Carrières-sous-Poissy, France
Carrières-sous-Poissy, France

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Salama S.,Hopital Prive de Parly | Salama S.,France Inter | Boitrelle F.,Poissy General Hospital | 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.


Boitrelle F.,Poissy General Hospital | Boitrelle F.,University of Saint Quentin en Yvelines | Pagnier M.,University of Saint Quentin en Yvelines | Athiel Y.,University of Saint Quentin en Yvelines | And 13 more authors.
Andrologia | Year: 2015

According to numerous assisted reproductive medicine practitioners, semen with normal characteristics might not require further investigation. However, on the scale of the individual spermatozoon, it is well known that normal morphology does not guarantee optimal nuclear quality. Here, for 20 patients with normal sperm characteristics and a high proportion of spermatozoa with noncondensed chromatin, we subsequently assessed chromatin condensation status (aniline blue staining) and morphology (Papanicolaou staining) of the same 3749 spermatozoa. Although the overall proportion of morphologically normal spermatozoa was not correlated with the overall proportion of spermatozoa with noncondensed chromatin, an individual spermatozoon's morphology appeared to be closely related to its chromatin condensation status. Morphologically normal spermatozoa with noncondensed chromatin were seen in all patients; the proportion averaged 23.3% [min 10.9%-max 44.4%]. Morphologically abnormal spermatozoa were more likely to have noncondensed chromatin than morphologically normal ones (P < 0.0001). Small-, large- or multiple-headed spermatozoa presented the highest degree of noncondensation (>80% for each type), and more than half the vacuolated spermatozoa also presented noncondensed chromatin. However, a morphologically normal spermatozoon may also have a noncondensed chromatin. © 2015 Blackwell Verlag GmbH.


Swierkowski-Blanchard N.,Poissy General Hospital | Swierkowski-Blanchard N.,University of Health Sciences | Alter L.,Poissy General Hospital | Alter L.,University of Health Sciences | And 16 more authors.
Basic and Clinical Andrology | Year: 2016

Background: According to our literature analysis, there are no data focused on spermatozoa emotional representations in childless men and data on the emotional repercussions of a diagnosis of infertility on men are still scarce. Thus, in this work, we investigated what the presence or absence of spermatozoa in the semen symbolize for men. Material and methods: To answer this question, 441 childless heterosexual men participated in an anonymous, prospective, Internet-based survey. Results: In response to the question "What would having a high or normal sperm count symbolize for you?" the most frequent answer was "ability to father a child". Men living with a partner were significantly more likely than single men to answer "ability to father a child" (p < 0.05) and less likely to answer "virility" and/or "ability to have an erection/ejaculation" (p = 0.001). In response to the question "If you found out that you had a low sperm count or no spermatozoa at all, how would you feel?", most of the men stated that they would be disappointed. Men living with a partner were more likely to state that they would feel ashamed (p < 0.05) or guilty with regard to their partner (p < 0.0001). Conclusions: These preliminary results should help us to improve (i) the way that male infertility is announced (it is easier to find the right words if one understands the possible importance of having a high sperm count) and (ii) the psychological, marital and sexual counselling provided to men with a diagnosis of infertility. © 2016 The Author(s).


Boitrelle F.,Poissy General Hospital | Boitrelle F.,University of Versailles | Albert M.,Poissy General Hospital | 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.,Poissy General Hospital | Boitrelle F.,University of Versailles | Guthauser B.,Poissy General Hospital | 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.,Poissy General Hospital | Boitrelle F.,University of Versailles | Guthauser B.,Poissy General Hospital | 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.


Jaoul M.,Poissy General Hospital | Jaoul M.,University of Versailles | Bailly M.,Poissy General Hospital | 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.


PubMed | Institute Mutualiste Montsouris, Poissy General Hospital and University of Health Sciences
Type: | Journal: Urology | Year: 2016

To assess sperm quality as a function of the sampling site (testis or epididymis) in obstructive azoospermia (OA).DNA fragmentation rates in spermatozoa sampled from the testis and epididymis (from patients with different aetiologies of OA) were assessed in a dUTP nick end labelling (TUNEL) assay.Twenty-one OA patients were included: 5 had congenital bilateral absence of the vas deferens, 8 had genital tract infections and 8 had idiopathic OA. A total of 8506 spermatozoa sampled from the testis, 18358 sampled from the caput epididymis and 18881 sampled from the corpus/cauda epididymis were assessed. For each patient, spermatozoa from the testis had a lower overall DNA fragmentation rate (6.71% 0.75 in average) than epididymal spermatozoa from the caput (14.86% 1.89 in average; p=0.0007) or the corpus/cauda (32.61% 3.11 in average; p<0.0001). The DNA fragmentation rates did not differ significantly as a function of the aetiology of OA. In this small series, all deliveries were obtained with sperm samples with a low DNA fragmentation rate and delivery rates tended to be higher when testicular sperm (rather than epididymal sperm) was used (35.7% vs. 12.1%, respectively; p=0.06).Our data argue in favour of using testicular sperm (rather than epididymal sperm) for patients with obstructive azoospermia.

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