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PubMed1998

[The effect of frequent ejaculation on semen's parameters in men with inadequate fertility].

The influence of frequent ejaculation on sperm quality in 96 men with oligozoospermia, asthenozoospermia or oligoastenozoospermia was investigated. Ejaculates were produced by each patient in short period of time (4-6 hours). In oligozoospermic group (n = 31) semen characteristics were similar between two ejaculates. In asthenozoospermic group (n = 27) the motility and the total motile sperm count increased significantly in the second ejaculate (32.1% 5.6 vs. 48.0% +/- 7.1 and 36.7 mln +/- 5.6 vs. 47.8 mln +/- 7.6 respectively). Similarly in oligoasthenozoospermic group (n = 38) the motility and the total motile sperm count increased significantly in the second ejaculate (28.1% +/- 5.3 vs. 44.2% +/- 6.2 and 7.1 mln +/- 1.2 vs. 11.3 mln +/- 2.7 respectively). In three groups, pooling two ejaculates increased significantly the total motile sperm count by 58.1%-136.6% comparing to first ejaculate. Pooling two sequential ejaculates from subfertile men is a simple method to increase the quality of sperm for assisted reproduction techniques.

Ejaculation↗
PubMed1999

Effects of intensified training and detraining on testicular function.

OBJECTIVE: To examine the effects of an increased training load and period of detraining on testicular function in male distance runners. DESIGN: Multiple-group time-series design using a control group. SETTING: University of Toledo and Toledo Hospital. PARTICIPANTS: Eight male runners and eight age-matched sedentary control subjects. Subjects were considered fit for participation after a physical and genital examination conducted by a physician. INTERVENTION: Subjects provided blood and semen samples every 2 weeks for 8 weeks. The training regimen for the runners consisted of 2 weeks at normal training (NT), 2 weeks at 143% of NT (IT1), 2 weeks at 186% of NT (IT2), and 2 weeks at 50% of NT (RT). These percentages represent increases in training distance (volume). MAIN OUTCOME MEASURES: Within the context of this investigation, the following hypothesis was developed: increases or decreases in training would not significantly alter sperm count, density, motility, or morphology, or concentrations of reproductive hormones or cortisol in runners. RESULTS: There were no statistically significant differences observed between runners and control subjects for any of the reproductive hormones or cortisol. In addition, there was no significant treatment effect for sperm count, motility, or morphology. The sperm levels in two runners in this investigation dropped to oligospermatic levels after IT2; however, total sperm count increased in both runners after 2 weeks of RT. CONCLUSION: Four weeks of increased training and 2 weeks of reduced training did not significantly affect the subjects in this investigation. It is possible that a particular level or degree of training must be surpassed before any clinical alterations are evident. Future longitudinal studies are necessary to identify the extent to which endurance training may alter reproductive hormones and testicular function.

Adult↗
PubMed1979

[Improvement of male fertility through ligation of varicocele? A study of 100 subfertile varicocele patients three months after ligation (author's transl)].

With 100 subfertile varicocele patients, three months after ligation (high ligation of the left internal spermatic vein in accordance with Bernardi) had control spermiograms made. An improvement of sperm count (upgrade in a higher class according to MacLeod's partition) was found in 28% of the cases, whereas an improvement of progressive motility was found only in 13%. The percentage of patients reaching the normal value in sperm count of over 40 mill./ml increased from 23% to 39%. The increase in these patients came primarily from the class of 20--40 mill./ml. In progressive motility, there was an increase of patients reaching the standard value of over 40%, from 6 to 11. However, if sperm count and progressive motility together were evaluated in the individual patients after ligation, only 6 patients presented a normospermia, i.e. a sperm count of more than 40 mill./ml with normal progressive motility. Thus 94 of the 100 patients must be considered as subfertile three months after ligation. A significant fertility improvement through ligation of varicocele has not yet taken place.

Adult↗
PubMed2002

Can varicocelectomy significantly change the way couples use assisted reproductive technologies?

