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PubMed1998

Endometrial leukemia inhibitory factor (LIF) as a possible cause of unexplained infertility and multiple failures of implantation.

PROBLEM: The possible role of leukemia inhibiting factor (LIF) in unexplained infertility and multiple failures of implantation (MFI) was evaluated. METHOD OF STUDY: By a specific and sensitive enzyme-linked immunosorbent assay (ELISA), the in vitro endometrial LIF secretion by explant cultures from women with unexplained infertility (n = 32) was examined. Endometrial samples were obtained on either days 8-11 of the proliferative phase or days 18-21 of the secretory phase. In some subjects (n = 11) an endometrial biopsy was performed twice, both in the proliferative and in the secretory phase of the cycle. The control group consisted of fertile women (n = 17). RESULTS: In fertile women the endometrial LIF secretion was 2.2 times higher in the secretory phase samples than in the proliferative phase samples (mean +/- SEM, 3259 +/- 314 pg in the proliferative phase vs. 7726 +/- 1192 in the secretory phase; P < 0.05). In contrast, infertile women exhibited no such elevation of cytokine production. Moreover, in infertile women with MFI the level of LIF in the secretory phase demonstrated the tendency to decrease (mean +/- SEM, 4953 +/- 1125 pg vs. 2162 +/- 541 pg; P > 0.05). When the amount of cytokine secretion was compared on the same day of the cycle between the two groups of women, the LIF production in fertile women on days 18-21 of the menstrual cycle was 3.5 times greater than in the infertile women with MFI and 2.2 times greater than in women without MFI (P < 0.01 and P < 0.05, respectively). On days 8-11 of the cycle, the level of LIF in these groups did not differ significantly, however, in infertile women the range of distribution of cytokine was largely varied, demonstrating the highest amplitude of variations in subjects with MFI. Analyses of the data for women to whom LIF was examined in both phases of the cycle showed that some subjects (27%) exhibited an elevated amount of LIF in the secretory phase of the cycle. This suggests that in these cases the endometrial factor(s) may be irrelevant to infertility. CONCLUSION: In the majority of infertile women there is a deregulation of LIF production in the endometrium during both the proliferative and the secretory phases of the cycle. The dysfunction of cytokine production is more profound in patients with MFI. The deregulation of endometrial LIF secretion throughout the menstrual cycle may be a possible cause of unexplained infertility and repetitive failures of implantation.

Abortion, Habitual↗
PubMed1999

Quantification of C3 and C4 in infertile men with antisperm antibody in their seminal plasma.

PROBLEM: Previous studies showed that some infertilities are caused by antisperm antibodies (ASAs). It was shown that some major complement (C) components are present in seminal fluid. Due to the role of C in the pathogenesis of ASAs, the existence and amount of two key C components (C3 and C4) were investigated in seminal plasma (SP). METHOD OF STUDY: Single radial immunodiffusion assay and a sandwich-type enzyme-linked immunosorbent assay (ELISA) were used for C3 and/or C4 quantification, respectively, in serum and SP, and the tray agglutination test was used for ASA detection in 12 fertile and 53 infertile men (18 ASA-positive [ASA+] and 35 ASA-negative [ASA-] men). RESULTS: Of the 18 ASA + infertile men, 61.11% had positive C3, whereas 27.77% showed positive C4 levels. ASA + infertile men showed significant differences in seminal plasma C3 mean values compared with ASA- infertile (P < 0.01) and fertile (P < 0.05) men, but the seminal plasma C4 values only showed differences compared with ASA- infertile men (P < 0.05). No significant differences were observed in serum C3 and/or C4 levels of ASA+ infertile men compared with other groups. No significant correlation was found between ASA titer and C3 and C4 levels in SP. A significant correlation existed between SP and serum C3 levels of ASA+ (r = 0.522, P < 0.01) and ASA- (r = 0.451, P < 0.01) infertile men, but no correlation was observed between C4 levels. CONCLUSIONS: In the presence of ASAs, the C system has no definitive activity in blood serum or outside the male genital tract. In SP, and in association with ASAs, C has no lytic activity by the classical pathway. The excess of C3 in SP of ASA+ infertile men may participate in other C-mediated activities in the male reproductive tract.

