PERITONEAL-FLUID FROM WOMEN WITH MODERATE OR SEVERE ENDOMETRIOSIS INHIBITS SPERM MOTILITY - THE ROLE OF SEMINAL FLUID COMPONENTS

Objective: To examine the mechanism of sperm motility inhibition by pe ritoneal fluid (PF) from women with endometriosis. Design: Prospective , randomized study. Setting: University-based andrology laboratory. Pa tients: Women with and without endometriosis. Interventions: Fresh sem en or Percoll-purified sperm fractions were combined with PF from wome n with endometriosis (n = 20), from fertile women without endometriosi s (n = 10), or with physiological saline. Main Outcome Measure: Sperm motility parameters were determined with computer-assisted semen analy sis. Data were evaluated by the analysis of variance and the Student's t-test. Results: Peritoneal fluid from women with minimal or mild end ometriosis did not inhibit sperm motility in semen. Peritoneal fluid f rom women with moderate or severe endometriosis caused approximately 4 0%, 50%, and 80% declines in sperm motility and in percent progressive motile sperm, after 4, 7, and 24 hours, respectively. Sperm velocity was inhibited by approximately 30% and 60% after 7 and 24 hours, respe ctively. However, in the Percoll-purified sperm fractions the same PF did not inhibit sperm motility within the 4- to 7-hour time frame, and only a 17% to 42% inhibition occurred after the overnight incubation. Sperm velocity was not affected. Conclusion: Cellular components of s eminal fluid appear to mediate the inhibitory action of PF, Assuming t hat the leukocyte components of semen and PF are common, the cell-medi ated inhibition of sperm motility is a likely contributor to endometri osis-related infertility.