PURPOSE: We assessed how varicocelectomy alters semen quality in a large cohort of infertile men and determined whether it can change patient candidacy for assisted reproductive technology procedures. MATERIALS AND METHODS: A cohort of 540 infertile men with clinical palpable varicocele underwent microsurgical varicocelectomy and were followed more than 1 and 2 years postoperatively for alterations in semen quality and conception, respectively. Preoperatively and postoperatively the total motile sperm count was calculated in all semen analyses. Based on total motile sperm count values patients were divided into 4 groups according to the type of assisted reproductive technology for which they qualified, including 0 to 1.5 million or less (intracytoplasmic sperm injection candidates), 1.5 to 5 million or less (in vitro fertilization candidates), 5 to less than 20 million (intrauterine insemination candidates) and 20 million or greater sperm (spontaneous pregnancy candidates). Preoperative and postoperative semen quality was compared among individuals in these cohorts to determine the shifts in assisted reproductive technology care that are possible after varicolectomy. RESULTS: Mean patient age was 29.5 years (range 18 to 58). Microsurgical varicocelectomy was bilateral in 393 patients (73%), on the left side in 146 (27%) and on the right side in 1 (0.2%). A positive response to varicocelectomy, defined as a greater than 50% increase in total motile sperm count, was observed in 271 patients (50%). An overall spontaneous pregnancy rate of 36.6% was achieved after varicocelectomy with a mean time to conception of 7 months (range 1 to 19). Of preoperative in vitro fertilization and intracytoplasmic sperm injection candidates 31% became intrauterine insemination or spontaneous pregnancy candidates after varicolectomy. Of intrauterine insemination candidates 42% gained the potential for spontaneous pregnancy. CONCLUSIONS: Varicocelectomy has significant potential not only to obviate the need for assisted reproductive technology, but also to down stage or shift the level of assisted reproductive technology needed to bypass male factor infertility.

Adolescent↗
PubMed1989

Methylmercury- and mercuric-chloride-induced alterations in rat epididymal sperm.

Four-week-old male albino rats weighing 70 +/- 5 g were treated intraperitoneally daily with 0, 5 and 10 micrograms methylmercuric chloride (MMC)/kg or 0, 50 and 100 micrograms mercuric chloride (MC)/kg body weight, respectively, over a period of 90 days. Studies were carried out a intermittent intervals, i.e. on days 0, 15, 30, 60 and 90 of the experiment. Gradual decrements in body and epididymal weights were observed from day 30 onwards in both the MMC- and MC-treated groups. Morphological deformations of epididymal epithelium were noted from day 30 onwards in the mercurial-treated groups. MMC treatment caused severe degeneration of the epididymal epithelium on days 60 and 90 in comparison to MC treatment. Total sperm count was significantly less in the MC-treated groups, while motile sperm count was affected most in the MMC-administered groups. The frequency of sperm abnormality increased consistently at both doses of mercurial treatment over a period of 90 days. Maximum sperm abnormality among the treated groups was noted in the groups given 10 micrograms MMC/kg. The observations revealed that MMC and MC have variable potency to alter epididymal structure and the sperm.

Animals↗
PubMedDate not supplied

[Evaluation of seminal and hormonal parameters in idiopathic varicocele before and after surgical intervention].

268 patients (age 16-47 years) affected with idiopathic varicocele, submitted to surgery, have been studied. Semen analysis, pampiniphorm plexus doppler examination and testosterone, estradiol, D4 androstenedione, DHEA-S, HPRL, 17-OH-P, FSH and LH (basal and after LH-RH) evaluation, before and 6 months after surgery, were performed. The patients were divided in 3 groups (A, B and C) according to sperm count. Pre-surgery seminal parameters in A group were significantly reduced in comparison with control group. Six months after surgery, a significant increase of total and forward progression, Swelling test, Acridine Orange and in vitro penetration (CMPT) was observed. Sperm count showed an increase, although being still significantly reduced in comparison with normal controls. In B group, before surgery, sperm count, viability, Acridine Orange and CMPT were significantly reduced in comparison with controls. Six months after surgery, viability, Acridine Orange and CMPT resulted significantly improved. In C group, before surgery, CMPT resulted significantly reduced in comparison with controls. After surgery, semen framework improved without significant differences in comparison with normal controls. No significant differences were observed for hormonal patterns before and after surgery.

Adolescent↗
PubMed1977

Serum gonadotrophins, testosterone and spermatogenesis in subfertile men.

