RESUMO
El diagnóstico clínico de resistencia insulínica (RI) es difícil, ya que el Clamp no es aplicable a la clínica. El así llamado "síndrome metabólico", un predictor clínico de la RI, no identifica alrededor de la mitad de los sujetos afectados. Previamente, definimos adecuadamente (Análisis ROC) los niveles de corte diagnóstico de los siguientes predictores bioquímicos: HOMA1, HOMA2, QUICKI e ISI-Composite, a través de analizar datos de 90 sujetos (53 no resistentes y 37 resistentes) que tenían una medición directa de su resistencia insulínica (Test de supresión pancreática, TSP, Test de Reaven) y también, una curva de tolerancia a la glucosa oral (CTG). Los puntos de corte obtenidos exhibieron un mucho mejor desempeño diagnóstico comparados con los puntos de corte convencionales. También encontramos un predictor nuevo, simple, económico y eficiente, el I0*G60. Definimos la "normalidad metabólica" de la CTG usando las medianas de los valores de varios parámetros en 312 sujetos con un G120 dentro de los 2 primeros terciles del grupo de normo-tolerantes a la glucosa (NGT, n=468; G120: 51-110 mg/dL, los con mejor función beta insular). A las medianas de la función beta insular y de la sensibilidad insulínica se les asignó un valor de un 100%. Se calculó el % relativo de función beta insular (%RFBI) y el % relativo de sensibilidad insulínica (%RSI) del resto de la cohorte (n=573) contra estos valores de referencia. El "OGTT Squeezer" se escribió en Excel. Las glicemias y las insulinemias de la CTG fueron las entradas del programa. Las salidas fueron: I0*G60, ISI-OL, QUICKI, and HOMA1 (predictores) y el índice insulinogénico, el índice de disposición, %RFBI y %RSI (parámetros). El programa también caracterizó la tolerancia glucídica de acuerdo a los criterios de la ADA 2003. El formato final del programa, HTML 5, facilita su uso. Desarrollamos tres versiones del programa: completa, abreviada y mínima.
Clinically, diagnosing insulin resistance (IR) is difficult since the Clamp is not applicable to clinical work. The so-called "Metabolic Syndrome", a clinical surrogate of IR, fails to identify around 50% of affected subjects. Previously, we properly defined (ROC Analysis) the diagnostic cut-offs of the following biochemical predictors: HOMA1, HOMA2, QUICKI, and ISI-Composite by analyzing data from 90 subjects (53 non-insulin-resistant and 37 insulin-resistant subjects) who had a direct measurement of insulin resistance (Pancreatic Suppression Test, PST, Reaven's Test), and also, an Oral Glucose Tolerance Test (OGTT). The resulting cut-offs exhibited much better performances compared with the conventional cut-offs. We also found a new, simple, inexpensive and efficient predictor, the I0*G60. We chose to define the "metabolic normalcy" of the OGTT by using the median values of several parameters in 312 NGT subjects with a G120 in the first 2 tertiles of the NGT group (n=468; G120: 51-110 mg/dL, those with the best beta-cell function). The median values of both Beta-Cell Function and Insulin Sensitivity of these subjects were assigned a 100% value. Both % Relative Beta-Cell Function (%RBCF) and % Relative Insulin Sensitivity (%RIS) of everyone else in the cohort (n=573) was calculated against these reference values. The "OGTT Squeezer" was written in Excel. The OGTT's glucose and insulin values served as the inputs of the program. The outputs were: I0*G60, ISI-OL, QUICKI, and HOMA1 (predictors), and Insulinogenic Index, Disposition Index, %RBCF, and %RIS (parameters). Moreover, the program characterized the OGTT according to the ADA 2003 criteria. The HTML 5 format of the program facilitates its use. We developed 3 versions of the program: complete, abbreviated, and minimal versions.
Assuntos
Humanos , Resistência à Insulina , Teste de Tolerância a Glucose/métodos , Prognóstico , Curva ROC , HomeostaseRESUMO
Bovine cervical mucus (BCM) is important for selection and transport of spermatozoa. When air-dried, BCM obtained at oestrus exhibits arborescent crystallizations, among other arrangements. Considering the relevant endocrine and reproductive information indirectly obtained from BCM crystallization, a morphological investigation was carried out to study its crystalline patterns. BCM samples were collected from healthy Holstein Friesian heifers at oestrus, their crystalline patterns photographed and its morphology analyzed. The majority of the crystallizations obtained showed the typical tree-like patterns reported for BCM. However, a highly symmetrical arrangement was found, characterized by a star-like morphology with six straight, highly defined axes that protrude from the same central point, forming 60º angles. In terms of current knowledge, this short report is the first to show this crystallization geometry in BCM, which, additionally, is remarkably similar to P6B mucus reported for periovulatory human cervical mucus. Even though the role of mucus presenting this type of crystallization is as yet unknown for bovines, its possible functions are also briefly discussed here.