Antibodies↗
PubMed1975

The use of antibodies developed by infertile women to identify relevant antigens.

In the first half of this century several studies demonstrated that temporary infertility may be induced by immunizing women with semen. Isolated examples of acute hypersensitivity reactions to sexual intercourse provide dramatic evidence that natural isoimmunization to semen occurs in man. The afferent immunological pathway in this process can be influenced by adjuvant effects of genital tract infection. This may be important in assessing the significance of antisperm antibodies in infertile women. In immunological studies of female infertility, the 3 most commonly used tests for humoral antisperm activity are microagglutination, macroagglutination and immobilization (complement dependent cytotoxicity). The sperm microagglutination test detects both antibody and non-antibody activity. The macroagglutination and immobilization tests both detect antibodies but to date the latter has provided the more meaningful results in infertile women. A prospective study of reproductive patterns in infertility patients indicated a lower subsequent fertility rate and a markedly higher abortion rate in women with antisperm antibodies compared to those without them. However, the association of antisperm antibodies with continuing infertility only reached a statistically significant level in women with a past history of unexplained infertility of at least 3 years' duration. Occlusion (condom) therapy in patients with antisperm antibodies has proved unsuccessful when compared with the natural reproductive patterns in untreated patients. Immunofluorescence studies are described and correlated with results of other tests for antisperm antibodies in serum and cerivcal mucus. The results of these and of other studies of naturally occurring antibodies in infertile women have identified antigens of actual or potential relevance to infertility and fertility control. These include (i) intrinsic spermatozoal antigens, (ii) seminal plasma antigens, (iii) blood group antigens, (iv) histocompatibility antigens and (v) nucleoprotein antigens.

Abortion, Spontaneous↗
PubMed2005

Identification of male factor infertility using a novel semen quality score and reactive oxygen species levels.

PURPOSE: To determine whether patients with male factor infertility can be accurately identified by calculating a novel semen quality score and measuring levels of reactive oxygen species during routine infertility screening. METHODS: Semen samples from 133 patients and 91 healthy donors were evaluated with manual and computer-assisted semen analysis. A principal component analysis model was employed to calculate a semen quality score. In brief, this score was calculated by base 10 logarithms multiplied by varying weights given to 9 sperm parameters. Reactive oxygen species levels were measured using chemiluminescence assay. RESULTS: The semen quality score had a sensitivity of 80.45% and accuracy of 77% at a cutoff of 93.1 in identifying patients with male factor infertility. The area under the receiver operating characteristic curves for the semen quality score was 84.28% (95% CI: 65.22%-100%). Reactive oxygen species levels [log10 (reactive oxygen species +1)] were significantly higher in male factor infertility patients. Reactive oxygen species had a sensitivity of 83.47% and specificity of 60.52% with an accuracy of 75% at a cutoff of 1.25 in identifying male factor infertility patients. The area under the receiver operating characteristic curve for reactive oxygen species levels was 78.92% (95% CI: 72.60%-85.23%). Semen quality scores were significantly and negatively correlated with reactive oxygen species levels in the donors and the male factor infertility patients. CONCLUSIONS: The semen quality score and reactive oxygen species levels in semen samples appear to be strongly associated with male factor infertility. Because both of these parameters are more sensitive than individual sperm parameters in identifying male factor infertility, they should be included in routine infertility screening.

Case-Control Studies↗
PubMed1989

LHRH pulse frequency in normal and infertile men.