In 210 subfertile men there existed a significant positive correlation between serum FSH and LH (0.41). No correlation was observed between the gonadotrophin levels and testosterone. In contrast to this FSH as well as LH were negatively correlated with the natural logarithm (ln) of the sperm count/ml ejacate (-0.44 and -0.18, respectively). When the positive correlation which existed between FSH and LH was used to calculate partial correlation coefficients, the coefficient between FSH and ln sperm count did hardly change (-0.41) the coefficient between LH and ln sperm count on the other hand became insignificant (-0.05). This suggests that spermatogenesis influences FSH serum levels in subfertile men by a decreased suppression when sperm production is diminished. Testicular biopsies taken from 97 of these patients were used to determine biopsy scores. These scores showed a significant negative correlation with FSH (-0.34) and a positive one with ln sperm count/ml ejaculate (0.45). Interestingly the biopsy score of 16 patients who fertilized their wives, was found to be higher compared with the score of the other patients who did not fertilize. The number of sperm/ml ejaculate and the FSH values of these 2 groups of biopsied patients were, however, not significantly different. This leads to the conclusion that the biopsy score is a better parameter for the evaluation of oligospermic men than either sperm count or FSH serum values.

Follicle Stimulating Hormone↗
PubMed1997

Varicocele treatment in pubertal boys prevents testicular growth arrest.

PURPOSE: There is evidence that varicocele damage, as reflected by loss of testicular mass, is most striking in the pubertal age group. We attempted to evaluate the long-term effect of early varicocele treatment on testicular growth and sperm count and, thus, determine its prophylactic value. MATERIALS AND METHODS: We compared testicular mass and sperm count in 32 men (mean age 28 years) who underwent surgery for varicocele at 11 to 15 years old (mean age 13) to those in 26 untreated, age matched men (mean age 30 years) with varicocele and 27 male controls (mean age 25 years). Mean followup in the treated group was 14.5 years (range 12 to 20). Testicular volumes were measured by ultrasonography. RESULTS: There was no significant difference between left and right testicular volumes in the treated or control group, in contrast to the untreated group, in which the left testicles were significantly smaller. Comparison of testicular mass showed a striking similarity between the treated and control groups, while there was a significant difference when the untreated group was compared to the control and operated groups. Total sperm counts were significantly less in the untreated than the treated and control groups. CONCLUSIONS: These data support the notion that testicular hypotrophy related to varicocele may be reversed by early intervention and they further strengthen the indication for varicocelectomy in children.

Adolescent↗
PubMed1981

Andrological evaluation of oligozoospermic men for AIH.

A protocol for the assessment of oligozoospermia prior to AIH is presented. Three to six carefully performed semen analyses at optimal intervals are required to confirm oligozoospermia. Routine semen analysis consist of volume, pH, viscosity, sperm count, motility, morphology, agglutination, fructose content, and leukocytes. Because of the high incidence of reproductive tract infection and chromosomal abnormalities in oligozoospermic men, microbiological investigation and full chromosomal analyses should be performed in all cases with sperm counts below 10 million/ml. Chromosomal abnormalities are an indication to reject a couple from AIH. Genital tract infections must be treated prior to insemination. Only sperm counts below 10 million/ml require the estimation of FSH levels. The existence of an oligozoospermia group with pituitary adenoma justifies routine PRL measurements in all cases of oligozoospermia and further investigations such as visual field examination and sella tomogram in case of hyperprolactinemia. Testicular biopsy may indicate an epididymal block that can be surgically repaired. Simultaneous in-depth evaluation of the female partner is emphasized, as oligozoospermia in the man does not rule out the possibility of an additional infertility factor in his partner. It is still controversial whether or not AIH, as compared to intercourse, will improve the conception rate for oligozoospermic men.

Cervix Mucus↗
PubMed2002

Lack of standardization in performance of the semen analysis among laboratories in the United States.