El moco cervical bovino es importante para la selección y el transporte espermático. El moco, obtenido durante el estro y secado al aire, exhibe cristalizaciones con formas principalmente arborescentes. Considerando la importante información endocrina y reproductiva que es posible obtener a partir de la cristalización del moco cervical, se efectuó una investigación morfológica con el propósito de estudiar sus patrones cristalinos. Las muestras de moco se obtuvieron de novillas Holstein Friesian en estro; posteriormente, los patrones de cristalización del moco fueron fotografiados para finalmente analizar su morfología. Las cristalizaciones obtenidas correspondieron a típicos patrones arboriformes previamente reportados. Sin embargo, lo que llamó la atención fue el hallazgo de un arreglo altamente simétrico en una novilla, caracterizado por una morfología similar a estrella con seis ejes rectos, bien definidos, que surgen desde el mismo punto central y forman ángulos de 60º. Según nuestro conocimiento, esta comunicación breve reporta por primera vez la presencia de dicha geometría de cristalización en vaquillas, la cual es muy semejante al patrón cristalino subtipo P6 reportado para el moco cervical perioBvulatorio humano. Si bien el rol ejercido por este tipo de cristalización de moco aún se desconoce en bovinos, se discuten aquí sus posibles funciones.
RESUMO
In the acrosome reaction, the spermatozoon plasma membrane fuses with the outer acrosomal membrane, resulting in the release of the acrosomal content. Several compounds, such as sex steroids, are known to modulate the acrosomal exocytosis. Testosterone regulates various functions in male reproductive physiology; however, little is known about the relationship between testosterone and the acrosome reaction. Thus, our objective was to study the effect of testosterone on the acrosome reaction of human spermatozoa. To evaluate the acrosomal exocytosis, spermatozoa were incubated with testosterone (0.2, 2.0 and 20 nmol l(-1)), progesterone and control medium for 60, 120, 240 and 1440 min. The acrosome reaction was assessed by staining with Hoechst 33258 and fluorescein isothiocyanate-conjugated P. sativum agglutinin lectin. In general, spermatozoa incubated with progesterone had the highest percentage of acrosomal exocytosis. The percentage of acrosome reaction obtained in the three treatments with testosterone differed from that observed for progesterone at 120, 240 and 1440 min (24 h). Additionally, significant differences were found between testosterone (2.0 and 20 nmol l(-1)) and progesterone after 60 min. Differences between control and the three testosterone treatments studied were obtained only at 1440 min. In general terms, these results show that testosterone exerts no inductor effects on the acrosome reaction of human spermatozoa.
Assuntos
Reação Acrossômica/efeitos dos fármacos , Espermatozoides/efeitos dos fármacos , Testosterona/farmacologia , Meios de Cultura , Humanos , MasculinoRESUMO
The acrosome is a secretory vesicle located in the sperm head. The acrosome reaction consists in the fusion of the sperm plasma membrane with the external acrosomal membrane. It has been observed that this reaction does not take place in spermatozoa incubated in cervical mucus, hydrogel that contains high concentrations of oestradiol in the peri-ovulatory period. The objective of the present study was to analyse the influence of oestradiol on the acrosome reaction in human spermatozoa to evaluate the possible inhibitory effect of this hormone. Spermatozoa were incubated in progesterone (10.1 nmol l(-1)); oestradiol plus progesterone (oestradiol at 840 pmol l(-1) and progesterone at 10.1 nmol l(-1)), oestradiol (840 pmol l(-1)) and control (without steroidal hormones) for 30 min, 60 min, 240 min and 24 h. The acrosome reaction was evaluated by stain with Hoechst 33258 and fluorescein isothiocyanate-conjugated Pisum sativum agglutinin lectin. Progesterone-incubated spermatozoa showed the highest percentage of acrosome reaction (P < 0.05). Spermatozoa incubated with oestradiol and oestradiol plus progesterone showed the lowest percentage of acrosome reaction. The present study demonstrates the inhibitory role of oestradiol on the acrosome reaction, stimulated by progesterone in human spermatozoa under physiological conditions.
