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Testicular sperm extraction (TESE) by open testicular biopsy, has become, since the introduction of the ICSI in 1992, the corner stone in treatment for azoospermia. This study reports the outcome of patients with open testicular biopsy for ICSI procedure indicated by azoospermia. 16 patients with azoospermia (12 obstructive and 4 non obstructive). The open testicular biopsy was performed prior the controlled ovarian hyperstimulation (COH) protocols of their couples, in two of the 16 patients no sperm were found in the biopsy, and the other 14 patients were admitted to 18 ICSI cycles, and the testicular samples were cryopreserved until oocyte capture. The controlled ovarian hyperstimulation (COH) was individualized in each case in accordance to the characteristics of each patient: 12 patients were used the long luteal phase GnRH agonist protocol, ultrashort protocol (Flare up) in one patient, GnRH antagonist in four, and the last one with endometrial preparation for cryopreserved embryo transfer. The mean of oocytes recovered was 11.71 +/- 7.24 oocytes per patient with a recovery rate of 72.64%. The fertilization rate was 49.35 +/- 29.24 and were transfered an average of 3 embryos per patient with a range between 1 and 5 embryos. In 18 cycles, 7 pregnancies occurred, four singles, one twin, one triple and one biochemical pregnancy. In conclusion the testicular sperm extraction (TESE) by open testicular biopsy is a good option for patients with azoospermia usually it achieves an adequate sample of testicular tissue with high possibilities of sperms recovery, in our study we obtained appropriate sperms in fourteen of sixteen patients for the ICSI procedure with good fertilization and pregnancy rates.

Objective: To determine the association, if any, between the human spermatic membrane integrity test and normal or altered membrane ABH glycosphingolipids expression., Methods: Semen samples from 50 patients who consulted at the infertility services of the Provincial del Centenario and Eva Peron de Granadero Belgorria teaching hospitals in Rosario (Argentina) were collected and analyzed in accordance with WHO guidelines. The percentage of dead sperm was analyzed by the eosin test while the percentage of swollen sperm was analyzed by the hypoosmotic test. They were classified according to their ABH expression, either diminished or absent (group 1) or normal (group 2), by applying the hemagglutination inhibition and specific antibody consumption technique. For the statistical analysis the two groups were compared with both spermatic viability tests using the non parametric Mann-Whitney technique for independent samples, since the assumptions for the application of the parametric test (test t) were not fulfilled., Results: A significant difference was found in the percentage of dead sperm (eosin test) of both groups (p < 0.001). However, there was no significant difference in the percentage of swollen sperm (hypoosmotic test) of the two groups., Conclusions: Our results and the data published in the literature indicate a relationship between a reduced ABH expression and spermatozoid membrane integrity, especially at the level of the head, which leads us to consider that ABH glycosphingolipids are mainly located in this segment of the human spermatozoon involved in the spermatozoon-ovum interactions.

The evaluation of spermatic morphology is of importance due to its prognostic value in potential male fertility, both in natural and in assisted reproduction. In the present work, the morphologic profile of samples of semen from normal and dispermic patients was determined, in order to establish a correlation between structure and function. Samples were obtained from male partners of infertile couples who attended andrologic consultation. The smears were stained by the Papanicolaou technique, and the criteria of the OMS and the recent modification of Kruger were followed to evaluate spermatic morphology. Of all the patients studied (n = 46), 35% were normospermics (A), 39% asthenospermics, 7% oligospermics, 2% terastospermics and 17% presented combined alterations. The average percentage of normal spermatozoa was of 23.7 +/- 1.23 in the whole population. When group A patients were compared with asthenospermics, significant differences were found in the percentage of spermatozoa with middle piece and tail alterations, in the last group (p < 0.02). Similarly, when samples were analysed according to the presence of alterations: none (A), one (B) two or more (C), it was observed that the percentage of normal forms decreased in the groups in that order (A < B < C); (A or B vs C p < 0.05). The percentage of tapering spermatozoa was significantly higher in group C (p < 0.01 vs A or B). From the above results, it appears that 1) the larger number of functional alterations is related to a higher percentage of structural anomalies, and 2) the deficient motility in the asthenospermic group, is associated to the middle piece and tail alterations.(ABSTRACT TRUNCATED AT 250 WORDS)

The recent advances in assisted reproduction procedures have helped to the better understanding of the female reproductive physiology and pathology, however, male infertility remains as a poor explained medical problem, nevertheless it occurs in almost 50% of infertile couples. Oligoasthenozoospermia is one of the more common causes of male infertility, therefore we measured in 10 patients with this diagnosis and in 10 fertile euspermic men, besides the parameters included in the standard semen analysis, the quantitative motility (photography method), capacitation-acrosome reaction and the sperm ability to fertilize zona-free hamster oocytes, with the aim to correlate the morphofunctional characteristics of the male gametes with their fertilizing capacity. The results showed significant differences in every parameter studied, including the correlation analysis. In relation with the in vitro induction of the acrosome reaction in both groups, we found significant correlations of the sperm fertilizing ability and the progressive sperm motility with this parameter (fertile group: RS = 0.834, P less than 0.005 & RS = 0.612, P less than 0.05; infertile group: RS = 0.986, P less than 0.001 & RS = 0.536, P less than 0.05 respectively), nevertheless the sperm rate which completed this process was low in relation to the total sperm population even in the fertile men (9.4 +/- 2.0% & 4.4 +/- 2.5% acrosome reacted cells after 18 h of incubation, in the fertile and infertile males respectively). The results also showed the presence of fully capacitated spermatozoa in both groups, since they penetrated the zona-free hamster eggs and decondensed their chromatin (73.9 +/- 13.4% & 10.4 +/- 7.7% penetrated eggs in the euspermic and oligoasthenozoospermic individuals respectively), however, the spermatozoa from the oligoasthenozoospermic men showed low polyspermy indexes too (0.1 penetrated spermatozoa/inseminated oocyte). In this last group we found, in addition, that the mean sperm velocity and the abnormal sperm morphology rate showed significant correlations with the fertilizing ability of the male gametes too (RS = 0.986, P less than 0.005 & RS = -0.942, P less than 0.005. respectively). These data allow us to suggest that before an infertile man is involved in any assisted reproduction program, the presence of possible morphofunctional alterations in the spermatozoa be analyzed, with the aim to be able to make a better prognosis about the success with these patients.