm count. The sperm immobilization test (SIT) was performed on 221 infertile women whose husbands had normal semen characteristics according to the criteria by WHO; 160 patients were treated by intracytoplasmic sperm injection (ICSI) because of poor semen characteristics, and 1013 virgin female children acted as the controls. A significant difference of the incidence in SIT was observed between the virgin female children and the women whose husbands had a normal sperm count (P < 0.0001). There was also a significant difference of the incidence in SIT between the women treated by intracytoplasmic sperm injection (ICSI) because of a severe male factor and those whose husbands had a normal sperm count (P < 0.05). These results indicate that production of sperm immobilizing antibodies in women begins after they have been exposed to a large enough amount of sperm. However, the precise amount of sperm required to produce the antibodies is not clarified by the present study.

Since transvaginal hydrolaparoscopy (THL) was introduced as the first-line procedure in the early stage of the exploration of the tubo-ovarian structures in infertile women, it has been shown that THL is a less traumatic and a more suitable outpatient procedure than diagnostic laparoscopy. In the present study, a minimally invasive surgery was carried out in infertile women with polycystic ovary syndrome (PCOS) by THL. Ovarian drilling using Nd:YAG laser vaporization by THL was performed in two clomiphen citrate-resistant infertile women with PCOS. After ovarian drilling with THL, a patient recovered an ovulatory cycle. These findings suggest that ovarian drilling by THL seems to be a safe procedure in infertile women with PCOS. However, further investigations are required to evaluate the effectiveness and risks of this minimally invasive operation. (Reprod Med Biol 2003; 2: 37-40).

Although laparoscopic adenomyomectomy may be a possible risk factor for uterine rupture in subsequent pregnancy, few reports have described it. A 35-year-old woman became pregnant 1 month after laparoscopic adenomyomectomy. At the 28th week, uterine contraction occurred, leading to intravenous ritodrine infusion. Severe abdominal pain and a non-reassuring fetal heart rate occurred abruptly and an emergency cesarean section was carried out. The uterus ruptured at the site of previous surgery of the uterine body, which was reconstructed. The mother and the infant did well postoperatively. We report the second case of uterine rupture during pregnancy subsequent to laparoscopic adenomyomectomy. A history of adenomyomectomy and a short interval to subsequent pregnancy may be risk factors for uterine rupture. (Reprod Med Biol 2007; 6: 175-177).