Assuntos
Reação Acrossômica/efeitos dos fármacos , Reação Acrossômica/fisiologia , Estradiol/farmacologia , Estradiol/fisiologia , Espermatozoides/efeitos dos fármacos , Espermatozoides/fisiologia , Muco do Colo Uterino/fisiologia , Feminino , Humanos , Técnicas In Vitro , Masculino , Progesterona/farmacologia , Progesterona/fisiologiaRESUMO
Background: The hyperinsulinemic euglycemic clamp is the gold standard to measure directly insulin resistance.Unfortunately, the procedure is technically demanding, expensive and, unsuitable for clinical work. Cliniciansare used to request an HOMA test (Homeostasis Model Assessment) to indirectly assess the presence of insulinresistance given that it is an inexpensive and readily performed test but it has several shortcomings. Aim: To studythe diagnostic performance of the HOMA test as it is done in our country. Material and methods: We selected 32 women aged 32 +/- 2 years and 18 men aged 42 +/- 3 years. Half of them were categorized as insulin resistant by the pancreatic suppression test with octreotide, that is highly correlated with the euglycemic clamp but simpler to perform. Insulin was measured in two different laboratories in Santiago (Barnafi-Krause and Laboratorio deNutrición, Universidad Católica) and HOMA results were calculated using serum fasting insulin and glucose levels.Results: The correlation coefficients between HOMA, calculated using insulin values of both laboratories, and the results of the pancreatic suppression test were 0.45 and 0.55 (p< 0.01). Only six of 25 subjects defined as insulin resistant by the pancreatic suppression test were detected with HOMA. Therefore, the sensitivity of the latter for insulin resistance was 24 percent. However all subjects defined as insulin resistant by HOMA (BK) hadan abnormal pancreatic suppression test. Conclusions: Even though HOMA test was positively correlated with insulin resistance, it had a poor diagnostic sensitivity. Clinicians should be aware that the HOMA test is proneto under-diagnose the presence of insulin resistance.
Assuntos
Humanos , Masculino , Feminino , Adulto , Homeostase/fisiologia , Resistência à Insulina/fisiologia , Sensibilidade e Especificidade , Valor Preditivo dos Testes , Índice de Massa CorporalRESUMO
Antecedentes: El síndrome de ovario poliquístico (SOP) es el desorden endocrino más común en las mujeres en edad reproductiva. Han sido asociadas al SOP resistencia a la insulina, obesidad y diabetes mellitus. Objetivo: Analizar en mujeres con SOP la relación entre testosterona, obesidad y problemas en el metabolismo de carbohidratos. Pacientes y Métodos: 60 pacientes, entre 14-32 años, fueron diagnosticadas según Consenso de Rotterdam. Se midió testosterona total (Ttotal), se realizó un test de tolerancia oral a glucosa e insulina (TTOG-I) y se calculó índice de masa corporal (IMC) en todas las pacientes. La distribución de cada variable y la relación entre testosterona y las otras variables fueron analizadas. Resultados: La media de Ttotal en todas las pacientes fue 2,2 nmol/L; 71,7 por ciento de los sujetos presentan IMC normal, 21,7 por ciento presentan IMC sobrepeso y 6,6 por ciento presenta IMC obeso. La media de Ttotal para cada grupo según IMC fue 2,2 nmol/L para normal y sobrepeso, y 2,75 nmol/L para obeso. Para TTOG-I, 43,3 por ciento tiene respuesta normal, con media de Ttotal = 2,2 nmol/L y media de IMC= 22,3 kg/m2, 56,7 por ciento tiene respuesta anormal, con media de Ttotal= 2,19 nmol/L e IMC= 23,1 kg/m2. Las pacientes normales y sobrepeso muestran respuesta similar al TTOG-I. Todas las pacientes obesas tienen TTOG-I alterado. Conclusiones: La alta prevalencia de desórdenes metabólicos apoya el hecho que éstos deben ser estudiados en estas pacientes. La ausencia de correlación significativa entre Ttotal y las otras variables sugiere que en el SOP múltiples factores están involucrados y que éste incluye diferentes subpoblaciones de pacientes, que requieren un diagnóstico adecuado. La clasificación de las pacientes con SOP en subgrupos podría ser útil antes del inicio del tratamiento.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Teste de Tolerância a Glucose , Resistência à Insulina , Síndrome do Ovário Policístico/metabolismo , Testosterona/análise , Índice de Massa CorporalRESUMO
