The exact mechanism of infertility in women endometriosis is unkown, although many reasons have been presented. Infertility associated with endometriosis may be mediated by the detrimental effect of peritoneal fluid(PF) on spermatozoa, oocytes or
embryos.
The purpose of his this study was to evalutate the effect of PF from patients with endometriosis on sperm motility using computer assisted sperm analysis(CASA). Samples of PF were collected from the Douglas puch of women undergoing pelviscopy for
infertility or laparotomy. Samples of follicular fulid(FF) were aspirated from women undergoing treatment in IVF program. The prepared spermatozoa were incubated in PF from pateints without endometriosis(Control group, n=28), in PF from stage 1
endometriosis (EM I group, n=28), in PF from stage 2 endometriosis (EM II group, n=28), in PF from stage 3 endometriosis (EM III group, n=28), in PF stage 4 endometriosis (EM IV group, n=28), and in follicular fluid (FF group, n=28).
The sperm motilityn parameters(curvilinear velocity (VCL), amplitude of lateral head displacement (ALH), beat cross frequency(BCF), straightness(STR), and linearity (LIN)) were measured after 1, 5, and 24 hours incubation. The sperm motility in
EM
IV
group after 24 hours incubation was 57.1±12.2% which was significantly lower in EM IV group after 5 hours incubation was 43.6±7.3% which was Significantly lower than that of control group, 53.5±13.6%(p<0.05). VCL in EM IV gorup after 24 hours
incubation was 52.9±31.9um/s that lower than that of control group, 67.8±39.7 um/s. ALH in EM IV group after 24 hours incubation was 4.0±2.5 um that wignificantly lower than that of control group, 5.5±2.8 um (p<0.05). There were not
significantly
different changes according to the each stage of endometriosis group. BCF, STR, and LIN in each EM group were not significantly different from that of control group.
To assess the effect of follicular fluid in relation to hyperactivation of spermatozoa, VCL, ALH, and LIN were measured. VCL in EM IV group after 24 hours incubation was 52.9±31.9 um/s that was lower than that of follicular fluid group,
85.8±48.1
um/s(p<0.05). ALH in EM IV group after 24 hours incubation was 4.0±25 um that was significantly lower than that of follicular fluid group, 5.9±2.4um(p<0.05). LIN in group after 24 hours incubation was not significantly different from that of
follicular fluid group.
Among the motility parameters, VCL, ALH, and LIN are related hyperactivation of spermatozoa. It has been suggested that sperm hyperactivation may generate forces to facilatate sperm detachment and migration and to increased contact penetration of
the
cumulus or zona pellucida. The fertilization rates are higher when the proportion of spermatozoa with hyperactivation are higher. So we predict the relationship of the fertilization are higher. So we predict the relationship of the fertilization
rates
and sperm motility parameters.
Our data show that PF from some patients with endometriosis have a detrimental effect on sperm motility and motility parameters especially VCL and ALH, This results suggest that PF from patients with endometriosis may be decreased the proportion
of
spermatozoa with hyperactivation. Therefore, we suggest that decrement of progressive motility, VCL, and ALH is one of the causes that induced infertility in patients with endometriosis.
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