OBJECTIVE: To determine the level of standardization in performance of the semen analysis among clinical laboratories in the United States. DESIGN: A survey was mailed to laboratories requesting information about the laboratory and performance of the semen analysis. Responses were received from 536 laboratories. SETTING: Clinical laboratories enrolled in the American Association of Bioanalysts Andrology Proficiency Testing Program. PATIENT(S): None. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Agreement among laboratories. RESULT(S): Sixty-one percent of respondent laboratories were part of an assisted reproductive technology program. The laboratories perform less than 50 (53%), less than 10 (25%), or less than 5 (16%) andrology laboratory procedures per month. The laboratories routinely report sperm count (94% of laboratories), motility (95%), morphology (85%) and forward progression (69%), and semen volume (96%) as part of the semen analysis. Only 64% of laboratories routinely report abstinence, and 60% of laboratories indicate the criteria used for sperm morphology on the report form. The most common lower limits of normality for sperm count and motility were >20 x 10(6)/mL (77% of laboratories) and >50% (59% of laboratories), respectively. Few laboratories performed quality control for sperm counts (29%), motility (41%), and morphology (41%). CONCLUSION(S): These data indicate a significant lack of standardization in the performance and reporting of semen analyses among laboratories in the United States.

Humans↗
PubMed2005

Deletions in L-type calcium channel alpha1 subunit testicular transcripts correlate with testicular cadmium and apoptosis in infertile men with varicoceles.

OBJECTIVE: To identify and understand predictors of successful varicocelectomy. DESIGN: Examination of testicular L-type voltage-dependent calcium channel (L-VDCC) mRNAs and proteins in testis biopsies and comparison of presence and absence of various mRNAs with testicular cadmium levels, with apoptosis, and with sperm count change after varicocelectomy. SETTING: University clinical urology practice and research laboratories. PATIENT(S): Infertile men with varicocele (left varicocele only, n = 18; bilateral varicoceles, n = 26) and controls (men with obstructive azoospermia undergoing testicular sperm extraction before intracytoplasmic sperm injection; n = 7). INTERVENTION(S): Left testis biopsies by percutaneous needle aspiration biopsy. Varicocele repair by subinguinal approach. MAIN OUTCOME MEASURE(S): Calcium channel mRNA sequence by reverse transcription-polymerase chain reaction and amplicon analysis; calcium channel protein distribution by immunocytochemistry; cadmium levels by atomic absorption and apoptosis by deoxynucleotidyl transferase labeling; and sperm counts in the ejaculate before and after varicocelectomy. RESULT(S): Calcium channel mRNAs are polymorphic in human testis biopsies from different men. Proteins from sequence-deleted exons 7 and/or 8 localize to germ cell membranes. Expression of undeleted L-type calcium channel mRNAs correlates with normal testes cadmium and increased sperm count after varicocelectomy. Apoptosis is lower in such cases. CONCLUSION(S): Expression of normal testicular L-VDCC sequence in exons 7-8 predicts postvaricocelectomy sperm count increase. Deletions may alter calcium channel function and affect testicular cadmium and apoptosis.

Adult↗
PubMed1990

Hypothalamic-pituitary-testicular function in 70 patients with myotonic dystrophy.

Hypothalamic-pituitary-testicular function was studied in 70 patients with myotonic dystrophy (MD). The diagnosis was confirmed by electromyography. The mean age of the patients was 36.2 +/- 13.2 yr and the duration of the disease was 11.17 +/- 8.01 yr. Testicular atrophy (testes less than or equal to 12 ml on a Prader orchidometer) was present in 65.5% of patients. Fertility among married patients was 66.6%. Mean testosterone plasma levels were 438 +/- 298 ng/dl vs 520 +/- 185 ng/dl in the control group (P = NS). Basal plasma FSH and LH levels, and their response after the administration of 100 mcg of LH-RH were significantly increased although a wide dispersion was observed. Sperm count was carried out in 27 cases, showing a normal count in 7, oligospermia in 12, and azoospermia in 8 patients. Testicular biopsy was performed in 45 patients being normal in 2, showing mild testicular damage in 8, moderate in 14, and severe in 18; it was nule in 3 of them. A significant relationship between testicular atrophy and the sperm count (p less than 0.01), testicular damage and testicular atrophy (p less than 0.025), and sperm count and testicular damage (p = 0.017) was found. Basal plasma FSH and LH level were significantly related to the degree of damage in the testicular biopsy. All these findings indicate a primary testicular pathology, prevailing tubular over interstitial damage. We have not found any association between the duration of the disease and gonadal dysfunction.

Adolescent↗
PubMed1995

Effectiveness of crossover transseptal vasoepididymostomy in treating complex obstructive azoospermia.

