Thesis (DTh)--Stellenbosch University, 2006. / ENGLISH ABSTRACT: This dissertation seeks to develop further the theological interpretation of the books of Samuel, by examining I Samuel I: 1-2:10 in the context of fertility and barrenness as blessing and curse. This reading was related to the Karanga understanding of fertility and barrenness. The contribution shows how the Biblical narrative can become a resource for ethical reflection in African communities such as the Karanga women. The hypotheses that guided this study, were that: a-Fertility and barrenness in the Old Testament should be understood in close conjunction with blessing and cursing as theological concepts in ancient Israel. b-Fertility and barrenness could also be examined in a relevant and contextual manner by relating it to the culture and understanding of the Karanga people. In order to achieve this, two major tasks were attempted. One: An exegesis of I Samuel I: 12: 10 in which Vernon Robbins' method of Socio- Rhetorical criticism was used. The method helped to identify that the text is a narrative, and that the author might have been the Deuteronomistic historian, who wrote in the period of the decline of the Judean monarchy and when the Jews were in exile. The narrative is used to tell about the despair of the Jews, and to inform the Jews that there was hope for restoration if they obeyed God. This ideology is woven in the story of a barren woman Hannah who suffered the despair of barrenness and was later blessed with a child because of her prayer and obedience to God. In the narrative God is described as one who cares for the marginalised, and one who changes the lives of his people, from curse to blessing. The method also helped to realise tbe culture and context of Hannah, and made it possible to relate this culture and context to other cultures that are similar. Secondly an empirical survey was conducted amongst one hundred Karanga women. The findings were that Karanga consider fertility as blessing and barrenness as curse. The curse is experienced in the suffering of the barren women. Barrenness is used to inflict pain, to marginalise women, and has become a major cause of divorce and death through the spread of HIV and Aids. A reading of the story of Hannah helped the Karanga women to identify their barren problems with Hannah, and to find a new way of understanding their own problem in terms of hope. This study was able to prove its hypothesis both through the exegesis and the discussions of the research findings. It was found that the narrative form of the text appealed effectively to the understanding of Karanga women. This was possible because narrative is one of the methods of communication that is used effectively by the Karanga in their language. Through using Hannah as a paradigm of curse and blessing in relation to barrenness and fertility, Karanga women were challenged to view their barren situations in a different way that is open to accept change from curse to blessing. The study has also contributed to see how an old text of the time of Hannah could in the present day contextually influence Karanga women's barren experiences through holding the same culture and also by having similar experiences barren of women. / AFRIKAANSE OPSOMMING: Hierdie dissertasie poog om die teologiese interpretasie van die boeke van Samuel verder te ontwikkel by wyse van 'n ondersoek van I Samuel 1:1-2:10 in die konteks van vrugbaarheid en onvrugbaarheid as 'n seën en as 'n vervloeking. Hierdie ondersoek verwys na die Karangabevolking se begrip van vrugbaarheid en onvrugbaarheid. Die bydrae toon aan hoe die Bybelse verhaal 'n bron vir etiese nadenke onder Afrika-gemeenskappe, soos die Karangavroue, kan word. Die hipoteses wat hierdie studie gerig het, was dat: a-Vrugbaarheid en onvrugbaarheid in die Ou Testament behoort begryp te word in 'n noue verbintenis met seën en vervloeking as teologiese begrippe in antieke Israel. b-Vrugbaarheid en onvrugbaarheid kan ook ondersoek word in 'n relevante en kontekstuele wyse deur dit te verbind met die kultuur en begrip van die Karanga-mense. Om dit te vermag, is twee hooftake onderneem. Die eerste was 'n eksegese van I Samuel 1: 12: 10 waarin Vernon Robbins se metode van sosioretoriese kritiek aangewend is. Hierdie metode het gehelp om die teks as 'n narratief te identifiseer en dat die skrywer die Deuteronomiese historikus kon gewees het, wat in die periode van die monargie van Juda geskryf het en ook tydens die Jode se ballingskap. Die narratief word gebruik om aan te toon hoe wanhopig die Jode was en om hulle in te lig dat daar hoop op hul herstel was indien hulle God gehoorsaam. Hierdie ideologie is verweef in die verhaal van die onvrugbare vrou, Hanna, wat aan die wanhoop van onvrugbaarheid gely het en later met 'n kind geseën is op grond van haar gebede en gehoorsaamheid aan God. In die narratief word God as die een beskryf wat na die gemarginaliseerdes omsien en wat die lewens van sy mense vanaf vervloeking tot seën omvorm. Die metode het ook meegehelp om die kultuur en konteks van Hanna te begryp en dit moontlik gemaak om hierdie kultuur en konteks te verklaar ingevolge die van ander soortgelyke kulture. Tweedens is 'n empiriese studie onder 'n honderd Karanga-vroue onderneem. Die bevindinge was dat Karanga-vroue vrugbaarheid as 'n seën en onvrugbaarheid as 'n vervloeking beskou. Die vervloeking word in die lyding van die onvrugbare vroue ervaar. Onvrugbaarheid word aangewend om pyn en lyding te veroorsaak, om vroue te marginaliseer en het 'n belangrike bron van egskeiding en dood deur die verspreiding van HIV en Vigs geword. Deur die verhaal van Hanna te lees, het die Karanga-vroue gehelp om hul eie onvrugbaarheidsprobleme met die van Hanna te identifiseer en om nuwe wyses te vind om hul eie probleme te verstaan in terme van hoop. Hierdie studie was in staat om sy hipoteses te bewys sowel by wyse van die eksegese en ook deur die bespreking van die navorsingsbevindings. Dit is bevind dat die narratiewe vorm van die teks duidelik tot die begrip van die Karanga-vroue gespreek het. Dit was moontlik aangesien 'n verhalende trant een van die kommunikasiewyses is wat doeltreffend deur Karanga-vroue aangewend word in hul taal. Deur Hanna as 'n paradigma van vervloeking en as seën te gebruik met verwysing tot onvrugbaarheid en vrugbaarheid, is Karanga-vroue uitgedaag om hul beskouing van hul onvrugbare toestand op verskillende wyses te betrag wat oop is om 'n verandering te aanvaar vanaf vervloeking tot seën. Die studie het ook daartoe bygedra om te sien hoe 'n ou teks uit die tyd van Hanna tans kontekstueel die Karanga-vroue se onvrugbaarheidservarings kan beinvloed waar hulle uit 'n soortgelyke kultuur kom en ook soortgelyke ervarings as Hanna het as onvrugbare vroue.

