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PubMed1989

Testicular function in patients with testicular cancer treated with orchiectomy alone or orchiectomy plus cisplatin-based chemotherapy.

Gonadal function was evaluated in 25 patients with metastatic testicular cancer who were treated with orchiectomy plus chemotherapy with cisplatin, vinblastine, and bleomycin (PVB) and in 21 patients with clinical stage I disease who were treated only with orchiectomy and then kept under surveillance. Four years after PVB treatment, none of the patients were azoospermic; after 5 years, the total sperm counts in 46% of the patients had reached their pretreatment levels. In the group under surveillance, sperm counts below the reference level persisted or developed in 55% of the patients. Sperm production was similar in the two groups of patients 1.5 years after treatment and beyond. We conclude that spermatogenesis is not restored in all patients treated with PVB because of both preexisting germ cell defects and treatment toxicity.

Adolescent↗
PubMed1989

[Early treatment of varicocele in children and adolescents].

Since 1970 we perform the prophylactic operation of grade II and III varicocele during childhood and puberty, even if there were overtreatment. Varicocele may very early interfere with testicular development and already causes histological changes in boys at the beginning of puberty. We have made a follow-up study of 25 adult men, who have been operated by high resection of spermatic vessels during childhood (mean age 13 years). Results are very good: no testicular atrophy and in nearly all cases a normal sperm count or only slight OAT-syndrome. Compared with a group of non-treated men of the same age sperm counts are better and the number of fertile sperms higher. For that reason we recommend treatment as early as possible in childhood and puberty.

Adolescent↗
PubMed2002

Effects of folic acid and zinc sulfate on male factor subfertility: a double-blind, randomized, placebo-controlled trial.

OBJECTIVE: To study the effects of folic acid and zinc sulfate treatment on semen variables in fertile and subfertile men. DESIGN: Double-blind, placebo-controlled interventional study. SETTING: Two outpatient fertility clinics and nine midwifery practices in The Netherlands. PARTICIPANT(S): One hundred eight fertile and 103 subfertile men. INTERVENTION(S): Both groups were randomly assigned to receive one of four treatments for 26 weeks: folic acid and placebo, zinc sulfate and placebo, zinc sulfate and folic acid, and two placebos. Folic acid was given at a daily dose of 5 mg, and zinc sulfate was given at a daily dose of 66 mg. MAIN OUTCOME MEASURE(S): Before and after treatment, standardized semen and blood samples were obtained for determinations of sperm concentration, motility, and morphology according to World Health Organization guidelines; semen morphology according to strict criteria; and blood folate and zinc concentrations. Effects of the four interventions were evaluated separately in subfertile and fertile men. RESULT(S): Subfertile men demonstrated a significant 74% increase in total normal sperm count and a minor increase of 4% abnormal spermatozoa. A similar trend was observed in fertile men. Pre-intervention concentrations of folate and zinc in blood and seminal plasma did not significantly differ between fertile and subfertile men. CONCLUSION(S): Total normal sperm count increases after combined zinc sulfate and folic acid treatment in both subfertile and fertile men. Although the beneficial effect on fertility remains to be established, this finding opens avenues of future fertility research and treatment and may affect public health.

Adult↗
PubMed2003

Assessing in vivo fertilizing capacity of liquid-preserved boar semen according to the 'Hanover gilt model'.

The goal of this study was to determine the ability of the Hanover gilt model to assess in vivo fertilizing capacity of preserved sperm and to consider whether any modifications to this model were needed. This model evaluates the fertilizing capacity of semen based on the fertilization rate, the rate of normal embryos and the accessory sperm count of 3-5-day embryos. Its distinguishing characteristics are the use of one-time insemination of sperm in reduced numbers, of spontaneously ovulating gilts and of ovulation detection through ultrasound examination of ovaries. Reduced sperm numbers allow for an accurate evaluation of the fertilizing potential of different semen treatments, thereby avoiding the compensatory effect of doses calibrated to maximize fertility. The model's usefulness was assessed in a trial run designed to compare the fertilizing capacity of liquid boar semen diluted into two different extenders. The diluent, the boar and the backflow, had no significant effect on any of the parameters studied. Gilts inseminated less than 24 h before ovulation had a significantly higher (p < 0.01) fertilization rate and accessory sperm cell count (p < 0.05) than those inseminated more than 24 h before ovulation. Very good/good embryos from homogeneous litters (only very good/good embryos were present) had a significantly higher (p < 0.01) accessory sperm count than those from heterogeneous litters (at least one embryo was of a different quality and/or oocytes were present). Both very good/good and degenerated/retarded embryos from heterogeneous litters had low accessory sperm numbers. This suggests that accessory sperm count is significantly related to the quality of the litter, but not to the quality of the embryo within gilts. It can be concluded that the Hanover gilt model is sensitive enough to show fertility differences (in this study, those associated with in vivo ageing of semen), while using relatively few gilts and little time.