Background: Urgent measures are required to stop the increase in the frequency of pregnancies and sexually transmitted diseases among teenagers. A means of facing this problem is promoting sexual abstinence among youngsters. There are studies that confirm the efficacy of this approach. Aim: To show the results of the application of a holistic sexuality program (TeenSTAR) among Chilean teenagers. Subjects and Methods: Students attending basic or high school were divided into a control or study group. The control group (342 students) received the usual education on sexuality given by their schools and the study group (398 students) participated in twelve TeenSTAR sessions lasting 1.5 hours each, given by a trained professor. Assessment of achievements was made using an anonymous questionnaire answered at the start and end of the program. Results: The rates of sexual initiation among control and study groups were 15 and 6.5%, respectively. Among sexually active students, 20% of those in the study group and 9% of those in the control group discontinued sexual activity. Conclusions: A higher proportion of students in the TeenSTAR program retarded their sexual initiation or discontinued sexual activity and found more reasons to maintain sexual abstinence than control students.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Gravidez , Comportamento do Adolescente , Gravidez na Adolescência/prevenção & controle , Serviços de Saúde Escolar/normas , Educação Sexual/normas , Abstinência Sexual , Distribuição por Idade , Chile , Saúde Holística , Avaliação de Programas e Projetos de Saúde , Distribuição por Sexo , Fatores SocioeconômicosRESUMO
With approximately 90 million cases annually, infection with Chlamydia trachomatis is the most prevalent sexually transmitted bacterial disease in the world. Considering that these infections are often asymptomatic and cause major complications like acute pelvic inflammatory disease, ectopic pregnancy, infertility or infant pneumonia, the estimated costs for diagnosis and treatment in the USA amounts to 2.2 million US dollars for each 500 cases. Therefore, there is a high need for correct, quick and cost-effective diagnosis and treatment of this urogenital tract infection. New innovative therapies provide good results with regard to efficacy and patients' compliance. The success rates of treatments are at least 95%. However, the occurrence of antibiotic resistance should not be ignored and new treatment schemes must be developed. The state-of-the-art of diagnosis and treatment of chlamydial infections as well as the pathophysiology is discussed in this review. In conclusion, infections with C. trachomatis is an important public health problem, especially in third world and developing countries, and more socio-economic studies linking secondary prevention of chlamydial infections, infertility and adverse pregnancy outcome are needed to understand more of its aetiology. In addition, diagnosis and treatment should be improved. Data in men revealed that past infections but not present infections are more related to male infertility. There is still controversial results. In future studies, function of the seminal vesicles and evaluation of the antioxidant capacity should be taken into account when role of C. trachomatis infection on male fertility is assessed.
Assuntos
Infecções por Chlamydia/complicações , Chlamydia trachomatis , Infertilidade Masculina/microbiologia , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/fisiopatologia , Humanos , Infertilidade Masculina/epidemiologia , Infertilidade Masculina/fisiopatologia , MasculinoRESUMO
The incidence of Chlamydia trachomatis (Ct) infection and the possible correlation between couples presenting with first-trimester spontaneous abortions and active Ct infection was assessed. Additionally, the ability of Ct to infect zona-free hamster oocytes was explored by incubating the oocytes with spermatozoa from infected patients. A total of 961 women and 750 men consulting our reproductive medicine centre were screened for Ct using direct immunofluorescence. The general incidence of Ct infection was 9.4% in females (90 of 961) and 13.9% in males (104 of 750). In women with spontaneous abortions the incidence of Ct was 21.0% (14 of 66) compared with 8.9% (23 of 59) for women without spontaneous abortions and term pregnancies (chi-square, P < 0.05). When both partners of the couples were considered (one or both partners infected), the incidence rose to 68.8% (22 of 32) (chi-square, P < 0.001). In vitro studies using electron microscopy demonstrated the presence of Ct on the surface of and inside the oocyte. These results indicate a correlation between an active Ct infection and spontaneous abortion. Electron microscopy studies suggested the possibility of direct oocyte infection by Ct. Two models are proposed for the pathogenesis of Ct-related early abortions: (i) direct zygote infection, and (ii) immune response to heat shock proteins expressed by the zygote and triggered by previous Ct infections.
