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PubMed2004

Chlamydiae in the ejaculate: their influence on the quality and morphology of sperm.

BACKGROUND: Given the lack of information concerning the role of Chlamydia trachomatis in male fertility, the aim of this study was to ascertain and analyze the quality of Chlamydiae-positive and -negative semen. MATERIAL AND METHODS: Sperm count was performed according to the 1999 World Health Organization (WHO) laboratory manual for examination of human semen and sperm-cervical mucus interaction, and sperm survival was assessed by a 120-min test. The evaluation of the morphological examination of ejaculates was carried out using the sasmo (strict morphological analysis of ejaculates) computer program. Chlamydiae were detected by immunofluorescent reaction using the Progen Biotechnik GmbH diagnostic set. Fisher's exact test and the chi-quadrate test were used for statistical analysis. RESULTS: Of the total of 627 sperm samples examined, Chlamydiae were detected in 136 cases (21.7%). Sperm analysis showed significant differences between Chlamydiae-positive and -negative samples. The Chlamydiae-contaminated group showed normal sperm morphology 14.4% lower, volume 6.4% lower, concentration 8.3% lower, motility 7.8% and velocity 9.3% lower than in Chlamydiae-negative samples. The average values for normal spermatozoa and motility in the Chlamydiae-positive group were also significantly reduced. CONCLUSION: Chlamydia trachomatis was found to be a possible factor in sperm pathology. These results could help to elucidate the role of Chlamydia trachomatis in male infertility.

Chlamydia Infections↗
PubMed1984

Two-dimensional electrophoresis of proteins in various fractions of the human split ejaculate.

Two-dimensional electrophoresis of six fractions of split ejaculates from normal men (median age 23 years, n = 6) revealed large differences in the pattern of proteins found between the prostate-enriched fractions and secretions associated with the seminal vesicles. The glandular contributions were assessed using the concentrations of spermine, zinc and prostatic acid phosphatase (PAP) for prostatic secretion, and fructose and prostaglandin E for seminal vesicle secretion in the various fractions. Aside from PAP, four additional proteins were apparently associated with the prostatic fraction, one of which shared the biochemical characteristics of the specific ventral lobe protein of the rat prostate, prostatein (molecular mass 16 000, pI 4.8). The presumptive vesicular fractions contained a large number of low molecular mass proteins (10-20 000), with widely varying pI-values. The concentration of albumin and transferrin appeared to be highest in the sperm cell enriched fractions, indicating a major contribution to the ejaculate of testicular/epididymal origin.

Adult↗
PubMed1986

The human sperm nucleus takes up zinc at ejaculation.

Ejaculated and vasal sperm were obtained from men referred for vasectomy, and sperm nuclear elements were determined by X-ray microanalysis. Sperm head zinc concentrations, expressed as the ratio Zinc to Sulphur, were significantly higher in ejaculated than in vasal sperm. A physiological sperm nuclear zinc uptake is discussed in relation to sperm chromatin decondensation.

Adult↗
PubMed1991

Successful treatment of infertility due to retrograde ejaculation by instillation of serum-containing medium into the bladder. A case report.

The treatment of infertility caused by retrograde ejaculation has often been ineffective. The unphysiological composition of the urine is the main reason complicating the recovery of motile sperm. We describe a case of retrograde ejaculation caused by a congenital defect of the internal sphinchter muscle of the urinary bladder. In this case, motile sperm were only recovered if the bladder had been filled previously with artificial culture medium (Ham's F-10) supplemented with the patient's own serum. Two pregnancies followed intrauterine insemination with sperm recovered in this way.

Adult↗
PubMed1994

Sperm motility inhibitor from human seminal plasma: presence of a precursor molecule in seminal vesicle fluid and its molecular processing after ejaculation.

Human seminal plasma contains a protein factor that has the capacity to inhibit the movement of demembranated and intact spermatozoa. This factor 'seminal plasma motility inhibitor' (SPMI) has been shown to originate exclusively from the seminal vesicles. The present results demonstrate that the biological activity of SPMI in semen decreases rapidly from 1000 U/ml, immediately after ejaculation, to 220 U/ml 2 h later. Immunoblots of seminal plasma proteins probed with an antibody against human SPMI, revealed the rapid processing of a predominant 52 kDa SPMI antigen, present in the seminal vesicle secretions. This precursor was degraded initially into intermediate molecular mass fragments of 25-40 kDa, and subsequently into smaller fragments of 17-21 kDa. When seminal vesicle fluid was mixed with prostatic secretions (3:1 v/v), proteases present in prostatic secretions were shown to be responsible for processing of the SPMI precursor. Addition of protease inhibitors such as phenylmethylsulphonyl fluoride (PMSF, 5 mM), benzamidine (100 mM) or ethylenediaminetetraacetic acid (EDTA, 5 mM) to the mixture of seminal vesicle and prostate secretions partially prevented the loss of activity of SPMI by 54%, 27% and 9%, respectively. However, the simultaneous addition of PMSF and benzamidine conferred almost total stability to the SPMI precursor activity. These results demonstrate that SPMI exists as a predominant 52 kDa precursor form in the seminal vesicles and is processed rapidly after ejaculation into less active, lower molecular mass forms by one or more serine proteases and/or metalloproteases of prostatic origin which are present in liquefied semen.

