The accumulated data suggest that inflammation can increase the level of reactive oxygen species (ROS), which contribute to impaired sperm function and male infertility. Therefore, we propose that inflammation-mediated production of ROS in male and female reproductive tracts hinder sperm fertilisation. To test this hypothesis, phorbol myristate acetate (PMA) with polymorphonuclear leucocytes (PMNs) was applied to generate endogenous ROS. We evaluated the time-dependent effects of ROS on human sperm motility, viability and mitochondrial membrane potential (MMP). The results showed that after treatment with PMA and PMNs, the motility of human spermatozoa significantly decreased to 50% on Day 1 and 15% on Day 4 compared with that of the, respectively, negative controls (P = 0.012). The viability of human spermatozoa decreased on Day 4 of PMA + PMNs treatment (P = 0.028). The MMP of human spermatozoa significantly decreased from Day 2 to Day 4 in the PMA + PMN group compared with that of the controls (P = 0.019). Taken together, the 4-day cultivation approach provided an accurate evaluation of sperm quality, especially sperm motility and MMP. Our findings indicated that endogenous inflammation increased ROS levels, which might induce sperm oxidative damage. Additionally, sperm motility might be one of the earliest and most sensitive indicators of this damage.

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The clinical awareness of Caesarean scar defect (CSD) as a cause of abnormal uterine bleeding and adverse obstetrical outcome is still lacking among gynaecologists and their patients. Patients with CSD are mostly asymptomatic, though the lesion may be associated with symptoms like abnormal uterine bleeding, pelvic pain, infertility, and adverse pregnancy outcome. This paper is to report two patients with incidental findings of CSD on ultrasound scanning and MRI and to discuss on their presentations, investigations, and dilemma on treatment options of this condition.

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Significantly elevated serum concentrations of lipid-associated sialic acid (LSA) were observed in 183 patients with invasive cervical carcinoma, 31 with uterine corpus adenocarcinoma and 71 with epithelial ovarian carcinoma prior to any treatment when compared with 50 normal control women (P < 0.05). Elevated LSA levels were also observed in five women with microinvasive cervical carcinoma and in four patients with uterine corpus leiomyosarcoma (P < 0.05). By contrast there were no significant elevations of serum LSA levels in 12 cases of cervical intraepithelial neoplasia, 32 of uterine corpus leiomyoma, 52 of benign ovarian cyst and 14 of mature ovarian teratoma when compared with normal control women. If the upper limit of the normal serum LSA concentration is set at 20 mg 100 ml-1, uterine corpus malignancy was distinguished from benign uterine corpus tumor with a sensitivity of 71% and a specificity of 94%; and ovarian malignancies were distinguished from benign ovarian masses with a sensitivity of 82% and a specificity of 85%. The positive predictive values of LSA assays in uterine and ovarian masses were 93% and 85%, respectively, whilst the negative predictive values were 75% and 81%, respectively. The sensitivity of LSA assays in cervical carcinoma was 57%. The present study suggests that serum LSA assays may be useful for the detection of gyncological malignancies.