Assuntos
Aborto Espontâneo/etiologia , Infecções por Chlamydia/complicações , Complicações Infecciosas na Gravidez/fisiopatologia , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/microbiologia , Infecções por Chlamydia/fisiopatologia , Chlamydia trachomatis/isolamento & purificação , Feminino , Técnica Direta de Fluorescência para Anticorpo , Humanos , Masculino , Microscopia Eletrônica , Gravidez , Primeiro Trimestre da Gravidez , Espermatozoides/ultraestruturaRESUMO
Chlamydia trachomatis infection is one of the most common sexually transmitted diseases. Its effect on male fertility, however, is still controversial. In this study, 284 male partners of infertile couples consulting the Center of Studies in Reproductive Biology (CEBRE) were analyzed. The incidence of C. trachomatis infection among male partners of infertile couples was 38.6%. There were no significant differences between infected and noninfected infertile men in any of the sperm parameters assessed (sperm concentration, motility and morphology). The results of the three bioassays developed to evaluate sperm physiology, namely spermatozoa-zona pellucida binding, acrosome reaction stimulated with human follicular fluid and zona-free hamster oocyte penetration, showed no differences between infected and noninfected men. Electron microscopy studies suggest that spermatozoa are active agents in the dissemination of the chlamydial infection; they could be acting as 'vehicles' for the pathogens. These, and other results, suggest that the possible effect of C. trachomatis on male fertility is not due to alterations in sperm 'quality' or function, but rather to the transmission of the disease to female partners, causing inflammatory processes and promoting the generation of antisperm antibodies.
Assuntos
Infecções por Chlamydia/complicações , Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis/isolamento & purificação , Infertilidade Masculina/etiologia , Espermatozoides/fisiologia , Animais , Chile/epidemiologia , Infecções por Chlamydia/microbiologia , Cricetinae , Humanos , Incidência , Masculino , Microscopia Eletrônica , Espermatozoides/ultraestruturaRESUMO
The mechanism by which GnRH increases sperm-zona pellucida binding in humans was investigated in this study. We tested whether GnRH increases sperm-zona binding in Ca(2+)-free medium and in the presence of Ca(2+) channel antagonists. We also examined the GnRH effect on the intracellular free Ca(2+) concentration ([Ca(2+)](i)). Sperm treatment with GnRH increased sperm-zona binding 300% but only when Ca(2+) was present in the medium. In Ca(2+)-free medium or in the presence of 400 nM nifedipine, 80 microM diltiazem, or 50 microM verapamil, GnRH did not influence sperm-zona binding. GnRH increased the [Ca(2+)](i) in the sperm in a dose-dependent manner. The maximum effect was reached with 75 nM GnRH. The GnRH-induced increase in [Ca(2+)](i) was fast and transient, from a basal [Ca(2+)](i) of 413 +/- 22 nM to a peak value of 797 +/- 24 nM. The GnRH-induced increase in [Ca(2+)](i) was entirely due to a Ca(2+) influx from the extracellular medium because the increase in [Ca(2+)](i) was blocked by the Ca(2+) chelator EGTA and by the Ca(2+) channel antagonists nifedipine and diltiazem. These antagonists, however, were not able to inhibit the progesterone-activated Ca(2+) influx. On the contrary, T-type calcium channel antagonists pimozide and mibefradil did not affect GnRH-activated Ca(2+) influx but inhibited the progesterone-activated Ca(2+) influx. Finally, the GnRH-induced Ca(2+) influx was blocked by two specific GnRH antagonists, Ac-D-Nal(1)-Cl-D-Phe(2)-3-Pyr-D-Ala(3)-Arg(5)-D-Glu(AA)(6)-GnRH and Ac-(3,4)-dehydro-Pro(1),-p-fluoro-D-Phe(2), D-Trp(3,6)-GnRH. These results suggest that GnRH increases sperm-zona binding via an elevation of [Ca(2+)](i) through T-type, voltage-operated calcium channels.