OBJECTIVE: To review the indications, surgical technique, and results of crossover transseptal vasoepididymostomies for treatment of complex obstructive azoospermia and oligospermia. DESIGN: Retrospective review of our experience with crossover transseptal end-to-side vasoepididymostomies in 10 men. INTERVENTIONS: Ten men underwent crossover transseptal end-to-side vasoepididymostomies. Nine men had primary and one had secondary infertility. Seven men were azoospermic, and the remaining 3 had severe oligospermia (sperm density < 1 x 10(6)/mL). All had a combination of irreparable ipsilateral ductal obstruction or agenesis with a normal testis and a poorly functional or absent contralateral testis. Contralateral testicular atrophy was associated with a prior hernia repair in 3 men, varicocele-induced atrophy in 2, and severe orchitis in 2. Cryptorchidism, testicular torsion, and one unknown cause were reported for three others. Congenital absence of the vas deferens caused the ipsilateral ductal pathology in 5 men. Three men had a vas injury from pediatric inguinal surgery, and 2 had an idiopathic vas obstruction. RESULTS: Twelve microsurgical crossover transseptal vasoepididymostomies were performed (2 men had repeat procedures). Anastomosis was performed to the caput in five men, the corpus in two, and the cauda in three men. Eight of nine men followed for 6 months or more had sperm in their ejaculate. Two of seven couples have established pregnancies. Total sperm counts ranged from 18 to 201 x 10(6) (mean, 98.1 x 10(6)) with motility of 5% to 37% (mean, 13%). Men with congenital absence of the vas deferens had significantly lower postoperative total sperm counts than men with all other causes of ductal pathology: 37.8 x 10(6) versus 135 x 10(6). No other characteristics (type of infertility, preop semen analysis, cause of testicular pathology, site of epididymal anastomosis) were useful predictors of postoperative sperm counts. CONCLUSIONS: If there is a solitary functioning testis with irreparable excurrent ductal obstruction or agenesis, a crossover transseptal vasoepididymostomy can restore patency in most men.

Adult↗
PubMed2007

Luminal suture thread as a guide for anastomosis: a new vasovasostomy technique.

OBJECTIVE: To use a new vasovasostomy technique for reversal of vasectomy. DESIGN: Case report. SETTING: Clinical and academic research environment. PATIENT: A patient who had undergone vasectomy. INTERVENTION: We used 4/0 prolene as a guide during anastomosis for reversal of vasectomy. MAIN OUTCOME MEASURE: Semen analysis. RESULT(S): Three months after the operation, the spermiogram showed the sperm count, the percentage of normal morphologic sperm, progressive motility, and vitality as 9 million/L, 70%, 33%, and 60%, respectively. Six months later, the spermiogram was repeated and the following results were obtained: the sperm count, the percentage of normal morphologic sperm, progressive motility, and vitality as 14 million/L, 65%, 40%, and 65%, respectively. CONCLUSION(S): This new technique is cost-effective, easy, cheap, and less time-consuming, and has a high success rate.

Adult↗
PubMed2003

Assessment of antifertility activities of abamectin pesticide in male rats.

The effects of abamectin pesticide on fertility of adult male Sprague-Dawley rats were investigated. Adult male rats were exposed to tap water containing 0, 571, 857, or 1714 ppm abamectin for 6 weeks. Based on fluid consumption, animals received 0, 1.19, 1.87, and 2.13 mg/animal/day abamectin, respectively. Fertility was significantly reduced in male rats ingesting abamectin at all three doses in that the number of females impregnated by them was significantly reduced. The number of viable fetuses was significantly reduced in females mated with males that ingested abamectin at 1.87 or 2.13 mg/animal/day. Significant increases in the total number of resorptions and the number of females with resorptions were observed in females mated with the exposed males at all three concentrations. The body weight gain and water consumption were significantly lower in males that ingested 2.13 mg/animal/day abamectin. Likewise, ingestion of abamectin at all three concentrations caused a significant increase in the weight of testes. Epididymal and testicular sperm counts and daily sperm production were significantly decreased in exposed males. The serum level of testosterone was significantly reduced, whereas the serum level of follicle-stimulating hormone was significantly increased in males that ingested abamectin at a concentration of 2.13 mg/animal/day. Histological evaluation of the testes revealed several abnormalities including infiltration with congested blood vessels with marked hemorrhage and a significant accumulation of connective tissue surrounding the seminiferous tubules. These results strongly suggest the adverse effects of abamectin pesticide on male rat fertility.