Thesis (MScMedSc)-- Stellenbosch University, 2013. / ENGLISH ABSTRACT: Much has been documented about the detrimental effects of adverse lifestyle factor exposure on the body. Exposure to factors, such as cigarette smoke, have proved to not only be a burden on global health and economy, but have also led to growing concerns about effects on systemic functions such as reproduction. The aim of the present study was to determine the effects of in utero and in vitro nicotine exposure on spermatozoal function and the antioxidant enzyme activity and lipid peroxidation (LPO) status of the male reproductive system. A better understanding of this process is necessary to combat the respective burdens of smoking and male infertility and for the prospective development of treatment strategies. Two experimental models were employed: Wistar rats were exposed to nicotine in utero while human and rat spermatozoa were exposed to nicotine in vitro. In utero studies were achieved by selecting healthy pregnant rats and treating them with 1 mg/kg-bodyweight/day nicotine or 1 ml/kg-bodyweight/day 0.85% physiologic saline throughout gestation and lactation. Male rat pups were selected and sacrificed at each of the following age groups (n=6): 42 days, 84 days and 168 days old. The pups were only exposed to the treatment/saline via placental uptake or lactation. Biochemical analyses of the tissue comprised of measurement of LPO and antioxidant enzyme activity. Results indicated a significant association of maternal nicotine exposure to decreased levels of primary antioxidant enzymes in rat testes. Of particular note was the observation that the treatment group, of which each of the respective antioxidant enzyme levels were significantly less than the control group, was the oldest (d168) rat group. In vitro studies were achieved by collecting sperm samples from healthy human donors (n=12), healthy rats (n=6) and obese rats (n=6). Samples were washed and exposed to different concentrations of high levels of nicotine (Control, 0.1mM, 1mM, 5mM, 10mM) in vitro. Semen parameters such as motility, viability and acrosome reaction were monitored at different time points (30min, 60min, 120min, 180min). Results revealed increasing in vitro nicotine concentrations were associated with decreased viability and acrosomal status of human spermatozoa and decreased progressive motility and viability of rat spermatozoa. Obesity was also associated with decreases in progressive motility and viability of rat spermatozoa. These results indicate that the acute in vitro exposure of spermatozoa to high levels of nicotine could adversely affect semen quality and may be an additive factor to the impediment of male fertility. In utero results reveal maternal nicotine exposure adversely affects male fertility in later life and seems to elicit more detrimental effects on the reproductive system than that of direct nicotine exposure to spermatozoa. Obesity also inhibits parameters of male fertility and these effects are exacerbated by nicotine exposure. The authors believe these adverse effects on the reproductive system to be related to an increased activation of leukocytes, excess production in reactive oxygen species (ROS) and consequent onset of oxidative stress (OS). Nevertheless this study agrees with other studies that nicotine exposure may be an additive factor to the impediment of male fertility. / AFRIKAANSE OPSOMMING: Daar is reeds baie bekend oor die moontlik newe effekte vir die liggaam wat met ‘n ongesonde lewenstyl gepaard gaan. Menslike blootstelling aan sulke faktore, soos sigaret rook, is wêreldwyd ‘n las vir gesondheid en ekonomie en het gelei tot geweldige kommer onder navorsers oor die moontlike komplikasies vir liggaamlike funksies soos voortplanting. Die doel van die betrokke projek was om die effekte van in utero en in vivo nikotien blootstelling op die antioksiderende ensiem aktiwiteit en lipied peroksidasie status van reproduktiewe weefsel en die funksionele parameters van spermatozoa te bepaal. ‘n Beter begrip van hierdie proses is noodsaaklik om die las van rook en vetsug teen te werk en vir die moontlike ontwikkeling van behandelingsstrategieë. Twee eksperimentele modelle is ontwerp: Wistar rotte is in utero blootgestel aan nikotien terwyl mens- en rot- spermatosoë ook in vitro aan nikotien blootgestel is. Vir die in utero studie is gesonde dragtige rotte gedurende swangerskap en laktasie met 1 mg/kgliggaamsgewig/ dag nikotien of 1 ml/kg-liggaamsgewig/dag 0.85% fisiologiese soutoplossing behandel. Manlike welpies is gekies en geoffer op elk van die volgende ouderdomme (n=6): 42 dae, 84 dae en 168 dae. Die welpies is slegs aan nikotien blootgestel deur plasentale opname en laktasie. Biochemiese analise van die testikulêre weefsel het ‘n beduidende assosiasie getoon tussen maternale nikotien blootstelling en verminderde vlakke van die primêre antioksiderende ensieme. Die 168 dag oue groep het ‘n merkbare vermindering getoon tussen kontrole en nikotien weefsel vir elk van die antioksiderende ensieme. Vir die in vitro studie is sperm monsters verkry vanaf gesonde mans (n=12), gesonde rotte (n=6) en vet rotte (n=6). Monsters is gewas en in vitro blootgestel aan verskeie hoë vlakke van nikotien (kontrole, 0.1mM, 1mM, 5mM, 10mM). Seminale parameters soos motiliteit, lewensvatbaarheid en akrosoom status is by verskei tydpunte gemeet (30min, 60min, 120min, 180min). Dit blyk dat verhoging in in vitro nikotien konsentrasies verband hou met verlaagde lewensvatbaarheid en akrosoom status van menslike spermatosoë en verlaagde progressiewe motilteit en lewensvatbaarheid van rot spermatosoë. Vetsug is ook geassosieer met verlagings in progressiewe beweeglikheid en lewensvatbaarheid van rot spermatosoë. In utero resultate openbaar dat maternale nikotien blootstelling manlike vrugbaarheid nadelig beïnvloed in latere lewe en blyk dat dit meer van ‘n nadelige uitwerking op die voortplantingstelsel het as dié van direkte nikotien blootstelling aan spermatosoë. In vitro blootstelling van spermatosoë aan hoë vlakke van nikotien, het wel ook semen kwaliteit nadelig beïnvloed. Vetsug inhibeer ook manlike vrugbaarheids parameters en hierdie effek word vererger deur nikotien blootstelling. Die outeure glo dat hierdie nadelige uitwerking op die voortplantingstelsel verband hou met 'n verhoogde aktivering van leukosiete, oortollige produksie van reaktiewe suurstof spesies en die gevolglike aanvang van oksidatiewe stres bevorder. Hierdie studie stem wel ooreen met ander studies wat nikotien blootstelling bestempel as ‘n bydraende faktor tot die struikelblok van manlike onvrugbaarheid. / Harry Crossley Foundation (South Africa)

Thesis (MScMedSc (Obstetrics and Gynaecology))--University of Stellenbosch, 2005. / Chapter 1 contains a review dealing with nuclear and morphological changes during spermatogenesis and spermatozoa transport with emphasis on the maturation of spermatozoa, capacitation, acrosome reaction and the interaction with the cumulus oophorus complex (COC). The oocyte and cumulus oophorus complex is also discussed particularly on the topic of maturity (oocyte and cumulus maturity). Also presented is a review of the fluorescent binding agents, namely Fluorescein Isothiocyanate labeled with Pisum sativum (FITC-PSA), Chlorotetracycline test (CTC) and Chromomycin A3 (CMA3). Chapter II describes all the materials and methods used during this study. Routine semen analysis is described with emphasis on normal spermatozoon morphology according to strict criteria. The evaluation of capacitation and acrosome reaction (AR) using the CTC and PSA-FITC staining methods as well as the evaluation of spermatozoon nuclear chromatin packaging using the CMA3 staining method is described. Chapter III represents the results recorded in this study. Compared with those spermatozoa cultured in medium alone, spermatozoa exposed to the cumulus mass were more likely to be capacitated and acrosome reacted, with a distinct increase in chromatin packaging quality. A general discussion of the results and future applications are discussed in Chapter IV. In short An in vitro model for spermatozoa penetration through the cumulus oophorus was established. The model can be applied to investigate the effect of the cumulus oophorus on sperm functions and to assist in the selection of functional sperm for intracytoplasmic sperm injection therapy. All relevant references are presented in Chapter V .

