[The motility of spermatozoa and male fertility].
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Biomedical subjects
Publications and source records attributed to J Raboch.
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Through analysis of 350 expertises in suits, where the man was accused of paternity, was found that these examinees often lived in a sterile marriage. When examined they often try to influence negatively the result of spermiologic examination. Sterility was ascertained here in only about 10% of cases. In the material consisting of 98 expertises in suits for denial of paternity it was found that about one half of these men were either divorced or in the course of divorce proceedings and about one third of them stated the infidelity of the wife. In more than one third of these cases sterility was proved. The court expert must often express his opinion as to the fertility of the man two or more years previously. His conclusion is especially difficult, where the spermiologic findings repeatedly vary within the limits of severe oligozoospermia with less than 5 million spermatozoids per 1 ml and where the motility is poor.
By means of Questionnaires HTDM and SAM the heterosexual development and sexual activity were investigated in the following groups of males: 1. the control group consists of 345 married men from sterile marriages, who were adequately developed somatosexually, had normozoospermia in the ejaculate and a good potency; 2. in 48 unilateral and 57 bilateral adult cryptorchids; 3. in 101 married men with a distinct testicular hypoplasia, the long axis of both sexual glands being shorter than 30 mm; 4. in 110 patients with a Klinefelter's syndrome; 5. in 14 patients with hypogonadotropic hypogonadism. Whereas the retardation of heterosexual development was found only in two groups (group 4 and 5), a distinctly lowered activity in sex life was ascertained in all four pathological samples.
An analysis has been performed of 95 expertises in men, who asked for compensation of after-effects in injury in their sex life. The regions most frequently affected were sexual organs, the head, the pelvis and the lower spine. Roughly one half of the examinees reacted strongly to the injury and its consequences. The most frequently reported symptoms were erectivity disturbances. The greatest subgroup consisted of men who had a rational attitude to an objective organic finding (about 38%). The second place is occupied by men in whom it was not possible to prove any somatic changes, but whose psychic reaction to injury was distinct and pronounced (about 31%). Roughly two out of three men reported a deterioration of their working capacity after injury and/or a disturbance of their interpersonal relations. Only 5% of the examinees underwent an expert examination during the first year following the injury. It is stressed that administrative procedures for damages should be performed with maximum speed especially in cases where there were no objectively proved after-effects.
It is described to which extent the fertility potential in the following six groups of patients living in sterile marriages is lowered: in 298 patients with Klinefelter's syndrome, 38 hypogonadotropic eunuchoids, 216 bilateral and 258 unilateral cryptorchids, in 500 men with testicular hypoplasia in whom the long axis of both testicles had always been shorter than 34 mm, and in 109 men with a varicocele. The opinion is expressed that the above mentioned pathologic states of the genital organs are of primary nature and occurred at various stages of somato-sexual development.
Measurement of the spermatozoal velocity indicated that the average motility in 111 ejaculates with volumes of more than 6 ml after 1 and 5 hours after ejaculation was highly significantly lower (p less than 0.01) than in the control group. The latter consisted of 166 ejaculates with volumes of less than 6 ml. The percentage of morphologically defective spermatozoa was practically identical for both groups and the difference in the decrease in motility of the spermatozoa 5 hours after ejaculation was statistically non-significant.
Approximately between 9 and 19 years of age 28 adolescents with one and 26 with both retractile testicles were andrologically examined and followed up. Retractile gonads during puberty often remained of subnormal size with the long axis shorter than 34 mm. In both groups in 50 to 60% of cases low sperm values were ascertained. The findings of azoospermia were only sporadic. In 40 cases a repeated examination of ejaculates after longer intervals was carried out. It was found that sperm values remained mostly on the level of the first examination which was performed in the majority of cases in the same year with the first emission of semen or in the following year. A more pronounced amelioration of sperm findings was ascertained only in about 12% of cases.
There are described findings in a paternity case in which a 29 years old man had repeatedly a severe oligozoospermia in his ejaculate and distinctly subnormal size of both testicles. On the basis of the investigation of HLA system of the accused, the mother and child it was concluded in the expert evidence that the accused was able to impregnate a woman.