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PubMed2001

Influence of a short or long abstinence period on semen parameters in the ejaculate of patients with nonobstructive azoospermia.

OBJECTIVE: To compare the effect of a short (4 days) or a long (14 days) abstinence period on sperm retrieval by extended sperm preparation in patients with nonobstructive azoospermia scheduled for testicular biopsy and intracytoplasmic sperm injection (ICSI). DESIGN: A prospective case control study. SETTING: Male infertility clinic in a university hospital. PATIENT(S): Fifty male patients with nonobstructive azoospermia, scheduled for testicular biopsy for ICSI. INTERVENTION(S): Diagnosis of nonobstructive azoospermia and a thorough microscopic search for sperm cells (extended sperm preparation). MAIN OUTCOME MEASURE(S): The number of sperm cells collected, sperm motility, and total motile sperm count after short and long abstinence periods. RESULT(S): There was a significant difference between long and short abstinence with an increase in sperm count (log-to-log transformed analysis of variance P<.025) and total motile sperm (P<.025 analysis of variance, P<.02 paired Student's t-test) in the former group, but no significant change in sperm motility (Wilcoxon and paired Student's t-test). In 18 patients, sperm concentration and sperm motility were similar in a second collection, done after the same abstinence period, compared with the same parameters in the first sample. When at least 10 motile sperm were defined as the cutoff number, allowing ICSI without testicular biopsy, no significant differences were found between the two abstinence periods. No clinical or laboratory male characteristic could predict the detection of 10 motile sperm by extended sperm preparation either after a short or a long abstinence period. CONCLUSION(S): Sperm count and total motile sperm were increased after a long abstinence period, with no change in sperm motility. No additional advantages were conferred by long abstinence as opposed to short abstinence when 10 motile sperm were defined as the cutoff number for ICSI. The recommended period of abstinence for extended sperm preparation and ICSI, whether short or long, should be individualized for each patient.

Adult↗
PubMedDate not supplied

Modulation of insulin-like growth factor-1 in the seminal plasma of infertile men.

It has been suggested that insulin-like growth factor (IGF)-1 plays an important role in the regulation of spermatogenesis in the testes. In the present study, concentrations of total IGF-1 were determined in the seminal plasma of fertile (n = 44), male-factor infertile (n = 34), and immunoinfertile (n = 10) men in order to investigate the role of IGF-1 in male infertility. Levels of IGF-1 were expressed both as nanograms per milliliter and as nanograms per milligram of protein. IGF-1 was detected in the seminal plasma of both fertile and infertile men. IGF-1 levels differed significantly between fertile and immunoinfertile groups (P < 0.035 to P < 0.0001), whether expressed as nanograms per milliliter or as nanograms per milligram of protein. The immunoinfertile group showed a 31.3-37.9% increase in the mean IGF-1 concentration over the fertile group. There was no statistical difference in the mean or median levels of IGF-1 between the fertile and male-factor infertile groups, whether expressed as nanograms per milliliter or as nanograms per milligram of protein. However, when the male-factor infertile subjects were divided into four subgroups based on which seminal parameter was defective, the subgroup having a low sperm count had IGF-1 levels that were significantly different from the fertile group, the immunoinfertile subgroup, and the other male-factor infertile subgroups. The low-sperm-count subgroup had the lowest mean and median IGF-1 levels of all the groups and subgroups tested. IGF-1 levels linearly correlated (r = 0.30-0.499) significantly (P = 0.023-0.027) with the total sperm count in the semen, whether analyzed with all groups together or in subgroups by condition. These findings suggest that IGF-1 has a role in fertility and that its derangement may be involved in male infertility, especially when mediated through low sperm count and immunologic factors.

Enzyme-Linked Immunosorbent Assay↗
PubMed2001

Clinical outcome of microsurgical subinguinal varicocelectomy in infertile men.

The present study assesses the clinical outcome of microsurgical subinguinal varicocelectomy in infertile men, especially with regard to sperm count, motility and fertility. Between June 1990 and October 1998, 272 patients had subinguinal microsurgical varicocelectomy operations for clinical varicoceles, and their long-term results were assessed. In nearly all the patients there was a significant improvement in sperm count and sperm motility after 3 and 6 months. Very few complications arose from this procedure. We concluded that microsurgical subinguinal varicocelectomy is an effective treatment for clinical varicoceles in infertile men. The significant improvement in the quality of spermatozoa, the low complication rates and the remarkably high pregnancy rates make this a valuable alternative to in vitro reproduction techniques.

