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Carrières-sous-Poissy, France

Salama S.,HOpital prive de Parly | Salama S.,France Inter | Boitrelle F.,Cytogenetics and Gynaecology | Boitrelle F.,University of Versailles | And 4 more authors.
Journal of Sexual Medicine | Year: 2015

Introduction: During sexual stimulation, some women report the discharge of a noticeable amount of fluid from the urethra, a phenomenon also called "squirting." To date, both the nature and the origin of squirting remain controversial. In this investigation, we not only analyzed the biochemical nature of the emitted fluid, but also explored the presence of any pelvic liquid collection that could result from sexual arousal and explain a massive fluid emission. Methods: Seven women, without gynecologic abnormalities and who reported recurrent and massive fluid emission during sexual stimulation, underwent provoked sexual arousal. Pelvic ultrasound scans were performed after voluntary urination (US1), and during sexual stimulation just before (US2) and after (US3) squirting. Urea, creatinine, uric acid, and prostatic-specific antigen (PSA) concentrations were assessed in urinary samples before sexual stimulation (BSU) and after squirting (ASU), and squirting sample itself (S). Results: In all participants, US1 confirmed thorough bladder emptiness. After a variable time of sexual excitation, US2 (just before squirting) showed noticeable bladder filling, and US3 (just after squirting) demonstrated that the bladder had been emptied again. Biochemical analysis of BSU, S, and ASU showed comparable urea, creatinine, and uric acid concentrations in all participants. Yet, whereas PSA was not detected in BSU in six out of seven participants, this antigen was present in S and ASU in five out of seven participants. Conclusions: The present data based on ultrasonographic bladder monitoring and biochemical analyses indicate that squirting is essentially the involuntary emission of urine during sexual activity, although a marginal contribution of prostatic secretions to the emitted fluid often exists. © 2014 International Society for Sexual Medicine.


Jaoul M.,Cytogenetics and Gynaecology | Jaoul M.,University of Versailles | Bailly M.,Cytogenetics and Gynaecology | Bailly M.,University of Versailles | And 8 more authors.
Basic and Clinical Andrology | Year: 2014

The suffering caused by infertility in a man can have multiple aspects. It can display a narcissistic dimension, an objectal dimension (object-libido) turned toward others or/and an identity dimension. Two clinical case reports were used here to (i) illustrate all these aspects of infertility suffering, (ii) to evidence the difficulty for infertile men to speak about their infertility and (iii) underlie the importance for professional of medical assisted reproduction to be attentive to this suffering that many men keep silent. An empathetic attention to infertile men may give a way to express this suffering and thus allow the beginning of a psychoanalytic approach which is necessary in infertility and especially for infertile men who do not easily express their suffering. © 2014 Jaoul et al.; licensee BioMed Central Ltd.


Boitrelle F.,Cytogenetics and Gynaecology | Boitrelle F.,University of Versailles | Albert M.,Cytogenetics and Gynaecology | Albert M.,University of Versailles | And 13 more authors.
Reproductive BioMedicine Online | Year: 2013

Since an embryo's ability to grow to the blastocyst stage and implant can be improved by selection of a normal spermatozoon with a vacuole-free head, this study set out to determine the nature of small sperm vacuoles observed under high magnification (>×6300). For 15 infertile men with various sperm profiles, high-magnification microscopy was used to select motile, morphometrically normal spermatozoa with no vacuoles (n = 450) or more than two small vacuoles (each of which occupied less than 4% of the head's area; n = 450). Spermatozoa acrosome reaction status and degree of chromatin condensation were analysed. Three-dimensional deconvolution microscopy was used to accurately image the nucleus and acrosome at all depths in all spermatozoa. In all 450 spermatozoa with small vacuoles, the latter were seen to be abnormal, DNA-free nuclear concavities. Spermatozoa with small vacuoles were significantly more likely than vacuole-free spermatozoa to have noncondensed chromatin (39.8% versus 9.3%, respectively; P < 0.0001). There was no significant difference between the two groups of spermatozoa in terms of acrosome reaction status. No association between chromatin condensation and acrosome reaction status was observed. Small human sperm vacuoles observed under high magnification are pocket-like nuclear concavities related to failure of chromatin condensation. The present study set out to determine the nature of small sperm vacuoles observed under high magnification (>×6300), since these structures reportedly have a harmful effect on embryo development and implantation. For 15 infertile men with various sperm profiles, high-magnification microscopy was used to select a total of 900 motile, morphometrically normal spermatozoa with no vacuoles (n = 450) or more than two small vacuoles (each of which occupied less than 4% of the head's area; n = 450). We subsequently analysed the spermatozoa's acrosome reaction status and degree of chromatin condensation. Three-dimensional deconvolution microscopy was used to accurately image both the nucleus and the acrosome at all depths in each of the 900 spermatozoa. In all 450 spermatozoa with small vacuoles, the latter were seen to be abnormal, DNA-free nuclear concavities. Spermatozoa with small vacuoles were significantly more likely than vacuole-free spermatozoa to have non-condensed chromatin (39.8 ± 2.4% versus 9.3 ± 1.3%, respectively; P < 0.0001). There was no significant difference between the two groups of spermatozoa in terms of the acrosome reaction status. No association between chromatin condensation and acrosome reaction status was observed. Small human sperm vacuoles observed under high magnification are pocket-like nuclear concavities related to the failure of chromatin condensation. © 2013, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.