Assuntos
Canais de Cálcio/fisiologia , Cálcio/metabolismo , Hormônio Liberador de Gonadotropina/farmacologia , Interações Espermatozoide-Óvulo/efeitos dos fármacos , Espermatozoides/metabolismo , Zona Pelúcida/metabolismo , Bloqueadores dos Canais de Cálcio/farmacologia , Diltiazem/farmacologia , Ácido Egtázico/farmacologia , Feminino , Humanos , Masculino , Mibefradil/farmacologia , Nifedipino/farmacologia , Pimozida/farmacologia , Verapamil/farmacologiaRESUMO
Objetivos: 1. Estudiar prevalencia de endometriosis en mujeres en edad reproductiva que consultaron por dismenorrea y/o infertilidad. 2. Evaluar relación entre CA 125 y hallazgo laparoscópico. 3. Identificar grado de endometriosis más frecuente según grupo etario. Material y métodos: se estudiaron 49 mujeres con ultrasonografía ginecológica, CA 125 y laparoscopia. Se divieron en: grupo I: < 25 años (n=16), grupo II: 26-41 años (n=33). Se comparó estadísticamente ambos grupos. Resultados: el motivo de consulta más frecuente en ambos grupos fue dismenorrea e infertilidad, respectivamente (p<0,0001). Se encontró endometriosis en 87,5 por ciento del grupo I y en 100 por ciento del grupo II, siendo en ambos más frecuente el grado IV (50 y 36,4 por ciento, respectivamente). No hubo correlación entre CA 125 y laparoscopia. Conclusión: un alto porcentaje de mujeres en edad reproductiva presentan una endometriosis avanzada al momento del diagnóstico. El CA 125 no se correlaciona con presencia ni etapificación de endometriosis. La laparoscopia continúa siendo la mejor alternativa
Assuntos
Humanos , Feminino , Adolescente , Adulto , /isolamento & purificação , Endometriose/epidemiologia , Dor Pélvica/etiologia , Dismenorreia/etiologia , Infertilidade Feminina/etiologia , Laparoscopia/estatística & dados numéricos , Sensibilidade e EspecificidadeRESUMO
Objetivos: estudiar a jóvenes con irregularidad menstrual, hirsutismo, acné u obesidad, su incidencia de anovulación y la respuesta de aquellas hiperandrogénicas a bajas dosis de conticoides. Materiales y métodos: en 229 pacientes entre 10 y 25 años se midió TSH, PRL, LH, FSH, TT, TL. La ovulación se caracterizó según el moco cervical y niveles de progesterona séricos y urinarios. En caso de HA se realizó un test de supresión con dexametasona. Resultados: el 44,5 por ciento del total de la población consulta por oligomenorrea y el 66,9 por ciento presenta hiperandrogenismo. El 30 por ciento mostró en forma concomitante hiperprolactinemia, hiper o hipotiroidismo. El 85 por ciento presentó anovulación y el 81 por ciento de las hiperandrogénicas tuvo un test de supresión positivo. Conclusiones: la patología más frecuente en esta población es el hiperandrogenismo, que responde a dexametasona. Las jóvenes con trastornos menstruales deben ser estudiadas precozmente; con un tratamiento adecuado para su patología se prevendrían casos de infertilidad, cáncer y dislipidemia
Assuntos
Humanos , Feminino , Adolescente , Adulto , Hiperandrogenismo/diagnóstico , Distúrbios Menstruais/etiologia , Acne Vulgar/etiologia , Corticosteroides/administração & dosagem , Anovulação/diagnóstico , Hirsutismo/etiologia , Obesidade/complicações , Oligomenorreia/etiologia , Testes de Função OvarianaRESUMO
La chlamydia trachomatis (Ct) es una de las infecciones de transmisión sexual más frecuentes en la población. Sin embargo, el efecto que pudiera tener la infección por Ct en hombres no está claramente establecido. En el presente estudio analizamos 237 varones miembros de una pareja que consultó por infertilidad en CEBRE. Se observó una incidencia de infección por Ct de 36,7 por ciento, la que aumenta a 69 por ciento al considerar la pareja como una unidad. No observamos diferencias significativas en ninguno de los parámetros seminales evaluados (concentración, movilidad, morfología) en hombres infértiles infectados y no infectados con Ct. Los resultados de los bioensayos funcionales diseñados para evaluar varios aspectos de la fisiología espermática no arrojaron diferencias entre hombres infectados o no infectados por Ct. Los estudios de microscopia electrónica sugieren que los espermatozoides son agentes activos de la dispersión de la infección al servir de vehículo para los cuerpos reticulares de clamydia. De este y otros estudios es posible sugerir que el efecto de Ct sobre la fertilidad masculina no se debería a daños en la calidad de los espermatozoides, sino más bien a la generación de anticuerpos anti-espermáticos, a la inflamación que acompaña a la infección y a la transmisión de Ct a la mujer