Adolescent↗
PubMed1981

Sperm shape abnormalities in carbaryl-exposed employees.

Semen was collected from 50 men occupationally exposed to carbaryl (1-naphthyl methyl carbamate) in a produciton plant for durations of 1 to 18 years and compared to semen from a control group of 34 unexposed, newly-hired workers. Employment, fertility, health, personal data, and blood samples were collected for each individual. Semen samples were analyzed for changes in sperm count, morphology, and frequency of sperm carrying double flourescent bodies (YFF). As a group, the exposed workers showed a significantly higher proportion of sperm with abnormal head shapes than did the control group (p < 0.005). Age, smoking habits, and medical problems did not appear to affect this result. This finding appears to be limited to men working in the carbaryl production area at the time of sampling. Sperm count and YFF did not show similar differences, which may be because they are known to be statistically less sensitive to small changes. Formerly exposed workers (away from carbaryl for an average of 6.3 years) showed a marginally significant elevation in sperm abnormalities compared to controls (p < .05, one-tailed statistical analyses) suggesting that the increase in abnormal morphology may not be reversible. However, the question of reversibility is sensitive to confounding factors and small sample sizes and, therefore, requires further study. With these data a definitive link between carbaryl exposure and human seminal defects cannot be established. Although a distinct effect on sperm morphology was seen in the exposed group, the increases in sperm shape abnormalities were not related to exposure dose (estimated by number of years on the job or job classification during the year prior to semen collection). Inexplicably, the increases in sperm abnormalities were seen primarily in currently exposed men who had worked with carbaryl for less than approximately 6 years. These findings suggest the need for further study since other workplace-related factor(s) may be responsible for the elevated sperm abnormalities seen in this study.

Adult↗
PubMed2002

Effects of testosterone plus medroxyprogesterone acetate on semen quality, reproductive hormones, and germ cell populations in normal young men.

Testosterone (T) treatment suppresses gonadotropin levels and sperm counts in normal men, but the addition of a progestin may improve the efficacy of hormonal contraception. This study aimed to investigate the speed and extent of suppression of testicular germ cell number induced by T plus or minus progestin treatment and correlate these changes with serum gonadotropins and inhibin B levels, testicular androgens, and sperm output. Thirty normal fertile men (31-46 yr) received either testosterone enanthate (TE, 200 mg im weekly) alone or TE plus depot medroxyprogesterone acetate (DMPA, 300 mg im once) for 2, 6, or 12 wk (n = 5 per group) before vasectomy and testis biopsy. Five men (controls) proceeded directly to surgery. The inclusion of DMPA led to a more rapid fall in serum FSH/LH levels (time to 10% baseline: FSH; 12.6 +/- 2.6 vs. 7.9 +/- 1.4 d; LH, 9.9 +/- 3.4 vs. 3.4 +/- 1.7 d, TE vs. TE+DMPA, respectively, mean +/- SD, both P < 0.0001), yet the mean time to reach a sperm count 10% of baseline was not different (23.7 +/- 7.3 vs. 25.3 +/- 13.9 d, NS). The maximum extent of FSH/LH suppression was identical at 12 wk (mean serum FSH 1.2 and 1.6%, and mean LH 0.3 and 0.2% of baseline: TE vs. TE+ DMPA, respectively) as was sperm count suppression (5 of 5 and 4 of 5 men, respectively, with sperm counts < or =0.1 x 10(6)/ml). Serum inhibin decreased to 55% control at 12 wk in the TE+DMPA group (P < 0.05) but was unchanged by TE treatment (86% control, NS). Testicular T levels declined to approximately 2% of control levels, but testicular dihydrotestosterone and 5alpha-androstane-3alpha,17beta-diol (Adiol) levels were not different to control. Germ cell numbers as determined by stereological methods did not differ between TE and TE+DMPA except at 2 wk when type B spermatogonia and early spermatocytes were significantly lower in the TE+DMPA group (P < 0.05). In all groups, a marked inhibition of Apale-->B spermatogonial maturation was seen along with a striking inhibition of spermiation. We conclude that: 1) the addition of DMPA hastens the onset of FSH/LH suppression, correlating with a more rapid impairment of spermatogonial development, but in the longer term, neither germ cell number nor sperm count differed; 2) testicular dihydrotestosterone and Adiol levels are maintained during FSH/LH suppression despite markedly reduced T levels suggesting up-regulation of testicular 5alpha-reductase activity; and 3) spermatogonial inhibition is a consistent feature, but spermiation inhibition is also striking and is an important determinant of sperm output.