The aim of this study was to examine the hypothesis that decreased LHRH pulse frequency may be responsible for the preferential rise in FSH in infertile men. The LH pulse pattern was determined as an index of hypothalamic LHRH secretion in 21 infertile patients with idiopathic azoospermia or oligoasthenozoospermia and 14 fertile age-matched controls by frequent blood sampling at 10-min intervals for 24 h. The infertile patients were further divided into three groups according to their relative concentrations of FSH and LH: (1) normal FSH and LH, (2) raised FSH but normal LH, and (3) raised FSH and LH. LH pulses were detected by a computerized algorithm (Munro) validated against a threshold method. Concentrations of FSH, testosterone, sex hormone-binding globulin and oestradiol were measured in pooled plasma. Luteinizing hormone pulse frequencies in normal men were not significantly different from the infertile group as a whole. Similarly, mean LH pulse frequencies in infertile subgroups 1, 2 and 3 were not significantly lower than normal. Pulse interval, however, was increased in subgroup 1 compared with normal. Mean 24 h LH in group 2 was significantly higher than normal, but still within the normal range. The total testosterone, but not the free testosterone index was significantly decreased in the infertile group compared with normal. There was no correlation between mean FSH and LH pulse frequency or interval. In conclusion, our results show that in patients with seminiferous tubular dysfunction, the typical pattern of raised plasma FSH, increased LH pulse amplitude, raised FSH: LH ratio and normal or marginally low testosterone was not associated with any significant deviations in LHRH pulse frequency from the range observed in normal fertile men. This is not compatible with the hypothesis that decreased LHRH pulse frequency is associated with or the cause of the preferential rise in FSH in men with idiopathic infertility. Thus unlike anovulatory infertility in females, functional defects of hypothalamic LHRH secretion remain an uncommon finding in male infertility. Attempts to treat idiopathic oligozoospermia by altering LHRH pulse frequency is therefore unlikely to yield any clinical benefit.

Adult↗
PubMedDate not supplied

Presence of interleukin-8 and the IL-1 receptor antagonist in the cervical mucus of fertile and infertile women.

BACKGROUND: Cytokines are involved in almost every aspect of reproduction, and recent studies suggested a relationship between cytokines and male/female infertility. In the present study, the levels of interleukin-8 (IL-8) and interleukin-1 receptor antagonist (IL-1Ra) were determined in the cervical mucus of fertile and infertile women. METHODS: Groups of patients were formed according to the results of the standard procedure for infertility investigation, including postcoital test and the presence of antispermatozoid antibodies in the sera of both partners and in seminal plasma, by mixed antiglobulin reaction (MAR) test and Kibrick agglutination test. IL-8 and IL-1Ra levels were determined in solubilized (ultrasonographic sonication) cervical mucus sampled in the midcycle by commercial ELISA kits and expressed as pg/mg proteins. RESULTS: The groups were designated as fertile (n=20) and infertile (n=48). The latter was divided into two subgroups, one consisting of infertile women with positive postcoital test and without antispermatozoid antibodies (n=30), and the other designated as infertile women with negative postcoital test (n=18). This subgroup was composed of women with negative postcoital test and without antibodies (n=10) and the women with negative postcoital test with antibodies (n=8). Similar levels of IL-8 and IL-1Ra were noted in the cervical mucus of infertile women and women with positive postcoital test and without antispermatozoid antibodies. A tendency of decrease (p=0.052) and significant decrease in IL-8 levels (p<0.05) was noted in negative postcoital test group and negative postcoital test group without antibodies, respectively, compared to the levels in the fertile examinees. A significant rise in IL-1Ra levels (p<0.05) was detected in the mucus of negative postcoital test group with further increase in negative postcoital test group with antibodies (p<0.02). CONCLUSION: Changes in IL-8 and IL-1Ra levels in the cervical mucus of infertile patients with negative postcoital test suggested the existence of the relationship between cervical cytokines and infertility in these women.

Adult↗
PubMed1997

Psychological adjustment of infertile women entering IVF treatment: differentiating aspects and influencing factors.