Adult↗
PubMed2006

Phosphodiesterase 5 inhibitors in the treatment of premature ejaculation.

To date, there is no FDA-approved therapy for premature ejaculation (PE). Recently, phosphodiesterase 5 inhibitors (PDE5-Is) have been demonstrated to have encouraging results in the treatment of PE by a few studies. The aim of this review was to assess the updated manuscripts and thereafter present the practical recommendations and possible mechanisms concerning PDE5-Is for treating PE. Using MEDLINE, we searched and assessed the peer manuscripts published from 1 January 1996 to 1 September 2005 about PDE5-Is for treating PE. The results show that the number of patients in all the reports is very few and most of the studies do not employ double-blinded and placebo-controlled tests, though they are prospective and randomized. Therefore, the results and conclusions might be biased. PDE5-Is are suggested to be used in PE with old age or associated with erectile dysfunction (ED), or to be employed alone or in combination with selective-serotonin reuptake inhibitors (SSRIs) when SSRIs fail to treat PE; behavioural therapy is proposed to be used for preventing the recurrence of PE following withdrawal of PDE5-Is. In addition, for the PE patient with a definite aetiological cause, the aetiology should be cured first, if PE still exists, followed by PDE-Is prescription. Possible mechanisms that are involved include relaxing the smooth muscles of vas deferens, seminal vesicle, prostate and urethra; decreasing the central sympathetic output; inducing peripheral analgesia; prolonging the duration of erection; and increasing confidence, the perception of ejaculatory control, overall sexual satisfaction, and decreasing the post-orgasmic refractory time to achieve a second erection after ejaculation. Well-designed multicentre studies are urgently warranted to further elucidate the efficacies and safety as well as mechanisms of PDE5-Is in the treatment of PE.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMedDate not supplied

Effect of various prostaglandins on the metabolism of fructose by epididymal and ejaculated ram spermatozoa in vitro.

The effects of a number of prostaglandins on the metabolism of fructose by epididymal and ejaculated ram spermatozoa were investigated using conventional Warburg techniques. Spermatozoa from the two sources were collected concurrently during electrical stimulation; the epididymal spermatozoa were harvested via a cannula inserted chronically into one vas deferens and thus were free from exposure to the seminal prostaglandins. In general, the metabolism of fructose by the spermatozoa was little affected by a wide range of prostaglandins at a concentration of 20 micrograms/ml. Of the PGs present in semen, PGE2, PGE3 and PGF2alpha had no significant effects whereas PGE1 and PGF1alpha significantly increased lactate accumulation and the latter increased oxygen uptake, in both cases without significantly changing fructose utilization, fructose oxidized or CO2 production. Both 15-methyl-substituted PGE2 and PGF2alpha and their corresponding methyl esters failed to change fructose metabolism and it is unlikely therefore that the lack of response to PGE2 and PGF2alpha was due to their being metabolized by the spermatozoa during the incubation. Of a number of breakdown products tested, PGA1 and to a lesser extent PGA2 appeared to inhibit the Krebs tricarbocyclic acid cycle and 15-keto 13,14-dihydro-PGF2alpha appeared to stimulate it. In general, epididymal spermatozoa responded to the PGs in the same way as ejaculated spermatozoa. Thus we did not confirm a suggestion in the literature that spermatozoa have lowered sensitivity to PGs in vitro once they have been in contact with the PGs in seminal plasma.

Animals↗
PubMedDate not supplied

Changes of ejaculation due to suppression of noradrenaline biosynthesis by diethyldithiocarbamate.

The effects of diethyldithiocarbamate on manually induced erection and ejaculation and on monoamines in the brain and male reproductive organs were investigated in male mongrel dogs. From the results obtained in this study it was concluded that diethyldithiocarbamate suppresses ejaculation, although penile erection is maintained, and that the suppression is not mediated by the central nervous system but by the changes of the monoamine levels in the organs relating to sperm transport.