Adult↗
PubMed1997

Electroejaculation versus vibratory stimulation in spinal cord injured men: sperm quality and patient preference.

PURPOSE: We compared semen quality and patient preference between penile vibratory stimulation and electroejaculation in spinal cord injured men. MATERIALS AND METHODS: We treated 11 spinal cord injured men with penile vibratory stimulation and electroejaculation in random order. End points examined were semen analysis, sperm functional assessment, and patient pain scores (1 to 10) and preferred procedure. Differences between the procedures were determined with the paired Student t test. RESULTS: There was no difference in antegrade sperm count but penile vibratory stimulation specimens had greater motility (26.0 versus 10.7%), viability (25.2 versus 9.7%) and motile sperm count (185.0 x 10(6) versus 97.0 x 10(6)). The retrograde sperm count was greater (but not significant) in electroejaculation patients. The total (antegrade plus retrograde) and motile sperm counts were not different. There was no difference in immunobead test (all negative), cervical mucus penetration or sperm penetration assay, although the percent hamster egg penetration approached significance (53.7% for penile vibratory stimulation versus 22.1% for electroejaculation, p = 0.06). There was no difference in the peak blood pressures and no complications were noted. Pain scores were significantly greater for electroejaculation compared to penile vibratory stimulation (5.2 versus 1.7, respectively). All patients preferred penile vibratory stimulation. CONCLUSIONS: There was a slight advantage in sperm quality and a high patient preference in favor of penile vibratory stimulation. Penile vibratory stimulation should be attempted first to induce ejaculation in spinal cord injured men, with electroejaculation reserved for failures.

Cell Survival↗
PubMed1979

A reassessment of the fractional postcoital test.

The present investigation was designed to reassess the fractional postcoital test (PCT). Specifically, the study addressed the question of whether the internal cervical mucus sperm count is significantly different from the sperm counts at other cervical levels. By means of standardized methodology, 25 normal postcoital tests were perfoemed on 22 couples. Cervical mucus from three different levels within the endocervical canal was examined for total count, motility, and sperm morphology. No significant difference could be found in these three parameters among any of the cervical levels (p greater than 0.05). Significantly fewer abnormal sperm were found in the cervical mucus when compared to the total abnormal forms in the semen (p less than 0.001). Therefore, while the fractional PCT is a reflection of cervical sperm, this study indicates that the three different cervical levels in the fractional PCT (internal-mid-external) are equally effective in the interpretation of the postcoital test.

Cell Count↗
PubMed1997

The relationships among reproductive endpoints in Swiss mice, using the reproductive assessment by Continuous Breeding database.

The database of Continuous Breeding mouse studies was evaluated to determine the relationships between the functional indicators of reproduction (pup measures) and the various necropsy endpoints collected for males and females. Of 72 chemicals studied, both males and females were affected in 33 studies, while females and/or conceptuses were affected in 7. Two compounds affected only males, 17 studies were negative, and in 13 studies with effects it was not possible to clearly determine the affected gender(s). Greater F0 dam weight was correlated with increased pup mass per litter; this relationship was strongest for the first litter, and weakest for the fifth litter. For both generations of treated females (F0 and F1), longer estrous cycles correlated with reduced numbers of pups; the relationship was stronger in F0 than in F1 females and was not seen in controls. Sperm parameters had different distributions in treated mice than in control mice. Fertility (total live pups/number of pairs cohabited) was reduced if there were > approximately 15% sperm abnormalities or if sperm motility (moving/not moving) was < approximately 37%. Both of these relationships appeared to have thresholds. Epididymal sperm count in treated animals, however, was linearly related to fertility, even within the control range, suggesting strongly that other factors are important. Using both treated and control data together, combining sperm count with motility could explain much (r = 0.77) of the variation in fertility; adding morphology did not significantly improve the correlation. The model was almost as strong using count and morphology, in which case adding motility did not strengthen the model. This analysis of these studies shows that while some endpoints (e.g., random-estrous-cycle-point ovary weight) correlate poorly with fertility, other necropsy endpoints (epididymal sperm count and motility, estrous cycle length, and testis and epididymal weights) can be useful (though not complete) surrogates of overall reproductive function. Indeed, over many studies, epididymal sperm count in treated animals correlates with fertility so well that even small reductions (approximately 20%) in count result in reduced fertility, suggesting that mice may be better models of human fertility than was previously believed.