Thesis (PhD)--Stellenbosch Uni versity, 2000. / ENGLISH ABSTRACT: Intracytoplasmic sperm injection (ICSI) introduced a revolutionary way of treatment for male factor infertility. With the exception of some cases of non-obstructive azoospermia, all other male factor infertility cases have the potential to be successfully treated with ICS!. The only prerequisite seems to be the presence of a motile or viable immotile sperm cell for each oocyte. In this study we report on our own experience with the development and implementation of the ICSI method in the Reproductive Biology Unit at Tygerberg Hospita!. An analysis of 5 years of ICSI experience showed that semen parameters, sperm morphology, motility and concentration did not influence fertilization and pregnancy rates adversely. In most cases, patients who could not be treated with in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT), due to poor semen parameters or fertilization failure, were treated successfully with ICS!. Even a case of globozoospermia was treated successfully with ICS!. Testicular spermatozoa, fresh or frozen-thawed, also resulted in excellent fertilization and pregnancy rates. Cryopreservation of testicular samples facilitated the management of the infertile couple, aiding the coordination of the recovery of vital gametes from both partners and also limiting the repetition of testicular biopsies. Incubation (maturation) of testicular spermatozoa also induced an enhancement in pregnancy rates. It can be concluded that ICSI proved to be a treatment method with success similar to that of in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT), in spite of a severe male factor. The study also indicated transfer route and embryo quality (viability) to be very important factors in the success of ICS!. The tubal transfer route was shown to be a significant contributor to the pregnancy success (compared to uterine transfer) as was the transfer of embryos that showed early division to the 2-cell stage, 26 hours post injection. The transfer of early dividing embryos into the fallopian tube resulted in a pregnancy rate of almost 40%, a result similar to that of GIFT with a mild male factor. The role of the oocyte in fertilization and pregnancy success was also revealed indirectly by the introduction of ICS!. Visual observation of denuded oocytes was possible and many morphological features, normal and abnormal, can be observed. Immature oocytes can also be identified and it was shown that they could be successfully matured in vitro before injection. In this study transmission electron microscopy (TEM) was used to study abnormalities in oocyte morphology. The standard method was adapted and modified for single cell TEM. The abnormalities observed included lysosomal and non-lysosomal degeneration (yellowish or darkly coloured oocytes), degeneration and vacuole formation (vacuolated oocytes), large secondary lysosomes filled with multiple small lipid droplets - lipofuscin body (refractile body) and a fragmented oocyte. It was also possible to study at ultrastructural level, possible reasons for fertilization failure in ICS!. Different stages of oocyte activation failure, cytoplasmic immaturity, sperm cell extrusion, abnormal sperm cell decondensation, female spindle abnormalities and technique related factors were observed. TEM was also successfully implemented to elucidate the reason for infertility in a patient with a longstanding, unexplained history of infertility. TEM evaluation of two of the patient's unfertilized oocytes revealed a spindle abnormality with contributing cytoskeletal anomalies at ultrastructural level. The modified TEM technique offers a valuable tool to study this small, but important group of patients with unexplained infertility. ThisTEM study opened up a new, valuable and interesting avenue of research with both diagnostic and prognostic value for patients with unexplained infertility. ICSI is therefore a valuable method in the treatment of especially male factor infertility. It is the most advanced fertilization technique developed in the last decade in this field. Not only can almost all male factor patients be treated, but unexplained female infertility can also be exposed, studied and hopefully in future also be treated with micromanipulation methods. / AFRIKAANSE OPSOMMING: Die ontwikkeling van die mikromanipulasie tegniek "Intracytoplasmic sperm injection" (ICSI) het die behandeling van die manlike faktor in infertiliteit, revolusionêr verander. Met die uitsondering van sommige gevalle van nie-obstruktiewe asoospermia, kan potensieel alle ander manlike infertiliteits faktore suksesvol met ICSI behandel word. Die enigste voorvereiste blyk "n bewegende of "n nie-bewegende, maar bewese lewende spermsel te wees. In hierdie studie word verslag gedoen oor die ontwikkeling en toepassing van die ICSI metode in die Eenhed vir Reproduktiewe Biologie by Tygerberg Hospitaal. 'n Analise van 5 jaar se resultate na die implementering van die ICSI metode het gewys dat die semen parameters, sperm morfologie, motiliteit en konsentrasie, nie "n effek op bevrugting- en swangerskapsyfers gehad het nie. Pasiënte wat, as gevolg van ontoereikende semen parameters, nie met die klassieke metodes, in vitro bevrugting (IVB) of gameet intrafallopiusbuis terugplasing (GIFT) behandel kon word nie, kon suksesvol met ICSI behandel word. Daar was selfs "n geval van manlike infertiliteit as gevolg van globosoospermie, wat suksesvol met ICS behandel is. Die ICSI metode het dit ook moontlik gemaak om uitstekende bevrugting- en swangerskap resultate met testikulêre spermatosoa .