Boitrelle F.,Cytogenetics and Gynaecology | Boitrelle F.,University of Versailles | Guthauser B.,Cytogenetics and Gynaecology | Guthauser B.,University of Versailles | And 12 more authors.
Basic and Clinical Andrology | Year: 2013

Motile sperm organelle morphology examination (MSOME) involves the use of differential interference contrast microscopy (also called Nomarski contrast) at high magnification (at least 6300x) to improve the observation of live human spermatozoa. In fact, this technique evidences sperm head vacuoles that are not necessarily seen at lower magnifications - particularly if the vacuoles are small (i.e. occupying <4% of the sperm head's area). However, a decade after MSOME's introduction, it is still not clear whether sperm head vacuoles are nuclear, acrosomal and/or membrane-related in nature. In an attempt to clarify this debate, we performed a systematic literature review in accordance with the PRISMA guidelines. The PubMed database was searched from 2001 onwards with the terms "MSOME", " human sperm vacuoles" , "high-magnification, sperm" Out of 180 search results, 21 relevant English-language publications on the nature of human sperm head vacuoles were finally selected and reviewed. Our review of the literature prompted us to conclude that sperm-head vacuoles are nuclear in nature and are related to chromatin condensation failure and (in some cases) sperm DNA damage. © 2013 Boitrelle et al.; licensee BioMed Central Ltd.


Boitrelle F.,Cytogenetics and Gynaecology | Boitrelle F.,University of Versailles | Guthauser B.,Cytogenetics and Gynaecology | Guthauser B.,University of Versailles | And 14 more authors.
Reproductive BioMedicine Online | Year: 2014

Intracytoplasmic morphologically selected sperm injection (IMSI) involves the use of differential interference contrast microscopy at high magnification (at least ×6300) to improve the observation of live human spermatozoa (particularly by showing sperm head vacuoles that are not necessarily seen at lower magnifications) prior to intracytoplasmic sperm injection (ICSI) into the oocyte. However, a decade after IMSI's introduction, the technique's indications and ability to increase pregnancy and/or birth rates (relative to conventional ICSI) are subject to debate. In an attempt to clarify this debate, this work performed a systematic literature review according to the PRISMA guidelines. The PubMed database was searched from 2001 onwards with the terms 'IMSI', 'MSOME' and 'high-magnification, sperm'. Out of 168 search results, 22 relevant studies reporting IMSI outcomes in terms of blastocyst, pregnancy, delivery and/or birth rates were selected and reviewed. The studies' methodologies and results are described and discussed herein. In view of the scarcity of head-to-head IMSI versus ICSI studies, the only confirmed indication for IMSI is recurrent implantation failure following ICSI. All other potential indications of IMSI require further investigation. Intracytoplasmic morphologically selected sperm injection (IMSI) involves the use of differential interference contrast microscopy at high magnification (at least ×6300) to improve the observation of live human spermatozoa (particularly by showing sperm head vacuoles that are not necessarily seen at lower magnifications) prior to intracytoplasmic sperm injection (ICSI) into the oocyte. However, a decade after IMSI's introduction, the technique's indications and ability to increase pregnancy and/or birth rates (relative to conventional ICSI) are subject to debate. In an attempt to clarify this debate, we performed a systematic literature review according to the PRISMA guidelines. The PubMed database was searched from 2001 onwards with the terms 'IMSI, 'MSOME' and 'high-magnification, sperm'. Out of 168 search results, 22 relevant studies (reporting IMSI outcomes in terms of blastocyst, pregnancy, delivery and/or birth rates) were selected and reviewed. The studies' methodologies and results are described and discussed herein. In view of the scarcity of head-to-head IMSI versus ICSI studies, the only confirmed indication for IMSI is recurrent implantation failure following ICSI. All other potential indications of IMSI require further investigation.

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