Animals↗
PubMed2001

Influence of swim-up method on the recovery of spermatozoa from different types of semen samples.

PURPOSE: To compare the effectiveness of swim-up method, using different types of semen samples. METHODS: In this retrospective study undertaken in university medical college infertility centre, subfertile couples undergoing Intra Uterine Insemination were selected. A total of 600 semen samples used for the preparation of sperm samples using swim-up method were analyzed. Relative Yield was calculated from the sperm count and motility before and after swim up from each semen sample in six different groups. RESULT(S): Statistically significant increase in relative yield was found in oligospermic samples (20.41) followed by teratospermia (16.98). However, relative yield was low in asthenospermic (11.97) and normal (> 60 million/ml) samples (11.66). CONCLUSION(S): Semen samples with good sperm count resulted in poor recovery after swim up. Swim-up method appears to be effective for oligospermic samples. Modifications like multiple tube swim up, using appropriate incubation time based on the initial semen parameter, will enhance the sperm yield after swim up.

Humans↗
PubMedDate not supplied

[Control observations on andrological patients treated with HCG/HMG with special reference to spermatogram and somatic development].

Between 1971 and 1976, 47 patients were treated in the department for andrology with daily alternating HCG/HMG injections. This treatment provides an attempt for examination of effects of a combined HCG/HMG therapy with a larger group of patients. As a condition for the HCG/HMG treatment a testicular biopsy was performed. It could be shown that in 70% of the cases there was no normal tabulus diameter, that the germinal epithelium was mostly low, and that in the germinal epithelium in 53,8% of the cases a spermiogenesis was demonstrable, but only in 3% of the cases sufficient spermatozoa existed. Most of the patients presented a disorganisation and desquamation of the germinal epithelium. During treatment no further testicular biopsies were made so that no statements can be given on the change of the tubules. Concerning the observation of the patients' sperm count it could be proved that, as a result of the HCG/HMG treatment, 33,3% of the patients showed an increase of motility and in 37,5% of the patients the number of spermatozoa increased. The paper describes two patients showing normal sperm count already after 8 to 12 weeks. Furthermore de Kretsers' observations on large decrease of spermatozoal number after the 150th day of treatment, and Paulsens' observations on hot flushes in some patients due to interruption of treatment, could be confirmed. The somatic development during HCG/HMG treatment showed an increase of volume of the testicles and an increase of the secondary hair. These changes also appeared already within 12 weeks after the beginning of treatment. In 38,5% of studied cases erections and ejaculations appeared already after 8 to 12 weeks as far as this didn't occur before treatment. In four cases pregnancy resulted from treatment. There was one early abortion. In all other cases gravidity and birth were normal. Only in one case negative side effects as a lack of concentration resulted. This study provides evidence that an alternating HCG/HMG treatment can be quite successful. Gonadotropin levels and the result of testicular biopsy have to be considered for clinical evaluation of treatment and therapeutic results.

Adolescent↗
PubMed1986

Effect of lead on human semen.

Semen qualities were studied in workers with an average age of 30 years and occupationally exposed to lead in a printing press. Another sample with the same average age but not exposed to lead were taken as control subjects. The average lead content in blood and seminal plasma of the exposed group were 42.5 mcg/100 ml and 14.80 mcg/100 ml, respectively. Their sperm counts and percentage of motile sperm were significantly affected. Significantly higher percentages of abnormal spermatozoa were also observed in these semen samples. The levels of seminal acid phosphatase, succinic dehydrogenase, and fructose in them were also significantly found to be low compared with those from the unexposed subjects. Cytochemical study of sperm head DNA in the exposed groups showed a low surface reaction.

Asia↗
PubMed1984

The postcoital test as a predictor of pregnancy among 355 infertile couples.

Late follicular phase postcoital tests in 355 infertile couples (selected to exclude severe defects in ovulation, seminal or tubal function) were scored for mucus characteristics and sperm motility. Cervical mucus characteristics were associated with postcoital sperm motility (P less than 0.001) but not with pregnancy. Postcoital sperm motility in cervical mucus was strongly associated with total motile sperm count per ejaculate (F = 5.38, P less than 0.001). Postcoital sperm motility was a weak predictor of pregnancy when more than five motile sperm were observed per high power microscopic field. When the log rank tests for postcoital sperm motility were repeated in groups with low (less than 10 million) and high (10 million or more) total motile sperm count per ejaculate, the association between postcoital sperm motility and pregnancy was not statistically significant. Regression analysis controlling for other potential predictors revealed no independent association between postcoital sperm motility and the later occurrence of pregnancy in this group of infertile couples.