(vars en gevries) te bereik. Die bevriesing van testisweefsel het ook bygedra tot beter hantering van sulke pasiënte. Herhaalde testisbiopsies word uitgeskakel en die koórdinasie van die verkryging van die manlike en vroulike gamete, word ook vergemaklik wanneer testisweefsel in gevriesde vorm beskikbaar is. Die studie het verder getoon dat wanneer testikulêre weefsel geïnkubeer word (om spermatosoa te laat matureer), die swangerskapsyfers verhoog was. Dit is dus duidelik dat die ICSI metode net so suksesvol soos die IVB en GIFT metodes toegepas kan word, selfs en veral in gevalle van erge manlike faktor infertiliteit. Die studie het ook verder getoon dat die plek waar embrios teruggeplaas word, asook die embriokwalitiet van teruggeplaasde embrios, belangrike bydraende faktore in die ICSI swangerskapsukses was. Embrioterugplasing in die buis van fallopius en terugplasing van embrios wat vroeë 2-sel deling, 26 uur na ICSI getoon het, is uitgewys as faktore wat ICSI swangerskap betekenisvol verbeter het. Dit was moontlik om "n swangerskapsyfer van ongeveer 40%, sootgelyk aan die van GIFT sonder "n erge manlike faktor, te bereik met die terugplasing van ten minste een vroeë deler embrio in die fallopiese buis. Die ICSI tegniek het ook indirek bygedra tot nuwe insigte met betrekking tot die rol wat die vroulike eiersel (oësief in ICSI bevrugting speel. Oósiete word gestroop van hulomringende selle vir die ICSI proses en kan dan maklik vir hul normale en abnormale morfologiese eienskappe evalueer word. Oësiete wat immatuur is kan ook so geïdentifiseer word en dit is moontlik om hulle suksesvol te matureer voor mikro-inspuiting. Transmissie-elektronmikroskopie (TEM) is in die studie gebruik om die ultrastruktuur van onbevrugde en abnormale oësiete te bestudeer. Hiervoor is "n bestaande tegniek gemodifiseer vir die hantering van "n enkele sel, in hierdie geval die oosiet. Lisasomale en nie-lisosomale degenerasie (oósiete wat geelof donker van kleur voorkom), degeneratiewe tekens en vakuole (oësiete met vakuole), groot sekondêre lisosome gevul met klein lipieddruppels ('refractile body') en 'n gefragmenteerde oosiet was van die morfologies abnormale eienskappe wat ultrastruktureel geïdentifiseer is. Moontlike faktore wat 'n rol kan speel in nie-bevrugting na ICSI kon ook op ultrastrukturele vlak met die tegniek geïdentifiseer word. Hierdie faktore het die volgende ingesluit: die onvermoë van verskillende stadiums van oosiet aktivering, sitoplasmatiese immaturiteit, uitwerping van die spermsel na die periviteliene spasie, abnormale spermsel dekondensasie, vroulike spoelvormings abnormaliteite en tegniekgekoppelde faktore. Die TEM tegniek is ook suksesvol aangewend om die infertiliteitsprobleem van 'n pasiënt wat vir etlike jare aan onverklaarbare infertiliteit gely het, te identifiseer. TEM het op die ultrastrukturele vlak gewys dat daar 'n spoel abnormaliteit in twee van haar onbevrugde oëslete was. TEM kan dus baie vrugbaar gebruik word in hierdie groep pasiënte om onverklaarbare infertiliteit, wat andersins ongeïdentifiseerd sou bly, te verklaar. Die ICSI metode is die mees revolusionêre tegniek wat die afgelope dekade vir die behandeling van veral manlike infertiliteit ontwikkel en baie suksesvol toegepas is. Die metode ook kan 'n bydraende rol speel in die hantering van onverklaarbare infertiliteit veral ten opsigte van die vroulike gameet. In die toekoms is dit moontlik dat selfs hierdie probleem met nuwe mikromanipulasietegnieke opgelos sal kan word.

This thesis examines attitudes toward infertility in early modern England and colonial New England from c.1620 to 1720 through infertility’s representation in contemporary medical, religious, and literary sources. This study uses an expanded definition of infertility, namely a 'spectrum of infertility', to capture the tensions that arose during periods of infertility and experiences of reproductive failure such as miscarriages, stillbirths, monstrous births, and false conceptions. A spectrum, more than a modern definition, more accurately represents the range of bodily conditions experienced by early modern women and men that indicated reproductive disorder in the body; by extension, the language of infertility expressed fears about disorder in times of social, religious, and political crisis in early modern society. The two societies' relationship was often described through reproductive language and the language of infertility appears in both societies when order - within the body, within marriages, or within and between communities - was threatened. This thesis contributes to a growing body of scholarship on infertility in early modern society by analysing its presence in communications within and between early modern England and colonial New England. It argues that understanding the English origins of the colonists' attitudes toward infertility is fundamental both to understanding the close connection between the two societies and to providing context for the colonists' perceptions about their encounters with new lands, bodies, environments, and reasons for emigration. As a result, this thesis seeks to break new ground in providing an overview of social, medical, and cultural reactions in both England and New England, demonstrating that similar language and tropes were used in both regions to communicate concerns about infertility. Exploring the interplay between the many sources addressing this health issue more accurately represents the complexity of early modern attitudes toward infertility, and the intimacy of the relationship between the fledgling New England colonies and their metaphorical Mother England.

