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Reversible inhibition of sperm production and gonadotrophin secretion in men following combined oral medroxyprogesterone acetate and percutaneous testosterone treatment.

Six men requesting male contraception received a daily oral dose of 20 mg medroxyprogesterone acetate (MPA) in combination with 50 or 100 mg percutaneous testosterone for 1 year. From the third month the sperm concentration was less than 10(6)/ml for all the men at one time or another during treatment, and usually less than 5 X 10(6)/ml, with an average reduction of 95% with respect to pre-treatment values. The sperm count returned to previous values 3-6 months after cessation of the treatment. While FSH and LH secretion was inhibited throughout the treatment period, plasma testosterone levels were not reduced. Oestradiol levels were unaffected while dihydrotestosterone was elevated. The secretory activity of the prostate and seminal vesicles was not appreciably affected; seminal carnitine concentration was reduced during the treatment with a subsequent return to pretreatment values. No pregnancies occurred during treatment. There was no impairment of libido in the subjects, nor any incidence of gynaecomastia, or increase in average body weight. The only observed metabolic side-effect was a moderate increase in glycaemia. A synergistic action of MPA and testosterone is proposed to explain the inhibition of gonadotrophin secretion.

Adult↗

The production, morphology, karyotypes and transport of spermatozoa from tertiary trisomic mice and the consequences for egg fertilization.

Tertiary trisomic males, carrying the small translocation chromosome from the T(1;13)7OH reciprocal mouse translocation as the extra chromosome, are oligospermic. Uterine and oviductal sperm counts were congruent to 10% of normal. Of the uterine spermatozoa, 77-2% were morphologically abnormal compared with 24-6% in the oviduct. Oligospermy in the tertiary trisomic males leads to delayed fertilization; 34-8% of the 109 eggs scored between 5-5--9-5 hr after mating were fertilized compared with 52-1% (n=343) at Day 2. Of the 179 morulae/blastocysts recovered at Day 4, 46-9% contained the small marker chromosome, which agrees with earlier cytological studies on secondary spermatocytes. These results indicate that euploid and aneuploid spermatozoa are formed in about equal numbers and there is no relationship between sperm morphology and karyotype.

Age Factors↗

[The effect of kallikrein on sperm motility (author's transl)].

The effect of kallikrein (240 KE/week i.m. or 600 KE/day orally) on the sperm count, sperm motility and morphology was investigated in 27 patients with pathological ejaculate findings. Kallikrein was administered over a period of 9 to 12 weeks. A significant increase in sperm motility was observed in patients with asthenospermia. No influence was noted on the ejaculate findings in patients with oligospermia. Interference between the kallikrein-kinin system and sperm motility is postulated.

Adult↗

Antibodies to spermatozoa. VII humoral and cellular aspects of sperm inmunity and infertility.

The occurrence of sperm antibody in serum and cervical mucus of women from intertile couples in the serum of their male partners, as well as cellular immunity to sperm, has been studied by agglutination and immobilization techniques. For a total of about 260 couples, the tests on serum showed that 18% of the women and 8% of the men were positive by the Kibrick technique and that 15% of the women and 4% of the men were positive by the F-D technique. The women who were positive in their cervical mucus were 8% of the group by the K-agg (Kibrick agglutination) technique, 2% by the MIS-agg. (Microscale agglutination) technique, and 40% by the MIS-imm. (Microscale immobilization) tecnique. In considering all three techniques. 42% of a group of 132 women were positive. Cellular immunity to sperm, by the Migration Inhibition method, was positive in 18% and zero per cent of infertile and fertile women, respectively.

Antibody Formation↗

Is high dosage testosterone an effective male contraceptive agent?

In male contraceptive trials, approximately half of normal men become azoospermic on high dosages of testosterone enanthate (TE), whereas the other half of men become severely oligozoospermic. To determine whether sperm function is reduced in men with severe oligozoospermia induced by TE, we studied sperm function in six normal men whose sperm counts were reduced to less than or equal to 5 X 10(6)/ml but not to azoospermia by high-dosage TE administration for 5 to 6 months and five normal men who received placebo (sesame oil) injections for the same period of time. Seminal fluid analysis and sperm function (as assessed by zona pellucida-free hamster ova penetration test, HOPT) were performed during a pretreatment period and after at least 3 months of TE or placebo treatment. HOPT was severely reduced in all six men, whose sperm counts were suppressed to severe oligozoospermia during TE (0.8 +/- 0.8% compared to 37 +/- 14% during the pretreatment period, P less than 0.05). Five men failed to penetrate any hamster ova, while the remaining man penetrated only 5% of ova during TE treatment. There were no significant changes in other seminal fluid measurements during high-dosage TE. The five men who received placebo injections did not demonstrate any significant changes in HOPT or seminal fluid analysis during the treatment period. In summary, we found that the fertilizing capacity of sperm is markedly diminished when sperm production is severely reduced by high-dosage TE administration. These findings suggest that male contraception may be achievable by reduction of spermatogenesis to severe oligozoospermia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Sperm auto-immunity associated with vasectomy, vasovasostomy and epididymovasostomy in Korean males.