OBJECTIVE: To evaluate the psychological adjustment of infertile women compared with a control group of mothers and to determine which personal or marital factors influence the amount of emotional disorders in the infertile group. DESIGN: Cross-sectional questionnaire study with a group of infertile women and a group of mothers attending a routine gynecological examination. SETTING: Infertile women and mothers received the questionnaires after a psychological or medical examination respectively, at a Sterility Center in a Department of Obstetrics and Gynaecology. PARTICIPANTS: One hundred and twenty-two infertile women, entering an IVF program, and 57 mothers attending a routine care visit. MAIN OUTCOME MEASURES: Stressful events, self-esteem, job and marital satisfaction, care and control measures of intimate bond, state-trait anxiety, depression, psychophysiological symptoms and global emotional factor scores. RESULTS: The organic infertile group was higher than mothers on satisfaction with their relationship with their husbands, perception of care and state-anxiety. The emotional factor scores of infertile women, controlled for stressful events, were influenced by a) number of IVF-cycles and availability for adoption, b) job position, job satisfaction and self-esteem, c) personality dimensions. State and trait anxiety scores were influenced by the level of global marital satisfaction. CONCLUSIONS: Infertile women, entering an IVF treatment program, do not necessarily show signs of psychological maladjustment. Their level of state-anxiety can be considered a situational response to the treatment stress. The infertility condition and its treatment can be effectively dealt with by women having a good personality disposition, a high level of self-esteem, who are satisfied with their job and relationship with their husband, and who are willing to adopt a child as a last solution for their maternal need.

Adaptation, Psychological↗
PubMed1986

Seminal plasma hormone profile in infertile men with and without varicocele.

Seminal plasma FSH, LH, prolactin, testosterone, and oestradiol were estimated in 41 infertile men with varicocele and 45 infertile men without varicocele who failed to impregnate their wives after 2 years of marriage and 30 fertile men. There was significant elevation of FSH in the seminal plasma of the infertile men with varicocele compared with the seminal plasma of the other infertile and fertile men. Seminal LH and prolactin values were similar in both infertile groups but significantly higher than in the fertile men. Testosterone and oestradiol levels in the seminal plasma of infertile men with varicocele were lower than in the fertile and the other infertile males. Finding that both steroids were decreased in infertile men with varicocele could explain disturbed function of spermatozoa in men with varicocele. Further analysis will elucidate the importance of these hormone findings in the seminal plasma of infertile men with varicocele.

Adult↗
PubMed1996

Psychological characteristics of infertile patients: discriminating etiological factors from reactive changes.

Our objective was to discriminate psychological factors playing an etiological role in infertility and psychological problems as consequences of infertility. The design was a prospective study of couples with initially Undetermined Fertility (UF couples) and couples with initially Known Infertility (KI couples). After a 13-month follow-up, three groups could be defined: fertile UF couples; infertile UF couples; and KI couples. Hypotheses were the following. If a psychological factor played an etiological role, measures in fertile UF couples should be different from measures in infertile UF couples and in KI couples. If a psychological measure reflected a reactive change, KI couples should differ from both groups of UF couples. Finally, if a psychological variable played both roles, the three pairwise comparisons between groups should reveal differences, with the largest difference between fertile UF couples and KI couples. The questionnaires used were the Child Project Questionnaire (CPQ), with three factor scores (different for men and women) and a Sexual Problems Score (SPS); the Dyadic Adjustment Scale; the State-Trait Anxiety Inventory; the Neonatal Perception Inventory. In women, on CPQ factor II, i.e. Frequency of Thoughts and Concerns related to the Project to Conceive a Child and on the SPS, KI women had scores significantly higher than both groups of UF women. In men, on CPQ factor II, i.e. Quality of Integration between Wish for a Child and Sexuality, men from fertile UF couples had significantly higher scores than men from both infertile groups; the two latter groups did not differ significantly. On the SPS, scores of men from infertile UF couples and scores of men from KI couples were significantly higher than scores of men from fertile UF couples; scores were similar in both groups of men from infertile couples. We conclude that in women, CPQ factor II and sexual problems reflected reactive changes to infertility and that in men CPQ factor II and sexual problems represented etiological factors.