Administration, Oral↗
PubMed2002

Effects of resin based dental composites on fertility of male mice.

The purpose of this study was to investigate the effect of leached substances from dental composites on the fertility of male mice. Twenty adult male Swiss mice were divided into two groups of 10. Leached substances from composite specimens were administered, intragastrically, daily to the mice in the test group and distilled water to the control group for 28 d. Each mouse from both groups was mated with two untreated females. After mating, fertility of male mice in both groups was assessed. There was a significant reduction in the number of pregnancies in females mated with test males in comparison to those mated with control males (12/20 vs. 18/20, respectively). Females impregnated by test male mice showed a significant increase in the number of resorptions out of the total number of implantations (11% test vs. 1.5% control). The testicular sperm count and daily sperm production of the males in the test group was significantly reduced. Moreover, the relative weights of the testes and seminal vesicles were also significantly reduced in the test group. These results suggest that leached components from resin based dental composite materials have an adverse effect on the fertility and reproductive system of male mice.

Animals↗
PubMed1997

Subcutaneous self-administration of highly purified follicle stimulating hormone and human chorionic gonadotrophin for the treatment of male hypogonadotrophic hypogonadism. Spanish Collaborative Group on Male Hypogonadotropic Hypogonadism.

The efficacy and safety of highly purified follicle stimulating hormone (FSH) associated with human chorionic gonadotrophin (HCG) was studied in 60 men with hypogonadotrophic hypogonadism. Of these men, 16 suffered from Kallmann's syndrome, 19 from idiopathic hypogonadotrophic hypogonadism and 25 from hypopituitarism. Basal testosterone concentrations were found to be far below the normal range. At baseline, 26 patients were able to ejaculate and all of them showed azoospermia, while the remaining patients were aspermic. All patients self-administered s.c. injections of FSH (150 IU x three/week) and HCG (2500 IU x two/week) for at least 6 months and underwent periodic assessments of testicular function. Testosterone concentrations increased rapidly during treatment and all but one patient reached normal values. Testicular volume showed a sustained increase reaching almost 3-fold its baseline value. At the end of treatment, 48 patients (80.0%) had achieved a positive sperm count. The maximum sperm concentration during treatment was 24.5 +/- 8.1 x 10(6)/ml (mean +/- SEM). The median time to induce spermatogenesis was 5 months. Eleven patients reported adverse events, generally not related to treatment. Three patients experienced gynaecomastia. No local reactions at injection site were observed. In conclusion, the s.c. self-administration of highly purified FSH + HCG was well tolerated and effective in stimulating spermatogenesis and steroidogenesis in these patients.

Adult↗
PubMed2004

Effects of exposure to genistein during pubertal development on the reproductive system of male mice.

Genistein, a soybean-originated isoflavone, is widely consumed by humans for putative beneficial health effects but its estrogenic activity may affect adversely the development of the male reproductive system. Twenty-one days old ICR mice weaned from dams fed with a casein-based AIN-76A diet during gestation and lactation were exposed to genistein (2.5 and 5.0 mg/kg/day, p.o.) for 5 weeks. 17beta-Estradiol (7.5 microg/kg/day) and corn oil were used for the positive and negative vehicle controls, respectively. The animals were fed the casein-based AIN-76A diet throughout the experiment. There were no significant differences in body weights of mice between the genistein groups and the negative control group. No significant differences in relative reproductive organ weights were found among all experimental groups. Sperm counts in epididymis and testes were slightly decreased in the genistein-exposed groups compared with control group. Sperm motile characteristics in genistein-exposed groups were slightly higher than those of the control group. Levels of phospholipid hydroxide glutathione peroxidase mRNA in the testis, epididymis, and prostate of mice exposed to genistein or estradiol were significantly higher than those of the controls (P<0.05). Exposure to genistein caused hyperplasia of Leydig cells in the testis and a slight increase of interstitial fibroblasts in the epididymis, while estradiol treatment caused severe damage to the testis and epididymis. These results suggest that dietary uptake of genistein during the juvenile period may affect male reproductive development, resulting in a slight decrease in sperm count, but with an increase in sperm motion quality.

Animals↗