In der Literatur finden sich viele Angaben zur Wirkung des Testosterons, zur Symptomatik eines Testosteron-Defizits, zu den Auswirkungen eines zu hohen Spiegels durch Doping und auch internationale Guidelines zur Diagnose und Therapie des Testosteron-Defizits. Zu dessen Ursachen ist vieles bekannt, vor allem zum angeborenen Mangel, weniger zum erworbenen Mangel. Es besteht eine Liste von Ätiologien, aber ohne Angaben zu deren Häufigkeit. Dies ist der Ausgangspunkt der Arbeit. In einer allgemein-internistischen Praxis werden Daten von einer Patientenpopulation von 108 Männern mit Testosteron-Defizit erhoben. Neben den Laborwerten und der Symptomatik werden Untersuchungsbefunde vor Therapiebeginn erfasst. Diese Angaben werden systematisch ergänzt durch eine Anamnese von Krankheiten, die in den Guidelines als Ätiologien des erworbenen Testosteron-Defizits stehen. Daraus können Prävalenzen dieser Krankheiten in der Patientenpopulation errechnet werden. Prävalenzen für die Gesamtbevölkerung sind in der Literatur zu finden. Diese werden statistisch miteinander verglichen. Für die Befunde Hodenvolumen kleiner als15 ml, Hodenhochstand, Infertilität und verminderte Zeugungsfähigkeit und St n. Vasektomie kann in der Patientenpopulation eine höhere Prävalenz nachgewiesen werden. Zwischen Hodenvolumen (gemessen mit Orchidometern nach Prader) und Testosteron-Spiegel besteht eine Korrelation, die mit einer linearen Regression dargestellt werden kann. Eine entsprechende Korrelation zwischen dem Intervall zwischen Vasektomie und Diagnose des Testosteron-Defizits und dem Testosteron-Spiegel ist nicht signifikant. Diese Daten werden anhand der Literatur diskutiert, speziell auch im Hinblick auf Inflammation in den Testes als mögliche gemeinsame Pathogenese. Als Schlussfolgerungen werden Empfehlungen für die Präventivuntersuchung des Mannes bei Hausärzten und Urologen, für Abklärungen beim Fertilitätsspezialisten und die Forschung dargelegt. / There are many indications in the literature about the effects of testosterone, on the symptoms of a testosterone deficit, on the effects of excessive levels of doping, and also international guidelines for the diagnosis and treatment of the testosterone deficit. There are many known causes of this, especially the congenital deficiency, less of the acquired deficiency. There is a list of etiologies, but no information about their frequency. This is the starting point of the work. In a general-internal practice, data are collected from a patient population of 108 men with testosterone deficit. In addition to the laboratory values ​​ and the symptoms, examination findings are recorded before the start of therapy. These data are systematically supplemented by an anamnesis of diseases that are included in the guidelines as etiologies of the acquired testosterone deficit. Prevalence of these diseases in the patient population can be calculated from this. Prevalence for the whole population can be found in the literature. These are compared statistically with each other. A higher prevalence can be detected in the patient population for the findings of testicular volume of less than 15 ml, meldescensus testis, infertility and reduced fertility and status after vasectomy. There is a correlation between testicular volume (as measured by Orchidometers according to Prader) and testosterone level, which can be represented by a linear regression. A corresponding correlation between the interval between vasectomy and diagnosis of the testosterone deficiency and the testosterone level is not significant. These data are discussed with reference to the literature, especially with regard to inflammation in the testes as possible common pathogenesis. Conclusions include recommendations for preventive examinations of the man in general practitioners and urologists, for examinations in fertility specialists and research.

Le contexte social dans lequel s’inscrivent le désir d’enfant et la procréation en Occident s’est profondément transformé au cours des dernières décennies. Après l’introduction de la contraception et l’augmentation du nombre d’enfants nés hors mariage, le développement des nouvelles techniques reproductives et de l’adoption, notamment l’adoption internationale, ont à leur tour contribué à la transformation des cadres dans lesquels s’inscrivent les relations de parenté et la formation des familles. À partir de l’étude de témoignages de couples québécois dont les échecs successifs en procréation médicalement assistée (PMA) ont mené à la décision d’adopter, cette thèse interroge les multiples dimensions qu’implique un tel type de trajectoire. Sur le plan social, tant la procréation médicalement assistée que l’adoption nécessitent l’intervention d’une tierce partie pour concrétiser et faire reconnaître l’établissement du lien filiatif, soit la médecine dans le cas de la PMA et celle des autorités juridiques et gouvernementales dans le cas de l’adoption. Les deux phénomènes mettent également en scène des situations et des enjeux hautement révélateurs des valeurs et des représentations collectives en matière de parenté et de famille. D’un premier abord, le type de parcours étudié semble illustrer le passage entre deux sphères complètement distinctes: celle de la nature et du biologique incarnée par la PMA et celle de la culture et du lien social incarnée par l’adoption. Or, l’étude des trajectoires des participants donne à voir une situation beaucoup plus complexe où s’entremêlent un ensemble d’explications et de facteurs relatifs au désir d’enfant, à la famille, à la parentalité qui ne font sens qu’une fois replacés dans le contexte des grandes tendances sociales et idéologiques qui traversent notre société. Plus globalement, les analyses proposées dans cette thèse participent au développement d’une anthropologie de la parenté qui tienne compte des dynamiques