Animals↗
PubMed1977

Son-sire-regression based heritability estimates of chiasma frequency, using T70H mouse translocation heterozygotes, and the relation between univalence, chiasma frequency and sperm production.

T(1;13)70H/+ translocation heretozygous mice were used for assessing heritability values for chiasma frequencies and the epididymal sperm count. The chiasma frequency estimates were based on 15 son-sire pairs, the translocation heterozygotes being maintained in a Swiss random-bred genetic background. The chiasma frequencies were scored separately for the T70H/+ derived multivalent, specific pairing segments within the multivalent and the remaining bivalents. Chiasma counts within these specified parts of the genome were positively correlated. The heritability estimates, significantly greater than zero, ranged from 0.78-0.98, depending on the chromosome segments included. These results indicate a strong genetic control on a cellular basis for the formation of chiasmata in the mouse. Despite significantly positive correlations and regressions between the various chiasma frequencies and the sperm count (for which 29 pairs of observations were available), no significant heritability estimate for the sperm count was obtained. The relation between the chiasma frequency and the sperm count was weakest when the chiasma count was confined to a region of the translocation-caused multivalent in which the absence of a chiasma almost always resulted in the production of an univalent. This indicates that in the translocation heterozygotes used, the overall chiasma frequency has a greater predictive value for the sperm count than autosomal univalence alone.

Animals↗
PubMed1994

Ultrasonic texture and volume of testicles in infertile men.

Ultrasound scanning of the testes and surgical biopsy were performed in 95 infertile men to evaluate the use of ultrasound in male infertility. Ultrasonic testicular volume was calculated using three measurements and the formula of an ellipsoid, and the ultrasonic texture was evaluated and given a score from 1 to 5, indicating increasing degrees of irregularity. The median score was 3 (range 1-5), which was higher than previously found in normal men (median score 2; range 1-5; P < 0.0001). The ultrasonic texture score was lower in testes with a uniform pattern of 100% spermatogenic tubules compared with the rest, both for the right (P < 0.001) and for the left (P < 0.0005) testis. Texture score was correlated with the number of obliterated tubules for both testes (P < 0.001). The mean ultrasonic testicular volume of the right testis was 10.30 ml, and that of the left 10.26 ml. Both were smaller compared with the findings in normal men (P < 0.0001). Ultrasonic testicular volume was negatively correlated with texture score (P < 0.001). A positive correlation between ultrasonic volume and sperm count was seen (P < 0.001). Sperm count was negatively correlated with texture score if calculated together with data from 119 men from the general population (P < 0.001). The study shows that ultrasonic volume and texture are valuable parameters in the evaluation of infertile men.

Adult↗
PubMed1996

Fertility potential after unilateral orchiopexy: simultaneous testicular biopsy and orchiopexy in a cohort of 87 patients.

PURPOSE: We investigated the prognostic value of the number of spermatogonia per tubular cross section in a testicular biopsy specimen obtained at orchiopexy for unilateral cryptorchidism. MATERIALS AND METHODS: A total of 87 consecutive 10 to 12-year-old cryptorchid boys underwent testicular biopsy simultaneously with unilateral orchiopexy. In adulthood 56 of the 87 patients agreed to measurement of serum follicle-stimulating hormone, luteinizing hormone, testosterone and testicular volume, and 54 provided specimens for semen analysis. RESULTS: The number of spermatogonia per tubular cross section correlated to the volume of the operated testis and total testicular volume in adulthood. Serum follicle-stimulating hormone negatively correlated to these volumes, sperm concentration and total sperm count. Contralateral testicular volume correlated to sperm concentration, total sperm count, and percent of living and mobile sperm. When biopsy revealed Sertoli cells only or 1 spermatogonium per 100 tubular cross sections, the age matched number of spermatogonia per tubular cross section was 1% or less. Of these patients 33% later presented with 5 million spermatozoa per ml. or less, no normal motility and generally lower sperm concentrations that those with more than 1 spermatogonium per 100 tubular cross sections (greater than 1%) in the biopsy specimen. When the value was greater than 1%, later sperm quality was not significantly reduced in comparison to that of the general population. CONCLUSIONS: The age matched number of spermatogonia per tubular cross section is significant in regard to fertility potential, and a value of 1% or less (approximately Sertoli cells only) may predict low fertility potential. To our knowledge Sertoli cells only have not been observed before 15 months of life, which makes it logical to treat cryptorchidism before this age even in unilateral cases.

