Biomedical subjects
Publications and source records attributed to L Dubin.
Rabbit anti-relaxin antisera, but not normal rabbit sera, causes a rapid decline of motility of washed human sperm. Preincubation of the antisera with relaxin eliminates this effect. This sperm immobilization effect can serve as a basis of a rapid screening test for anti-relaxin antisera and as a novel adjuvant to barrier contraceptive methods.
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Relaxin has recently been identified in human seminal plasma (SP). This investigation was undertaken to determine the effect of relaxin on sperm motility. Washed ejaculated human sperm were incubated with or without porcine relaxin. In a series of 37 normal specimens (motility greater than or equal to 60%) relaxin attenuated the decline in grade of forward progression and percentage of motile sperm. Relaxin had a similar effect on a series of 47 subfertile specimens (motility 30% to 40%). Endogenous relaxin may play a role in delaying declines of motility and grade of forward progress in ejaculated sperm.
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Two previously fertile males have requested surgical vasectomy reversal after divorce and failure of their new younger wives to conceive by repeated inseminations with their stored frozen semen. The sperm had been preserved for six and five years, respectively, as "fertility insurance" prior to sterilization by bilateral vasectomy. It is clear that the storage of fertile semen does not guarantee future fertility.
Polyzoospermia is a rare cause of male infertility. In our clinical practice, patients with exceedingly high sperm counts (ranging from 650 million/ml to 1.75 billion/ml) have invariably been found to have associated poor sperm motility and poor sperm migration in postcoital tests, although the sperm appear morphologically normal. Cases of two infertile couples are presented in which each husband had sperm counts greater than 1 billion/ml. Two methods are reported for the successful management of their infertility problems: (1) precoital dilutional douching and (2) in vitro seminal fluid dilution with 5% dextrose-Ringer's lactate solution and artificial insemination homologous. Each method resulted in improved sperm motility, postcoital tests, and pregnancy.
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Fructose, zinc, and prolactin determinations were performed on the seminal plasma of normospermic (n = 30), oligospermic (n = 30), and azoospermic (n = 30) men to determine whether there was a correlation between any of these substances and seminal quality. None of these azoospermic men had congenital bilateral absence of the vasa, but in a separate group of such men (n = 10) these same studies were performed. Fructose was determined photometrically, zinc by atomic absorption, and prolactin by radioimmunoassay. Zinc and fructose levels in all three groups showed no statistical differences. Prolactin was found to be significantly higher in the seminal plasma of normospermic men than was found in the seminal plasma of oligospermic or azoospermic men. In men with congenital bilateral absence of the vasa and seminal vesicles, zinc was elevated, fructose was absent, and prolactin was markedly depressed.
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Six hundred male patients were examined for circulating spermagglutinating antibodies by the Kibrick sperm-agglutination test and 20% demonstrated autoantibodies. The high incidence of positive findings may be explained by the select population studied. Of 80 men tested who demonstrated more than 10% agglutination in their semen, but were otherwise normospermic, 41% demonstrated positive titers by the Kibrick method. Of 300 men examined for circulating sperm-immobilizing antibodies by the Isojima sperm-immobilizing test, 6% had autoantibodies. This high incidence of positive findings demonstrates the need for these tests in males who otherwise appear normospermic or demonstrate an unexplained infertility.
Radioimmunoassays were performed on the seminal plasma of normospermic, oligospermic, and azoospermic men to determine the levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone. FSH levels in the seminal plasma of all three groups were found to be similar to the levels normally found in blood serum. LH levels in the seminal plasma of azoospermic and oligospermic men were within the normal range found in blood serum but were elevated in the normospermic samples. Testosterone levels in the seminal plasma of all three groups tested were considerably lower than the normal range found in blood serum.
A new Silastic seminal fluid collection device has been tested and compared in vitro with glass jars, latex condoms, and the Milex polyethylene sheath. In a series of tests utilizing 50 different semen samples and observing the effects on motility over a period of 4 hours, the Silastic seminal fluid collection device demonstrated sperm survival slightly better than that with glass jars, superior to that with the polyethylene Milex sheath, and far greater survival (by several hours) than with the latex condom. The Silastic collection device was found to be more comfortable and more pleasurable to the patients than was the Milex sheath. The accuracy of seminal volume measurements was also found to be better in the Silastic collection device.
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The evaluation and management of infertility problems in Orthodox Jewish couples can be made difficult because of restrictions which may be imposed by religious rules. The origins of the religious laws governing semen collection, diagnostic and therapeutic genital surgery, menstruation, and homologous and donor insemination are reviewed. Contemporary rabbinic authorities are quoted; their opinions may serve as guidelines for the patient and urologist dealing with infertility problems.