Adjustment Disorders↗
PubMed1998

[Analysis of female infertility structural factors].

The study was aimed to evaluate, within the population of infertile women, the interrelations between such characteristics as patient's age, duration and type (primary, secondary) of infertility, its etiologic factor as well as the treatment outcome (pregnancy rate). Retrospective analysis was performed in 176 women aged 20-43 years (mean age 29.5 years). Primary infertility was less common in older women (above 35 years). Duration of primary infertility was independent of age, on an average 1.5 years shorter compared to secondary infertility. Participation of all causal factors in the structure of infertility was steady--11.6-20.2%. The most frequent reasons of secondary infertility were unexplained infertility 55.3% and tubal pathology--19.1%. The pregnancy rate was 30% in all treated women. In the studied population of women, pregnancy rate was not significantly influenced by the patients's age, type of infertility and its cause.

Adult↗
PubMedDate not supplied

Oxidative stress in normospermic men undergoing infertility evaluation.

The purpose of this study was to determine whether normospermic infertile men have high seminal oxidative stress, using 3 measures of oxidative stress: reactive oxygen species (ROS), total antioxidant capacity (TAC), and a composite ROS-TAC score. Forty-three normospermic men without leukocytospermia and 19 healthy donors who came to our infertility clinic were included. Patients were categorized into 3 groups: group I, varicocele and no female factor (n = 16); group II, positive female factor (n = 16); and group III, idiopathic infertility (n = 11). In addition, 52 treated male factor patients and 19 donors were included as reference groups. We measured seminal ROS, TAC, and the ROS-TAC score in the patient groups and the controls. Normospermic infertile patients as a group had higher ROS levels (mean log [ROS + 1] 1.76 +/- 0.13) compared with controls (1.39 +/- 0.16; P = .03). Patients in the idiopathic subgroup had significantly higher ROS levels (2.29 +/- 0.25; P = .004) than controls. Normospermic infertile patients as a group not only had reduced TAC levels (970.18 +/- 73.95 Trolox equivalents), but each subgroup also had significantly lower TAC than controls (1650.93 +/- 95.87; P < .003). The ROS-TAC scores in all normospermic infertile patients as a group (35.7 +/- 1.8) as well as in each subgroup was significantly reduced compared with the ROS-TAC levels in the controls (50.0 +/- 2.1; P < .005). We conclude that oxidative stress is associated with male factor infertility. The presence of oxidative stress in infertile normospermic men may explain previously unexplained cases of infertility otherwise attributed to female factors.

Humans↗
PubMed2001

Thyroid autoimmunity and infertility.

We aimed to study the prevalence of thyroid autoimmunity in infertile women; to assess whether thyroid autoantibodies were associated with non-organ-specific autoantibodies; and to investigate the influence of this dysfunction on the couples' chances of pregnancy. We assayed serum levels of thyroid stimulating hormone (TSH), free thyroxine, and microsomal and thyroglobulin autoantibodies in 149 infertile women. In patients with serum TSH levels in the hypothyroid or hyperthyroid range and/or with thyroid autoantibodies, we performed thyroid ultrasound examinations and assayed some non-organ-specific autoantibodies. We compared the duration of infertility in infertile patients with normal thyroid (control group), with thyroid abnormalities, and with thyroid autoantibodies in euthyroidism. Thirty infertile patients (20.1%) had thyroid abnormalities. The prevalence of thyroid autoantibodies was 17.4%. In infertile patients with thyroid autoantibodies, we found a poor association with non-organ-specific autoantibodies. Only the women with thyroid abnormalities and ovulatory dysfunction had a mean duration of infertility significantly longer than that of the control group. When the data were analyzed for euthyroid women with thyroid autoantibodies, we found no significant variation in the duration of infertility. Although we found a high prevalence of thyroid autoantibodies in infertile patients, the presence of these autoantibodies per se did not reduce the chance of pregnancy.