Biopsy↗
PubMed2000

Relationship of seminal plasma transferrin with seminal parameters in male infertility.

This study was undertaken to investigate whether there is relationship between seminal plasma transferrin and seminal parameters which included sperm count, motility and morphology. The study included 100 male subjects in the age group of 23-41 yrs including 7 proven fertility, 6 post-vasectomised and 87 subjects were of idiopathic infertility. Estimation of seminal plasma transferrin concentration was done by using Mancini's single radial immunodiffusion technique. Study of the seminal parameters (Sperm count, Motility and Morphology) was done by using guidelines of WHO Manual. Mean seminal plasma transferrin concentration in proven fertility subject was 5.35 mg/dl (+/- 2.07) and in normozoospermic subject was 4.63 mg/dl (+/- 2.50) which was significantly higher (P < 0.001) than those of oligozoospermic, azoospermic and post-vasectomised subjects. Coefficient of correlation between seminal plasma transferrin concentration and sperm count was statistically significant (r = 0.3087, P < 0.001). The seminal plasma transferrin concentration was correlated with the percentage of motile sperms and was statistically significant. However no correlation could be demonstrated with various grades of motility. Statistically significant correlation was not found between transferrin and sperm morphology. The present study demonstrates that seminal plasma transferrin concentration is correlated with sperm count and percent motile sperms. Thus sertoli cell secretion-transferin has a positive influence over spermatogenesis and can be used as a marker of testicular function.

Adult↗
PubMed1983

An evaluation of the mouse sperm morphology test and other sperm tests in nonhuman mammals. A report of the U.S. Environmental Protection Agency Gene-Tox Program.

The literature on the mouse sperm morphology test and on other sperm tests in nonhuman mammals was reviewed (a) to evaluate the relationship of these tests to chemically induced spermatogenic dysfunction, germ-cell mutagenicity, and carcinogenicity, and (b) to make an interspecies comparison to chemicals. A total of 71 papers were reviewed. The mouse sperm morphology test was used to assess the effects of 154 of the 182 chemical agents covered. 4 other murine sperm tests were also used: the induction of acrosomal abnormalities (4 agents), reduction in sperm counts, (6 agents), motility (5 agents), and F1 sperm morphology (7 agents)). In addition, sperm tests for the spermatogenic effects of 35 agents were done in 9 nonmurine mammalian species; these included analyses for sperm count, motility, and morphology, using a large variety of study designs. For the mouse sperm morphology test, 41 agents were judged by the reviewing committee to be positive inducers of sperm-head shape abnormalities, 103 were negative, and 10 were inconclusive. To evaluate the relationship between changes in sperm morphology and germ cell mutagenicity, the effects of 41 agents on mouse sperm shape were compared to available data from 3 different mammalian germ-cell mutational tests (specific locus, heritable translocation, and dominant lethal). The mouse sperm morphology test was found to be highly sensitive to germ-cell mutagens; 100% of the known mutagens were correctly identified as positives in the sperm morphology test. Data are insufficient at present to access the rate of false positives. Although it is biologically unclear why one might expect changes in sperm morphology to be related to carcinogenesis, we found that (a) a positive response in the mouse sperm morphology test is highly specific for carcinogenic potential (100% for the agents surveyed), and (b) overall, only 50% of carcinogens were positive in the test (i.e., sensitivity approximately equal to 50%). Since many carcinogens do not produce abnormally shaped sperm even at lethal doses, negative findings with the sperm test cannot be used to classify agents as noncarcinogens. We conclude that the mouse sperm morphology test has potential use for identifying chemicals that induce spermatogenic dysfunction and perhaps heritable mutations. Insufficient numbers of chemicals agents have been studied by the other sperm tests to permit similar comparisons. A comparison of 25 chemicals tested with sperm counts, motility, and morphology in at least 2 species (including man, mouse and 9 other mammals) demonstrated good agreement in response among species. With further study, interspecies comparisons of chemically induced sperm changes may be useful for predicting and evaluating human effects.

