Laparoscopic recovery of sperm from peritoneal fluid, in patients with negative or poor Sims-Huhner test

Abstract

Several opinions about the importance of the Sims-Huhner test (SHT) are reported in the literature. Paradoxical are the results relative to conception following a positive or negative SHT. Pregnancy frequently occurs in women with a negative or poor SHT. This observation prompted the author to look for the presence of sperm in peritoneal fluid during laparoscopy in eight patients with a negative SHT and in three with a poor SHT. Complete evaluation was performed to rule out other infertility causes. The peritoneal fluid was aspirated from the cul-de-sac and again after washing the Douglas space and fimbriated portion of the fallopian tubes with 5 to 10 ml of normal saline solution, using a Verres needle. Samples were processed with the Sayk unit, by a special cytosedimentation technique developed for study of the cerebrospinal fluid. In six of the eight patients with a negative SHT and in the three with a poor SHT, sperm were found in the aspirate. No immature or morphologically abnormal sperm were recovered. This procedure illustrates the limitation of the long-accepted SHT in the prognosis for infertile couples. Investigations to eliminate the fixed stage in the processing are being studied to standardize the test.