Adult↗
PubMed2001

[The psychological effect of clinical examination on women with tubal infertility].

OBJECTIVE: To comprehend the psychological effects in the course of diagnosis and treatment of infertility on the sexuality, emotional feeling and marriage of women with tubal infertility. METHODS: The study involved 180 hospitalized patients who were awaiting tube operation from May to September in the year 2000. A survey was made by using questionnaire about sexuality, emotional feeling and marriage after infertility examinations. RESULTS: The sexual intercourse frequency of 46.2% infertile women decreased and no influences on sexual living satisfaction were confirmed during basal body temperature (BBT) examination. 92.3% to 93.2% of the infertile women were sad after hysterosalpingography(HSG) and laparoscopy. 78.9% of them felt remorse when the result of semen examination was normal. 56.6% of them would choose in vitro fertilization and embryo transfer(IVF-ET); 38.9% of the infertile couples' wedlock would not be stable and 10.5% of them would be divorced in the case of continuing infertility 2 years after tube operation. CONCLUSION: Sexual intercourse in almost half of the infertile couples decreased during BBT examination. Most infertile women became sad when they were informed of the abnormal results of HSG and laparoscopy and the normal results of semen analysis.

Adult↗
PubMed2005

[Expression of leptin mRNA in luteinized granulosa cells and leptin levels in serum and follicular fluid of non-obese infertile patients with polycystic ovary syndrome].

OBJECTIVE: To investigate the expression of leptin mRNA in luteinized granulose cells and the leptin level in serum and follicular fluid of non-obese patients with polycystic ovary syndrome (PCOS). METHODS: Granulosa cells were collected from the puncture fluid of follicle of 16 obese infertile patients with PCOS to undergo external fertilization. Fasting venous blood was collected while collecting the ova. RT-PCR was used to detect the expression of leptin mRNA in the granulosa cells. ELISA was used to detect the leptin level in the serum and follicular fluid. Twenty normal women undergoing external fertilization because of male infertility of their husbands were used as controls. RESULTS: The expression of leptin mRNA (A value) was 1.5 +/- 0.4 in the obese infertile patients with PCOS and was 1.8 +/- 0.6 (P > 0.05) in the controls. Both the leptin levels of serum and follicular fluid were not different between the obese infertile patients with PCOS and controls (both P > 0.05). The leptin level in follicular fluid was significantly correlated with both the serum leptin level in the obese infertile patients with PCOS (r(s) = 0.838, P = 0.000) and the control group (r(s) = 0.712, P = 0.000). The expression level of leptin mRNA in the luteinized was not correlated with the leptin level of follicular fluid in both the obese infertile patients with PCOS and the control group (both P > 0.05). The fertility rate was not different between the obese infertile patients with PCOS (7/16) and the controls (9/24) (P = 0.693). CONCLUSION: The expression of leptin mRNA is normal in the follicular fluid of the obese infertile patients with PCOS. The leptin levels in serum and follicular fluid of the obese infertile patients with PCOS are similar to those of normal women. The leptin level in follicular fluid depends mainly on the circulating leptin level.

Adult↗
PubMed2006

Emotional distress of infertile women in Turkey.

OBJECTIVE: To determine the prevalence, severity and predictability of psychiatric symptoms of infertile women and the effects of infertility on marital and sexual relationships. METHODS: A semi-structured interview form, symptom check list, Beck Depression Inventory, State-Trait Anxiety Inventory and the Maudsley Marrital Questionnaire were utilized for 50 infertile women and 40 healthy women as a control group. RESULTS: Depression, anxiety and strength of psychological symptoms were significantly higher in the infertile group. Depression was decreased as the rate of employment, economic status and education increased. Infertility, infertility treatment, and marriage duration were positively correlated with depression and the strength of psychological symptoms. Sexual relationships were negatively affected the longer the duration of infertility treatment lasted. CONCLUSION: Special attention must be given to identifying psychiatric problems in infertile women. Relationship and sexual difficulties also appear central to infertility-related stress; targeting problems in these domains will have maximal therapeutic benefit.