Animals↗
PubMed2001

Inhibin B: comparison with indexes of fertility among formerly cryptorchid and control men.

Infertility may be a consequence of cryptorchidism. We previously reported, using a large study cohort, that 38% of formerly bilateral cryptorchid men, 10% of unilateral cryptorchid men, and 5% of the control group were infertile. Men from this cohort donated blood and semen samples for inhibin B, FSH, LH, testosterone, free testosterone, and semen analyses. Results are reported comparing the entire group; some comparisons are based on normal or low sperm density. Data are also presented for men who had fathered children or had unsuccessfully attempted paternity. Mean (+/-SD) inhibin B levels were lower for the cryptorchid men (109 +/- 59 pg/mL) than the control men (153 +/- 60; P < 0.001), and FSH levels were higher (7.4 +/- 6.2 and 4.0 +/- 3.2; P < 0.0001). Inhibin B levels correlated with all other parameters for the cryptorchid group; however, correlations for the control group were only found with gonadotropins. Among the cryptorchid men, levels were significantly greater among men with normal sperm counts than men with low sperm counts (124 +/- 47 vs. 75 +/- 48 pg/mL; P < 0.0001). No difference was present for the control group (155 +/- 61 vs. 149 +/- 63 pg/mL). When the fertile group (based on paternity) vs. the infertile group (based on attempted paternity) were compared, significant differences were found for the cryptorchid group (117 +/- 62 vs. 73 +/- 52 pg/mL; P < 0.03), but not the control group (163 +/- 62 vs. 146 +/- 73 pg/mL). These data reveal relationships not apparent among the control group of men, which includes infertile men. Inhibin B data suggest that a larger portion of formerly cryptorchid men have compromised testicular function than indicated by paternity data. Low levels of inhibin B among individuals are an indication of diminished seminiferous tubule function and thus compromised potential for fertility. Low inhibin B levels together with elevated FSH levels and decreased sperm density are indicative of a high risk of infertility.

Cohort Studies↗
PubMed1980

Experimental zinc deficiency in man. Effect on testicular function.

Dietary zinc intake was restricted (2.7 to 5.0 mg daily) for 24 to 40 weeks in five male volunteers. Their mean age was 57 years. Oligospermia (total sperm count less than 40 million per ejaculate) was induced in four out of five subjects. A decrease in the sperm count occurred during zinc restricion and the early phase of zinc repletion before body stores of zinc were restored to normal. The duration of oligospermia in the four subjects ranged from 6 to 14 months. Oligospermia was reversed after zinc supplementation in physiologic amounts. The baseline sperm concentration and total sperm count per ejaculate in all five subjects dropped significantly (p < 0.05) after zinc restriction and returned to normal 6 to 12 months after zinc supplementation. The decrease in sperm count coincided with decline in Leydig cell function and was reversed after zinc supplementation in low doses. Our study has demonstrated that dietary restriction of zinc can affect testicular function adversely. This effect of zinc deficiency, however, is a reversible process and can be corrected by proper supplementation with zinc.

Aged↗
PubMed2006

Within- and between-subject variation in semen parameters in infertile men and normal semen donors.

OBJECTIVE: To determine within- and between-subject variation of semen parameters in infertile and normal men. DESIGN: Retrospective analysis of 74 infertile men and 65 normal men producing five or more ejaculates each. SETTING: Clinical andrology laboratory. SUBJECT(S): Men presenting to an infertility clinic for semen analysis and normal men providing donor semen for cryopreservation. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Within-subject coefficients of variation (CVw) and between-subject coefficients of variation (CVb), calculated for sperm count, motility, and velocity, semen volume, and motility and velocity after cryopreservation. RESULT(S): The number of ejaculates ranged 5-20 in patients (479 total) and 5-136 in donors (2,043 total). Sperm counts, motility, and velocity were statistically greater in donors, whereas semen volume was significantly greater in patients. The CVw in patients and donors was greatest in sperm counts (54.2% and 45.8%, respectively) and lowest in velocity (20.1% and 19.9%, respectively). The CVb in patients and donors was markedly higher than CVw for all parameters in both patients and donors. The CVw was lower, and the CVb was higher, in donors compared with patients. The CVw was not affected by age of the individual or abstinence period. Cryopreservation resulted in a marked increase in variability. Intraclass correlations indicated that a minimum of three semen samples were required to achieve reliability. CONCLUSION(S): These data indicate large within- and between-subject variation in sperm parameters, especially sperm count, in both patients and healthy donors, and further substantiate the need for measurement of multiple ejaculates before characterizing a man as normal or infertile.