Animals↗
PubMedDate not supplied

On the brain monoaminergic systems relating to ejaculation. III) Further study by using a peripheral decarboxylase inhibitor.

In the previous papers it was reported that ejaculation is facilitated by the brain dopaminergic system, particularly by that in the anterior hypothalamus, and inhibited by the serotonergic system. In an attempt to clarify more precisely the results, a further study was done in dogs by using a peripheral cecarboxylase inhibitor, Ro 4-4602, in combination with tetrabenazine and L-dopa. As a result it was found that in addition to the brain dopaminergic system, the increase in 5-HT level in the limbic system and the decrease in 5-HT level in the brain stem facilitate ejaculation.

Animals↗
PubMedDate not supplied

Micro disc gradient gel electrophoresis of seminal plasma proteins before and after vasectomy and in different split ejaculate fractions.

The seminal plasma proteins of patients before and after vasectomy as well as in different split ejaculate fractions were investigated using gradient polyacrylamide gel electrophoresis. Considerable interindividual variations of the protein patterns were observed. A distinct high molecular weight proteins band was found to disappear after vasectomy. This protein band could b4 attributed to the sperm-rich fraction of split ejaculates. It seems to be of testicular-epididymal origin and may be of interest for functional characterization of the testicular-epididymal fluid and for diagnosis of an occlusion of the excretory duct system.

Body Fluids↗
PubMedDate not supplied

On suppression of ejaculation by Alpha-methyldopa.

Alpha-methyldopa caused inhibition of ejaculation. The cerebral mechanism which induced the inhibition was pursued by determining changes of brain monoamines in dogs. As a result, suppression of the dopaminergic system in the brain by alpha-methyldopa is found to be the origin of the inhibition of ejaculation. This inhibition was recovered by L-dopa with pretreatment with a peripheral decarboxylase inhibitor.

Animals↗
PubMedDate not supplied

Role of the spinal monoaminergic systems in suppression of ejaculation by alpha-methyldopa.

Alpha-methyldopa causes inhibition of ejaculation by suppressing the dopaminergic system in the brain. The spinal mechanism which works together with this brain inhibitory mechanism was persued by determining the changes of spinal monoamines in dogs. As a result, it was found that suppression of the dopaminergic system by alpha-methyldopa is caused also in the spinal cord just as in the brain and that this suppression can be a direct origin of the inhibition of ejaculation.

Animals↗
PubMedDate not supplied

Correlation between gamma seminoprotein in seminal plasma and ejaculate parameters.

Gamma seminoprotein (G-SM) levels in seminal plasma were determinated in 62 ejaculates using an enzymimmunoassay. There was no statistical significant difference in G-SM between men with normozoospermia (n = 14), asthenozoospermia (n = 17), OAT-syndrome (n = 18) and azoospermia (n = 13). Also there was no correlation of G-SM levels in those samples with normal (n = 14) or pathological (n = 35) motility and normal (n = 17) or pathological (n = 32) swelling test. Ejaculates with high viscosity (n = 12) showed similar G-SM levels than those with normal (n = 50) viscosity. According to these results seminal G-SM levels does not appear to provide an useful marker for evaluation of male fertility.

Ejaculation↗
PubMed2005

Influence of motility and vitality in intracytoplasmic sperm injection with ejaculated and testicular sperm.

The vitality of spermatozoa used for intracytoplasmic sperm injection (ICSI) is a crucial factor for fertilization, establishment and outcome of a pregnancy in assisted reproductive technique cycles. The sperm origin may also be a limiting factor, although little is known about this issue. It is known that the motility of injected spermatozoa and their origin from ejaculate or testicular biopsies are important predictors in terms of fertilization, pregnancy and birth rates. Oocytes of patients in 2593 cycles were retrieved in our in vitro fertilization programme and inseminated via ICSI. We used motile (group 1, n = 2317) or immotile ejaculated spermatozoa (group 2, n = 79), motile sperm retrieved from testicular biopsies (group 3, n = 62) and immotile spermatozoa from testicular biopsies (group 4, n = 135). Female age and number of oocytes retrieved did not differ significantly among the groups. The fertilization rates were as follows: 67.1% in group 1, 49.8% in group 2, 68.3% in group 3 and 47.8% in group 4. The pregnancy rates in cases where three embryos had been transferred amounted to 35.7% in group 1, 17.3% in group 2, 38.3% in group 3 and 20.5% in group 4. The embryo quality showed no differences between groups 1 and 3 (14.5), and between groups 2 (11.8) and 4 (10.8). The abortion rate was similar in groups 1-3, but increased in group 4 (26.6%, 27.3%, 31.6% and 55.5%). Irrespective of their origin, the fertilization potential of injected spermatozoa was found to be influenced by motility. The resulting pregnancy and birth rates, i.e. the potential of the resulting embryos to implant and to achieve viable pregnancies, seem to be additionally dependent on the sperm origin. This was well shown by declining rates when spermatozoa in a relatively early stage of maturity had been used. We see increasing evidence that the degree of sperm maturity has an important impact on the outcome of ICSI. In obstructive azoospermia, spermatozoa retrieved from the epididymis should be used rather than testicular biopsy spermatozoa, or testicular sperm should be preincubated in culture medium before ICSI.

