Objective: To correlate components of the plasminogen activator (PA) system with fertility outcome parameters in participants in an IVF/intracytoplasmic sperm injection (ICSI) procedure. Design: Case-control study. Setting: Outpatient clinic for IVF/ICSI treatment at the Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. Patient(s): One hundred and fifty-six couples undergoing an IVF/ICSI procedure. Intervention(s): None. Main Outcome Measure(s): Urokinase-type plasminogen activator (u-PA), tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), and t-PA-PAI-1 complex concentrations in the ejaculate, spermatozoa, and follicular fluid (FF). Result(s): Concentrations of t-PA were higher in spermatozoa of the male factor subfertility group (geometrical mean, 77.1 pg/million spermatozoa; 25th-75th percentiles, 31.8-211.2), compared to fertile men (geometrical mean, 1.91; 25th-75th percentiles, 0.74-5.79) and idiopathic subfertile men (geometrical mean, 3.14; 25th-75th percentiles, 0.97-9.97). Furthermore, the concentration of t-PA in spermatozoa was significantly associated with pregnancy (odds ratio [OR], 0.995). Likewise, a trend was shown for higher t-PA concentrations in the FF of women with fallopian-tube pathology (geometrical mean, 18.5 pg t-PA/mg protein; 25th-75th percentiles, 11.4-25.7) or endometriosis (geometrical mean, 18.8; 25th-75th percentiles, 11.4-27.1), compared to fertile women (geometrical mean, 14.3; 25th-75th percentiles, 10.3-17.6) and idiopathic subfertile women (geometrical mean, 13.9; 25th-75th percentiles, 9.5-17.8). Also, t-PA in FF is associated with the proportion of cleaved embryos (regression coefficient, 0.16). The concentrations of u-PA, PAI-1, and t-PA-PAI-1 complex were comparable between diagnostic subgroups in both men and women. Conclusion(s): The t-PA concentrations in spermatozoa and FF tend to be higher in human subfertility, and seem to be associated with some fertility outcome parameters.

Fertility, in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), plasminogen activator inhibitor 1 (PAI-1), tissue-type plasminogen activator (t-PA), urokinase-type plasminogen activator (u-PA)
dx.doi.org/10.1016/j.fertnstert.2006.07.1510, hdl.handle.net/1765/35542
Fertility and Sterility
Erasmus MC: University Medical Center Rotterdam

Elbisch, I.M.W, Steegers-Theunissen, R.P.M, Sweep, F.C, Zielhuis, G.A, Geurts-Moespot, A, & Thomas, C.M.G. (2007). Possible role of the plasminogen activation system in human subfertility. Fertility and Sterility, 87(3), 619–626. doi:10.1016/j.fertnstert.2006.07.1510