et des tensions qui touchent la famille moderne. / The social context surrounding reproduction and the desire for children in the West has undergone a profound transformation in recent decades. Following the introduction of contraception and the increase in the number of children born out of wedlock, the development of new reproductive technologies and adoption, particularly international adoption, has in turn contributed to transforming the frameworks surrounding kinship and the formation of families. Based on the testimonials of Québec couples whose successive failures in medically assisted procreation (MAP) have led them to the decision to adopt, this thesis examines the multiple dimensions involved in this type of trajectory. Socially, both AR and adoption require the intervention of a third party to establish and legitimize filiation: the medical profession in the case of AR, and legal and government authorities in the case of adoption. Both phenomena also put into play situations and issues that are highly revealing of values and collective representations regarding kinship and the family. At first glance, the type of path studied seems to illustrate a transition between two completely separate spheres: that of nature and biology embodied by AR, and that of culture and social relations embodied by adoption. However, the study of the participants’ trajectories reveals a much more complex situation in which a set of explanations and factors related to the desire for children, the family, and parenthood intertwine and make sense only when viewed in the context of the major social and ideological trends that our society is undergoing. More generally, the analyses proposed in this thesis contribute to the development of an anthropology of kinship that accounts for the dynamics and tensions that affect the modern family.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

L’infertilité affecte jusqu’à 15-20% des couples en âge de se reproduire. C’est pourquoi, mieux comprendre les mécanismes à la base de la fécondation est essentiel pour l’identification de nouvelles causes d’infertilité et l’optimisation des techniques de reproduction assistée. La capacitation est une étape de la maturation des spermatozoïdes qui se déroule dans le tractus génital femelle. Elle est requise pour la fécondation d’un ovocyte. Notre laboratoire a démontré que des protéines du plasma séminal bovin, appelées protéines Binder of SPerm (BSP), se lient aux phospholipides portant des groupements choline à la surface de la membrane des spermatozoïdes lors de l’éjaculation et promeuvent la capacitation. Ces protéines exprimées par les vésicules séminales sont ubiquitaires chez les mammifères et ont été étudiées chez plusieurs espèces dont l’étalon, le porc, le bouc et le bélier. Récemment, l’expression de gènes homologues aux BSP a été découverte dans les épididymes d’humains (BSPH1) et de souris (Bsph1 et Bsph2). Notre hypothèse est que les BSP chez ces deux espèces sont ajoutées aux spermatozoïdes lors de la maturation épididymaire et ont des rôles dans les fonctions spermatiques, similaires à ceux des protéines BSP bovines. Les protéines BSP humaines et murines représentent une faible fraction des protéines totales du plasma séminal. Pour cette raison, afin d’étudier leurs caractéristiques biochimiques et fonctionnelles, des protéines recombinantes ont été produites. Les protéines recombinantes ont été exprimées dans des cellules Escherichia coli origami B(DE3)pLysS en utilisant un vecteur d’expression pET32a. Suivant la lyse cellulaire, les protéines ont été dénaturées avec de l’urée et purifiées par chromatographie d’affinité sur ions métalliques immobilisés. Une fois liées à la colonne, les protéines ont été repliées à l’aide d’un gradient d’urée décroissant avant d’être éluées. Cette méthode a mené à la production de trois protéines recombinantes (rec-BSPH1 humaine, rec-BSPH1 murine et rec-BSPH2 murine) pures et fonctionnelles. Des expériences de chromatographie d’affinité et de co-sédimentation nous ont permis de démontrer que les trois protéines peuvent se lier à des ligands connus des protéines BSP comme la gélatine et l’héparine en plus de pouvoir se lier aux spermatozoïdes. Nos études ont également révélées que les deux protéines rec-BSPH1 peuvent se lier aux liposomes de phosphatidylcholine (PC) et sont capable de promouvoir la capacitation des spermatozoïdes. À l’opposé, rec-BSPH2 ne peut ni se lier aux liposomes de PC, ni stimuler la capacitation. Finalement, les protéines recombinantes n’ont aucun effet sur la réaction acrosomique ou sur la motilité des spermatozoïdes. Chez les bovins, les protéines BSP induisent la capacitation grâce des interactions avec les lipoprotéines de haute densité (HDL) et les glycosaminoglycanes. Puisque le HDL est également un joueur important de la capacitation chez la souris, le rôle de la protéine native BSPH1 murine au niveau de la capacitation induite par le HDL a été étudié. Les résultats obtenus suggèrent que, in vivo, la protéine BSPH1 de souris serait impliquée dans la capacitation via une interaction directe avec le HDL. Comme les protéines BSPH1 humaines et murines sont orthologues, ces résultats pourraient aussi s’appliquer à la fertilité humaine. Les résultats présentés dans cette thèse pourraient mener à une meilleure compréhension de la fertilité masculine et aider à améliorer les techniques de reproduction assistée. Ils pourraient également mener au développement de nouveaux tests diagnostiques ou de contraceptifs masculins. / Infertility can affect as much as 15-20% of couples of reproductive age. Therefore, elucidating mechanisms occurring during fertilization is needed to resolve cases of infertility and optimize assisted reproductive technology procedures. Sperm capacitation is a maturation step that takes place in the female genital tract