Adult↗
PubMedDate not supplied

Male gonadal function in survivors of childhood Hodgkin and non-Hodgkin lymphoma.

The aim of this study was to investigate the impact of therapy on long-term gonadal function of young people cured of childhood lymphomas and to assess whether a prepubertal state during the treatment protects the gonads from chemotherapy and/or radiotherapy late effects. Clinical evaluation, semen analysis, and endocrine status were studied in 20 survivors of childhood lymphomas. Five patients received Inverted Y radiotherapy, 2320 cGy (1550-4000); all 20 received chemotherapy as follows: MOPP/ABVD protocol, 9 patients; COMP protocol, 5 patients; MOPP protocol, 3 patients; other protocols, 3 patients. Semen analysis results were as follows: normal values, 4/20 patients; oligospermia, 8/20 patients; azoospermia, 8/20 patients; FSH above normal level, 10/20 patients; 4/5 who received Inverted Y irradiation were azoospermic and 1 was severely oligospermic. Treatment damage to the testis involves tubular germinal elements. Radiotherapy and chemotherapy combinations that included nitrogen mustard or cyclophosphamide were associated with high rates of oligospermia and azoospermia. MOPP/ABVD combination did not have a significant better outcome of sperm counts compared to MOPP alone. Age at chemotherapy did not correlate with the sperm count; hence a prepubertal state did not protect the gonad from the late effects of treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Effect of zinc administration on seminal zinc and fertility of oligospermic males.

Fourteen infertile males (age 24-45 years; married over 2 years) with idiopathic oligospermia (sperm count less than 40 millions/ml) were investigated for the effect of oral zinc sulphate (220 mg) for 4 months on their serum and seminal zinc levels, and seminal parameters. With zinc administration serum zinc levels remained essentially unaffected, however, seminal zinc levels increased significantly. There was significant improvement in sperm count, number of progressively motile and normal spermatozoa, and acid phosphates activity. Wives of 3 patients conceived. Observations suggest that zinc has potential to be used in male infertility. However, further studies are warranted.

Adult↗
PubMed1996

Reprotoxic and genotoxic studies of vanadium pentoxide in male mice.

Effects of vanadium pentoxide (V2O5) treatment on reproductive function and testicular DNA in male mice were investigated. These functions were evaluated with fertility rate, implants, resorptions, sperm counts, motility, and morphology. The DNA damage in individual testis cells was analyzed by single-cell gel electrophoresis technique (COMET assay). V2O5 treatment resulted in a decrease in fertility rate, implantations, live fetuses, and fetal weight, and an increase in the number of resorptions/dam. Sperm count, motility, and morphology were impaired with the advancement of treatment. Vanadium treatment induced DNA damage depending on the dose in the testis cells that was expressed and detected as DNA migration in the COMET assay. The distribution of DNA migration among cells, a function of dose, revealed that the majority of cells of treated animals expressed more DNA damage than cells from control animals. It is concluded that vanadium pentoxide was a reprotoxic and genotoxic agent in mice.

Animals↗
PubMed1984

Isolated follicle-stimulating hormone deficiency in men: successful long-term gonadotropin therapy.

Two men with primary infertility after 6 to 11 years of marriage were found to have isolated follicle-stimulating hormone deficiency syndrome (IFDS). Their endogenous gonadotropin secretion was compared with that of two other infertile men with hypothalamic disease (Kallmann's syndrome) and pituitary tumor with hyperprolactinemia. Treatment with intramuscular gonadotropin was given to produce circulating and 24-hour urine levels of luteinizing hormone and follicle-stimulating hormone at or above the upper limit of the normal male range to ensure continued gonadal stimulation. Sperm counts increased in IFDS men within 6 to 26 weeks, with maximum total sperm counts of 33.5 and 20 million after 9 to 80 weeks. Pregnancy occurred after 20 weeks' therapy in one patient's wife with the subsequent delivery of a normal male infant. IFDS may be a treatable cause of male infertility given adequate gonadotropin therapy.

Adult↗
PubMed1988

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↗
PubMed1979

Pregnancies associated with sperm concentrations below 10 million/ml in clinical studies of a potential male contraceptive method, monthly depot medroxyprogesterone acetate and testosterone esters.