The prevalence and pattern of circulating antisperm antibodies were assessed in the serum of Korean males undergoing vasectomy, vasovasostomy, epididymovasostomy and in a control group of men with normal semen by means of the gelatin agglutination test and the tray agglutination test. Sperm-agglutinating antibodies in serum were positive at a titre of 1:32 or greater in 3% of normospermic control males and in 27% of vasectomized men. No significant changes were observed in prevalence of the antibodies over the period following vasectomy. There were no significant differences in prevalence of antibodies in patients with and without postoperative sperm granulomas. Antibodies were positive in 35% of vasectomized men just prior to vasovasostomy and in 29% of patients 12 months after a successful (patent) reversal operation. There was no significant difference in prevalence of antibodies in patients with successful and unsuccessful vasovasostomies. Antibodies were positive in 20% of men who achieved pregnancies and in 43% of those with persisting infertility in the presence of a patent vasovasostomy. Sperm agglutinating antibodies were present in 5% of the patients with pathological epididymal obstruction. They were negative in patients with a patent epididymovasostomy and positive in 17% of those with an unsuccessful epididymovasostomy. The four patients who achieved a pregnancy after epididymovasostomy were antibody-negative. The prevalence of antibodies in the serum of patients with azoospermia due to surgical vasal obstruction was higher than that in patients with azoospermia due to pathological epididymal obstruction. The agglutination patterns produced by sperm antibodies in the total group of positive sera were tail-to-tail in 56%, head-to-head in 30% and mixed in 14%.

Adolescent↗

Sperm autoimmunity in vasectomized men and its relationship to atherosclerotic coronary artery disease.

A study is reported of sperm autoimmunization in 707 men and its relationship with atherosclerotic coronary artery disease. The following groups were studied: healthy vasectomized men (278), healthy non-vasectomized men (231), vasectomized men with atherosclerotic coronary disease (ACD; 87) and non-vasectomized men with ACD(111). The gelatin agglutination test (GAT), tube slide agglutination test (TSAT) and sperm immobilization test (SIT) were used to detect circulating anti-sperm antibodies. Sperm antibodies developed within 6 months of vasectomy and persisted for more than 20 years. There was no difference in the incidence of antibodies in vasectomized healthy and ACD men. The results of this study provide no evidence for an association between cardiac disease and vasectomy.

Adult↗

Recovery of spermatozoa from human vaginal washings.

Sperm survival, in terms of numbers, motility, viability, and metabolic activity, was studied in vaginal washings obtained daily from 22 healthy, fertile, married women during one complete menstrual cycle. The numbers of sperm (counted on Papanicolaou-stained filters) were never large compared to the number of sperm in a single ejaculate. Forty-eight hours after intercourse, only 6% of the specimens showed any evidence of sperm. Motile sperm were observed in only six of 94 postcoital specimens examined within 12 hours after intercourse. Lack of sperm in specimens collected after reported intercourse was associated with contraceptive practices other than the rhythm method, which most of the subjects were using. Fluorochromatic studies of recovered sperm treated with acridine orange indicated sperm viability and phase contrast studies of sperm treated with tetrazolium salts revealed metabolic activity. Our data on sperm motility, numbers, and staining reactions support the conclusion that the small number of sperm that remain in the vagina after intercourse quickly become inactivated.

Cell Count↗

Effect of topically applied adrenergic blockers on fertility.

The contraceptive properties of two adrenergically active drugs, propranolol and reserpine, were measured in vivo and in vitro. Propranolol became effective as a spermicide for human sperm at a concentration of about 2 x 10(-3) M and for rat sperm at 2 x 10(-2) M. Reserpine was also more effective on human than rat sperm and about 20 times less effective than propranolol. Both propranolol and reserpine prevented implantation when instilled into the uteri of rats. The anti-implantation effect persisted for up to 5 days after instillation of propranolol. When freely breeding rats eventually became pregnant after daily vaginal instillation of propranolol, the number of uterine implantations decreased as the concentration of vaginally instilled propranolol increased. The implantations tended to be toward the fundal end of the uteri, away from the source of propranolol, thus indicating a topical rather than a systemic anti-implantation effect.

Animals↗

Fertilizing capacity and sperm antibodies in vasovasostomized men.

In order to explain the discrepancy between the patency rate (80%) and the pregnancy rate (46%) in a series of vasovasostomies, attention was focused on a group of patients who became normospermic. The mean age at vasectomy, the duration of vasobstruction, and the parameters of semen analysis were not different for those couples who achieved a pregnancy (n = 8), compared with those couples without pregnancy (n = 7). In the group with pregnancy, six of the eight patients had low titers of serum agglutinins (absent to 1:32), and the fertilizing capacity of their spermatozoa was normal. None had immobilizing antibodies. In the group without pregnancy, six of the seven patients had elevated serum agglutinins (greater than 1:256), and four had agglutinating antibodies in their seminal plasma as well as serum immobilizing antibodies. The spermatozoa of seven patients failed to fertilize zona-free hamster ova. It is concluded that a loss of fertilizing ability of the spermatozoa due to sperm antibodies is an important cause of infertility in vasovasostomized men.

Adult↗