Adult↗
PubMed1997

Rapid recovery of spermatogenesis after mitoxantrone, vincristine, vinblastine, and prednisone chemotherapy for Hodgkin's disease.

PURPOSE: Because the effects of mitoxantrone on human male fertility were unknown, we determined prospectively the effects of three courses of mitoxantrone (Novantrone), vincristine (Oncovin), vinblastine, prednisone (NOVP) chemotherapy on the potential for fertility of men with Hodgkin's disease (HD). PATIENTS AND METHODS: Semen analyses were performed on 58 patients with stages I-III HD before, during, and after chemotherapy and after the sperm count recovered from the effects of abdominal radiotherapy that was given after chemotherapy. RESULTS: Before the initiation of treatment, 84% of the patients were normospermic. Sperm counts declined significantly within 1 month after the start of NOVP chemotherapy. In the month after chemotherapy, 38% of patients were azoospermic, 52% had counts < 1 million/ mL, and 10% had counts between 1 and 3 million/mL. Between 2.6 and 4.5 months after the completion of chemotherapy, sperm counts recovered rapidly to normospermic levels in 63% of patients. In the remaining patients who were followed up for at least 1 year after standard upper abdominal radiotherapy, counts also recovered to normospermic levels. CONCLUSION: NOVP chemotherapy, like most other regimens, produced marked temporary effects or spermatogenesis. However, sperm production recovered very rapidly, within 3 to 4 months after the end of NOVP chemotherapy. This pattern was caused by killing differentiating spermatogenic cells, but there was little cytotoxicity or inhibition of stem cells from mitoxantrone or the other drugs. After the combination of NOVP plus abdominal radiotherapy, sperm counts and motility were restored in most patients to pretreatment levels, which were compatible with normal fertility.

Adult↗
PubMed1990

Semen quality and sex hormones among mild steel and stainless steel welders: a cross sectional study.

Welding may be detrimental to the male reproductive system. To test this hypothesis, semen quality was examined in 35 stainless steel welders, 46 mild steel welders, and 54 non-welding metal workers and electricians. These figures represent a participation rate of 37.1% in welders and 36.7% in non-welding subjects. The mean exposure to welding fume particulates was 1.3 mg/m3 (SD 0.8) in stainless steel welders using tungsten inert gas, 3.2 mg/m3 (SD 1.0) in low exposed mild steel welders using manual metal arc or metal active gas (n = 31), and 4.7 mg/m3 (SD 2.1) in high exposed mild steel welders (n = 15). The semen quality of each participant was defined in terms of the mean values of the particular semen parameters in three semen samples delivered at monthly intervals in a period with occupational exposure in a steady state. The sperm concentration was not reduced in either mild steel or stainless steel welders. The sperm count per ejaculate, the proportion of normal sperm forms, the degree of sperm motility, and the linear penetration rate of the sperm were significantly decreased and the sperm concentration of follicle stimulating hormone (FSH) was non-significantly increased in mild steel welders. A dose response relation between exposure to welding fumes and these semen parameters (sperm count excepted) was found. Semen quality decreased and FSH concentrations increased with increasing exposure. Significant deteriorations in some semen parameters were also observed in stainless steel welders. An analysis of information from questionnaires obtained from the whole population including subjects who declined to participate indicated an underestimation of effects due to selection bias. Potential confounding was treated by restriction and statistical analysis. The results support the hypothesis that mild steel welding and to a lesser extent stainless steel welding with tungsten inert gas is associated with reduced semen quality at exposure in the range of the Danish process specific threshold limit values of welding.

Adult↗