and is deemed to be essential for sperm to fertilize an oocyte. Our laboratory has demonstrated that proteins from bovine seminal plasma called Binder of SPerm (BSP) proteins bind to choline phospholipids on the sperm membrane upon ejaculation and promote capacitation. These proteins expressed in seminal vesicles are ubiquitous amongst mammals and have been studied in many species including stallion, boar, ram and goat. More recently, the expression of BSP-homologous genes has been discovered in the epididymis of humans (BSPH1) and in mice (Bsph1 and Bsph2). We hypothesized that the BSP homologs in these two species are added to sperm during epididymal maturation and play similar roles in sperm functions as bovine BSP proteins. BSP proteins in humans and mice constitute only a minute percentage of the seminal plasma proteins. Thus, to study their biochemical and functional characteristics recombinant proteins were produced. Recombinant proteins were expressed in Escherichia coli origami B(DE3)pLysS cells using a pET32a expression vector. Following cell lysis, proteins were denatured using urea and purified by immobilized metal ion affinity chromatography. Once bound to the resin, proteins were refolded using a decreasing urea gradient after which they were eluted. This method led to the production of three pure, functional recombinant proteins (human rec-BSPH1, mouse rec-BSPH1 and mouse rec-BSPH2). Using affinity chromatography and co-sedimentation experiments, we were able to demonstrate that all three recombinant proteins bind known ligands of BSP proteins including gelatin, heparin and have the ability to bind to sperm. Studies also revealed that both rec-BSPH1 proteins bind to phosphatidylcholine (PC) liposomes and promote sperm capacitation. However, rec-BSPH2 neither binds to PC liposomes nor stimulates capacitation. Recombinant proteins had no effect on acrosome reaction or sperm motility. In bovine, BSP proteins promote sperm capacitation through interactions with high-density lipoproteins (HDL) and glycosaminoglycans. Since in mice HDL is also a major factor implicated in capacitation, the role of the native murine BSPH1 protein in HDL-induced capacitation was investigated. Results obtained suggest that, in vivo, murine BSPH1 protein could act in capacitation via a direct interaction with HDL. As human and murine BSPH1 are orthologs, these results could possibly also apply to human fertility. The results presented in this thesis could lead to a better understanding of male fertility and help improve assisted reproduction technology procedures. They could also lead to the development of diagnostic tests as well male contraceptives.

Perçu pendant fort longtemps comme un saint anaphrodite et « castré » avant d’être reconnu comme l’écrivain le plus sensuel des Lettres grecques modernes, Alexandre Papadiamantis (1851-1911), auteur prolifique de près de cent quatre-vingt nouvelles et de trois romans et trésor national hellène, est un artiste antinomique qui ne cesse d’intriguer la critique et de susciter des débats contradictoires. Le présent travail propose une lecture de son œuvre complète axée sur un sujet controversé dont aucune étude systématique n’a été entreprise, malgré un siècle de surabondante critique littéraire : le désir érotique, que nous entendons essentiellement comme le rapport à un objet de convoitise explicitement ou implicitement désigné comme tel, humain ou inhumain, vivant ou inanimé, suscitant un certain nombre de réactions physiques et/ou psychiques et sollicitant un réseau complexe de sens, de sensations, de méditations, d’excitations et de significations représentées par le biais des mots. Une telle définition emphatise l’imbrication de la pulsion et du langage et distingue le désir de l’amour, ce dernier constituant plutôt une stase du désir, un arrêt et une fixation sur l’« autre ». Notre objectif est de comprendre comment l’érotisme ainsi défini s’exprime dans les textes, quels en sont les enjeux psychologiques, les interconnexions avec les techniques narratives, les choix stylistiques et les particularités linguistiques et quelles transformations littéraires il subit dans l’œuvre, en somme, quels sont sa destinée mythique, son aboutissement idéologique et son apothéose thématique, en somme son issue dans l’écriture. / Viewed for ages as an anaphrodite and « castrated » saint before being recognized as the most sensual writer in modern Greek literature, Alexandros Papadiamantis (1851-1911), prolific author of approximately one hundred and eighty short stories, and three historical novels, and deemed to be a Hellenic national treasure, is an antinomic artist who keeps intriguing critics and arousing open debates. The present thesis offers a reading of his complete work based on a controversial subject of which no systematic study has been undertaken before, despite a century of numerous literary comments : erotic desire, defined as the connexion with an objet of lust explicitely or implicitely defined as such, human or inhuman, alive or inanimated, and which rises a number of physical and/or psychological reactions, a complex network of meanings, sensations, meditations, actions and fantasies represented through words. This definition emphasizes the interweaving of drive and language and discerns between desire and love, the latter being rather a stasis of desire, and a fixation on the « other ». Our goal is to understand how eroticism thus defined is expressed throughout the texts, to point out the psychological issues associated with it, its interconnections with the narrative techniques, stylistic choices and linguistic particularities and the literary transformations it undergoes throughout the Papadiamantian opus, that is to say its mythic destiny, its ideological culmination and its thematic apotheosis, in short its outcome in writing.