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Hum. Reprod. Advance Access originally published online on July 29, 2008
Human Reproduction 2008 23(11):2444-2451; doi:10.1093/humrep/den283
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Prostate-specific antigen in vaginal fluid after exposure to known amounts of semen and after condom use: comparison of self-collected and nurse-collected samples

Luis Bahamondes1,4, Juan Diaz2, Nadia Maria Marchi1, Sara Castro1, Marina Villarroel1 and Maurizio Macaluso3

1 Human Reproduction Unit, Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Caixa Postal 6181, 13084-971 Campinas, SP, Brazil 2 Population Council, New York, NY 10017, USA 3 Division of Reproductive Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30341-3724, USA

4 Correspondence address. Tel: +55-19-3289-2856; Fax: +55-19-3289-2440; E-mail: bahamond{at}caism.unicamp.br

BACKGROUND: Prostate-specific antigen (PSA) in vaginal fluid indicates exposure to semen, and was used to assess condom effectiveness, although validity and reliability have not been fully evaluated. Our objective was to compare PSA in self-collected samples with samples collected by a nurse.

METHODS: We conducted two studies, each with 100 women aged 18–48 years. In the first, a nurse exposed each participant to her partner’s semen (10, 100 and 1000 µl), and nurse and participant collected samples. In the second, each participant sampled before and after using two male condoms (MC) and two female condoms (FC); a nurse collected another sample afterwards.

RESULTS: PSA concentration increased with semen exposure, but was lower in nurse-collected samples. Both procedures were sensitive, almost 100% after exposure to 100–1000 µl of semen. PSA detection rates with MC and FC were 13% and 28% in self-collected samples, 8% and 9% in nurse-collected samples. Concordance between sample types was 93% with the MC (95% CI: 89%; 96%), 78% with the FC (95% CI: 72%; 84%). PSA decay between sampling times may explain higher values in self-collected samples.

CONCLUSIONS: PSA is a highly sensitive surrogate endpoint for condom effectiveness studies. Self-collected and nurse-collected samples are equivalent, but sample collection timing is critical.

Key words: condoms/semen exposure/PSA/women

Submitted on May 8, 2008; resubmitted on June 18, 2008; accepted on June 24, 2008.


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