Adult↗
PubMed2006

Chlamydia trachomatis infection & female infertility.

BACKGROUND & OBJECTIVES: Chlamydia trachomatis is a well recognized sexually transmitted pathogen. Besides its potential to produce genital tract infection, C. trachomatis is increasingly being associated with long-term complications like infertility. The present study was undertaken to assess the role of C. trachomatis in female infertility as such data are lacking. METHODS: Women of primary and secondary infertility (n=110) and 30 healthy term pregnant women as control group were enrolled in the study. Detailed clinical history of each patient was recorded. Hysterosalpingography was performed in all patients. Endocervical swabs were collected for culture on cycloheximide treated McCoy cell line and for antigen detection by ELISA. RESULTS: C. trachomatis was detected in 31 (28.1%) of the 110 infertile women while one (3.3%) in control group was positive for C. trachomatis (P<0.01). Cell culture alone identified 25 (22.72%) patients suffering from chlamydial infection while C. trachomatis antigen was detected by ELISA in 18 (16.37%) patients. The one control case was positive for Chlamydia antigen by ELISA and not by cell culture. Chlamydial positivity was seen in 20 of the 74 (27%) women with primary infertility and in 11 of the 36 (30.6%) with secondary infertility. Of the 58 asymptomatic women, 21(36.2%) had chlamydia infection while among the 52 symptomatic cases 10 (19.2%) were infected; 38 per cent women with chlamydial infection also had tubal occlusion. INTERPRETATION & CONCLUSION: A significantly high rate of C. trachomatis infection was found in infertile women and more so in asymptomatic females and in secondary infertility cases. Lack of symptoms make clinical diagnosis of chlamydial infection difficult. Screening of infertile women for C. trachomatis is therefore recommended so far early therapeutic interventions.

Antigens, Bacterial↗
PubMed2006

[The Aging Male's Symptoms (AMS) scale in Japanese men attending an infertility clinic].

There is a gradual decline in testosterone and free testosterone with age. Physical and psychological changes can occur due to this decline of androgens--a syndrome known as "partial androgen decline in the aging male" (PADAM). Male infertility and erectile dysfunction (ED) can also be caused by androgen deficiency. Thus, male infertility, ED and PADAM are interrelated. We evaluated the prevalence of PADAM symptoms in 215 infertile patients in an infertility clinic using the Aging Males Symptom (AMS) scale. Results of the evaluation of 301 men, (30-39 years old) using the same scale, who were part of a multiphasic health screening program, served as controls. The total score of the infertile patients was lower than that of the controls. Especially, the scores of the psychological and somatic subscales were significantly lower in infertile patients (P=0.009, P=0.012, respectively). Thirty three (15.3%) of the 215 infertile patients had ED. Although the score of sexual subscale was higher in the ED patients than in the controls, the scores of the psychological and somatic subscales were not significantly different from those in the controls. In conclusion, PADAM symptoms in Japanese infertile patients were not severe. Moreover, general function was better preserved in the infertile patients than in the controls. The psychological and somatic functions of ED patients were also well preserved.

Adult↗
PubMedDate not supplied

Clinical approaches to male infertility with a case report of possible nifedipine-induced sperm dysfunction.

BACKGROUND: Male infertility has many causes, and recently it has been suggested that calcium channel blockers might contribute to male infertility. METHODS: A case consistent with nifedipine-induced male infertility is described. MEDLINE was searched for articles on the effect of calcium channel blockers and the general causes of infertility, with an emphasis on male infertility, using the key words "nifedipine," "male infertility," "sperm," and "calcium channel blockers." RESULTS AND CONCLUSIONS: Male infertility induced by calcium channel blockers should be included in the differential diagnosis of infertile couples in appropriate cases. Whether a calcium channel blocker could be developed as a male contraceptive remains to be determined. Further studies are needed to determine the prevalence of infertility among men taking calcium channel blockers.

Adult↗