Adult↗
PubMed1991

Sperm retrieval by electro-ejaculation. Preliminary experience in patients with secondary anejaculation.

Twelve patients with spinal cord injury and 2 diabetics with secondary anejaculation underwent 26 sessions of electro-ejaculation, using a technique which has previously been popular only in veterinary medicine. Ejaculate was obtained on 21 occasions. Semen quality was adequate for cryostorage on 9 occasions (8 patients); on 8 occasions (5 patients) it was used for immediate artificial insemination of the partner. To date, there has been 1 pregnancy resulting in a live birth.

Adult↗
PubMed1992

An unusual case of retrograde ejaculation.

Despite normal seminal analyses obtained for assay by masturbation, persistent negative postcoital tests led to the testing of postejaculatory urine following normal intercourse. This disclosed an unusual problem of retrograde ejaculation occurring only during intercourse. The mechanism for this selective form of retrograde ejaculation is unknown.

Ejaculation↗
PubMed2004

Standards for clinical trials in male sexual dysfunction: erectile dysfunction and rapid ejaculation.

INTRODUCTION: The introduction of safe and effective therapies for sexual dysfunctions depend upon appropriate clinical protocol design, study procedures, data collection and analysis. AIM: To provide recommendations/guidelines concerning state-of-the-art knowledge for standards for clinical trials in sexual dysfunction in men, particularly in the areas of erectile dysfunction and rapid ejaculation. METHODS: An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Standards for Clinical Trials in Male Sexual Dysfunction Committee, there were six experts from four countries. MAIN OUTCOME MEASURE: Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. RESULTS: Drug development requires a multiphased approach. Phase 1 studies investigate multiple-dose safety, tolerability and pharmacokinetic issues. Phase 2 programs explore dose ranging (lowest effective, maximally tolerated and toxic doses). Phase 3 trials provide the substantial evidence including drug-drug interaction data and studies in special populations. Clinical studies require validated outcome assessment instruments conducted in defined but representative patient populations. Daily diaries or per-event questionnaires are patient-reported outcomes that assist in retrospective questionnaire interpretation. A qualified biostatistician should calculate the sample power for the trial, type of statistical model and design employed, use of covariate or subgroup analyses, and calculation of effect sizes. CONCLUSIONS: More research is needed in developing standards for use in the development of clinical trials and outcomes assessment researching either erectile dysfunction or rapid ejaculation.

Consensus↗
PubMed2005

Premature ejaculation--does country of origin tell us anything about etiology?

INTRODUCTION: Premature ejaculation is a common sexual problem. The etiology of this condition is unclear. It has been suggested that some racial groups may be more at risk than others. We had a clinical impression that in our unit in London, UK, there was a preponderance of men from Islamic and Asian backgrounds. AIM: We therefore undertook a retrospective analysis of our clinic population over an eighteen-month period. METHODS: A total of 123 patients were identified with a clinical diagnosis of PE based on the DSM-IV and UK national guidelines. MAIN OUTCOME MEASURE: Demographic and clinical data were collected retrospectively: parameters of patients seen in the previous 18 months were identified, including self-identified ethnicity and age. Patient-defined ethnicity was compared with the ethnicity of self-referring patients attending our general sexual health services (outpatients), and also with local population census data. RESULTS: A total of 60% of patients were from Islamic or Asian backgrounds but 12% and 11% came from those racial groups in local population census data and our general clinic population respectively (P<0.001). CONCLUSIONS: It thus appears that there is a preponderance of men from Islamic and Asian backgrounds presenting to our unit with premature ejaculation. The reasons for this are unclear. Possible mechanisms include psychosocial, familial, or genetic influences.

Adult↗