A high DNA fragmentation index (DFI) when performing the sperm chromatin structural (SCSA) assay was claimed to be so specific for male subfertility that even IVF and ICSI did not result in live pregnancies. The present study was designed to corroborate or refute these findings. The SCSA test was performed on the male partner from couples failing to have a successful pregnancy despite at least 2 previous IVF attempts. In contrast to the aforementioned studies, ongoing pregnancies were found despite working with a group of recalcitrant patients. Nevertheless, a high DFI score was associated with a trend for lower ongoing pregnancy rates especially related to a high miscarriage rate. Other more recent studies seem to support our conclusions. A high DFI score should influence a patient to choose IVF as a therapeutic modality sooner, especially with ICSI.

No abstract

No abstract

These data reinforce the utility of transurethral fluid expression for preoperative evaluation of urethral diverticula. Additionally, MRI is an excellent adjunctive diagnostic tool and may assist in establishing the diagnosis when there is high clinical suspicion of a urethral diverticulum but nonconfirmatory findings on cystourethroscopy.

Males with 100% of their sperm coated by antisperm antibody have a very small chance of achieving a pregnancy by intercourse or conventional intrauterine insemination (IUI). A previous study found that treatment of the sperm with the protein digestive enzyme chymotrypsin improved the efficacy of IUI. The present study was designed to corroborate or refute this previous study and compare efficacy to IVF with ICSI. This time the subjects were an even more difficult group with 100% of the sperm coated by autoantibodies.