A potential male contraceptive approach was evaluated in clinical trials involving monthly injections of depot medroxyprogesterone acetate and either subdermal implants of testosterone propionate or monthly injections of testosterone enanthate. Pregnancies occurred in partners of 9 men with recent sperm counts of 10 million/ml or below. In 5 of the 9 instances, the sperm counts were less than 1 million/ml. It appears that male contraceptive methods involving spermatogenic suppression may require attainment and maintenance of azoospermia. The pregnancy rate cannot be calculated, because the extent of other contraceptive use is uncertain. There were no spontaneous abortions. 6 pregnancies were carried to term, and all progeny were normal, based on physical examination at birth or 3 months after birth.

Contraceptive Agents, Male↗
PubMed1989

Recovery of sperm production after chemotherapy for osteosarcoma.

Because treatment with surgery and combination chemotherapy produces a high cure rate in young men with osteosarcoma, their subsequent reproductive function is an important concern. Semen analyses of osteosarcoma patients, therefore, were performed before, during, and after treatment with the PADIC regimen consisting of cisplatin, Adriamycin (doxorubicin), and dacarbazine or, in some cases, the PADIC regimen plus additional drugs. Results showed that semen volume was not affected and that sperm motility was reduced only during treatment. Although nearly all patients were rendered azoospermic during treatment, sperm production resumed in 30 of 32 patients examined at least 2 years after treatment. Analysis with correction for censored data indicates that, in 78% of treated men, sperm counts will return to more than 10 million/ml. The percentage of men whose sperm counts recovered to normal was lower for those receiving cisplatin dosages greater than or equal to 600 mg/m2; no trends were observed with Adriamycin and dacarbazine dosages. The inclusion of additional drugs such as methotrexate, bleomycin, dactinomycin, or cyclophosphamide (less than 4 g/m2) did not significantly affect the recovery of spermatogenesis. We conclude that the risk of long-term infertility from treatment with the PADIC regimen is low.

Adolescent↗
PubMed1994

Modulation of ochratoxin-produced genotoxicity in mice by vitamin C.

Ochratoxin A (OA), when administered orally daily for 45 days to albino Swiss mice, Mus musculus, at a level equivalent to the human dietary concentration of 1 microgram/kg body weight/day, increased the production of abnormalities in both mitotic and meiotic chromosomes as well as in the gross morphology of the sperm head. The sperm count per unit volume of caput epididymal suspension also decreased. Vitamin C at a concentration equivalent to the human therapeutic dose (10 mg/kg body weight/day), when administered orally concurrently with OA, significantly minimized the incidence of these abnormalities. The protective effect of vitamin C was most marked in mitotic chromosomes followed by that in meiotic chromosomes and sperm head morphology; the improvement in sperm count was least marked. The possible mechanism of this effect is discussed.

Administration, Oral↗
PubMed2000

The effects of cryopreservation on semen from men with sarcoma or carcinoma.

PURPOSE: This study evaluated prefreeze and postthaw semen quality before treatment in patients with different types of sarcomas and carcinomas to determine whether cryopreservation would be of value for these patients. METHODS: Semen specimens were obtained from 50 normal donors and from 21 patients with carcinoma and from 14 patients with sarcoma. The specimens were cryopreserved by a standard freezing procedure using TEST-Yolk buffer. Prefreeze and postthaw sperm motion characteristics were measured. RESULTS: Prefreeze total motile sperm count was significantly higher in donors (median: 129.6 x 10(6)/ml) than in men with carcinoma (46.9 x 10(6)/ml, P < .001) or sarcoma (66.3 10(6)/ml, P = .04). The percent motility and percent linearity were significantly lower in patients with carcinoma. In postthaw specimens, total motile sperm count, curvilinear velocity, and linearity were significantly lower in patients with carcinoma. CONCLUSIONS: The two patient groups in this study had poor semen quality when compared with healthy donors both before and after cryopreservation. Sarcoma patients had better semen quality than carcinoma patients. As cancer therapy in these men could significantly impair their reproductive potential, these men should be advised to preserve their semen before starting treatment.

Adult↗
PubMed1987

Hyperthermia and human spermatogenesis: enhancement of the inhibitory effect obtained by 'artificial cryptorchidism'.

Decreased sperm count and motility were observed in men after induction of local testicular hyperthermia by raising the testicles into the inguinal canal during the day in adult volunteers. A similar technique in which the testicles were better maintained in the inguinal canal resulted in more marked suppression of spermatogenesis. As assessed by the total motile sperm count, the mean inhibitory effect of hyperthermia was at least 97% after 2 months using this technique. This effect of 'artificial cryptorchidism' may be of practical interest in the manipulation of male fertility.

Adult↗