Effect Of Peritoneal Fluid From Infertile Patients With Endometriosis On Human Sperm Motility And Sperm Ultrastructure

Objective:Observe the effect of peritoneal fluid of infertile patients with minimal or mild Endometriosis(EM) on human sperm motility and ultrastructure in comparison with normal women , Analyse whether TNF- a in the peritoneal fluid of EM contributes to infertility by impairing sperm motility and ultrastructure. And explore the role of peritoneal fluid in the infertility of EM patients.Materials and Methods:Women with minimal or mild EM underwent laparoscopy for infertility serverd as cases(n=20). Normal women undergoing tubal ligation serverd as controls I(n=15). HTF culture serverd as controls II(n=5). Peritoneal fluid was aspirated from women with minimal or mild EM or from women undergoing laparoscopic tubal ligation. Sperm motility, motion characteristics and ultrastructure were assessed following incubation in vitro with three groups after 1,3,5 hours by means of CASA and electron microscope. Again the levels of TNF-a were measured in peritoneal fluid of cases and controls I.Results:1. The levels of TNF-a in peritoneal fluid of EM was higher than that of normal women (p<0.05) and was positively correlated with R-AFS grades of EM (p<0.05).2. Sperm motility (VSL, VCL, VAP, MOT) differed significantly between cases and controls I afer 1, 3, or 5 hours of incubation with the peritoneal fluid (p<0.05). No significant differences were found between controls I and controls II (p>0.05).3. The levels of TNF-α in peritoneal fluid of EM had negative correlation with the sperm motility and motion characteristics (VSL, VCL, VAP, MOT) respectively after 5 hours' incubation(p<0.05).4. The membrane of sperm caput and principal piece were damaged and the cytoplasm of them were swelling after incubated 5 hours with peritoneal fluid of EM .Acrosome of sperm was also damaged .No obvious change of sperm ultrastructure was found in controls I or controls II.Conclusion:1. The high levels of TNF-a in peritoneal fluid of EM indicates it may play a role in progression and infertility of EM .2. TNF-a in peritoneal fluid of EM seems to contribute to infertility by damaging the sperm motility .3. TNF-α in peritoneal fluid of EM seems to contribute to infertility by impairing the ultrastructure of human sperm .