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PubMed1984

[The effect of Chinese drug therapy on the patients with male infertility. 1. Concomitant administration of ninjinto and hachimijiogan on patients with male infertility].

Ten patients (age range, 28 to 36 years with a mean of 32.3 years) with male infertility were orally given Ninjinto and Hachimijiogan concomitantly at a daily dose of 7.5 g each for 96 to 182 days (mean 116.8 days). Ten percent of these patients showed remarkable improvement in their volume of semen, 10% showed improvement and 80.0% showed no improvement. Thirty percent of these patients showed remarkable improvement in the number of sperm, 10.0% showed improvement, and 60.0% showed no improvement. Twenty percent of these patients showed remarkable improvement in their sperm mobility, 30.0% showed improvement and 50.0% showed no improvement. The fertility index was improved markedly in 60.0%, improved in 20.0% and not improved in 20.0%. The spouses of 2 patients became pregnant. Side effects were seen in only 30.0% (epigastralgia) of these patients. Laboratory examination of these patients revealed no significant change. These results suggested that concomitant administration of Ninjinto and Hachimijiogan is effective on patients with male infertility.

Adult↗
PubMed1996

Sperm immobilization antibodies in infertile male sera decrease the acrosome reaction: a possible mechanism for immunologic infertility.

OBJECTIVE: To study the effect of sperm-immobilizing antibodies from male sera on spontaneous and A23187-induced acrosome reactions (AR). DESIGN: Swim-up spermatozoa obtained from three fertile donors were incubated with 13 sera with sperm-immobilizing antibodies obtained from infertile men and three control sera obtained from healthy fertile males. Sperm acrosomes were examined by staining with pisum sativum agglutinin labeled with fluorescein isothiocyanate (30 micrograms/ml; Sigma Chemical Co., St. Louis. MO) as spontaneous and A23187 (used at a final concentration of 10 microM; Sigma Chemical Co.) induced. RESULTS: The incidence of spontaneous AR of spermatozoa incubated with antisperm antibody positive male sera (6.2 +/- 0.7) was significantly (P < 0.001) lower than that of spermatozoa incubated with control sera (10.7 +/- 0.5). And the incidence of A23187-induced and -inducible (incidence of induced minus spontaneous) ARs of spermatozoa incubated with sperm antibody-positive male sera (12.4 +/- 1.9 and 6.2 +/- 1.9) was significantly lower (P < 0.001) than that of spermatozoa incubated with control sera (31.0 +/- 0.5 and 20.3 +/- 0.9). Sperm-immobilizing antibody-positive sera decreased spontaneous, A23187-induced, and inducible ARs. CONCLUSIONS: Sperm-immobilizing antibodies from male sera interfere with fertilization by inhibiting the AR.

Acrosome↗
PubMed1990

Male infertility and its treatment: a review of over 4700 patients treated for male related infertility.

Changes in semen parameters are presented for 4708 patients treated for infertility. The largest group comprised patients with oligoasthenozoospermia of various grades (57.7%). Improvement in the seminal state was noted in 70.3%. The percentage of achieved normospermia increased proportionally to the initial semen state. Pregnancy rate also increased proportionally to the initial seminal state. Among the patients' wives 20.4% conceived: 28.2% of these pregnancies had occurred after having achieved normospermia, while in 71.8% the seminal states were still below the accepted normal values.

Humans↗
PubMed2003

Thyroxine treatment modified in infertile women according to thyroxine-releasing hormone testing: 5 year follow-up of 283 women referred after exclusion of absolute causes of infertility.

BACKGROUND: Mild hypothyroidism may contribute to disturbed reproductive function. We hypothesized that frequent thyroxine-releasing hormone (TRH) testing to fine-tune thyroxine (T4) therapy instituted upon every TRH-induced thyroid-stimulating hormone (TSH) rise above the mean of a healthy population (i.e. 15 mIU/l) would improve fecundity compared with historical data. METHODS: In a cohort of 283 infertile women followed over 5 years, we assessed (i) pregnancy, abortion and delivery rates, (ii) thyroid function over time in women who conceived compared with those who did not, and (iii) various thyroid parameters with respect to fertility. RESULTS: Overall conception rate of 37% was higher (P < 0.05) than previously reported and independent of thyroid function prior to T4 therapy, thyroxine dose or elevated thyroid autoantibodies. Never achieving basal TSH <2.5 IU/l or TRH-stimulated TSH <20 mIU/l with T4 therapy resulted in lower conception rates (P < 0.05). Median time to conception was 6 months, but 18 months in women who declined TRH testing (P < 0.02). Overall abortion rate was 9%. Only first trimester miscarriages occurred. CONCLUSIONS: Based on the presented protocol, high pregnancy and parturition rates were observed. Whether this is due to early T4 therapy remains to be determined. Abortions appeared to be associated with higher TSH but not with elevated thyroid antibodies.

Abortion, Spontaneous↗
PubMed2003

Is laparoscopy still the gold standard in infertility assessment? A comparison of fertiloscopy versus laparoscopy in infertility. Results of an international multicentre prospective trial: the 'FLY' (Fertiloscopy-LaparoscopY) study.

BACKGROUND: The aim of this prospective multicentre study was to compare the two endoscopic techniques of laparoscopy and fertiloscopy in routine evaluation of the pelvis in infertile women. METHODS: A total of 92 women was selected in 14 University Hospitals to undergo fertiloscopy followed by transabdominal laparoscopy by a team of two surgeons in each hospital. RESULTS: A high degree of concordance was observed between these two techniques, in that if fertiloscopy did not detect any abnormalities, this was also confirmed by laparoscopy. Discordance was observed in similar numbers of cases: eight after laparoscopy and nine after fertiloscopy. The diagnostic index for fertiloscopy and laparoscopy was calculated; sensitivity (86 and 87% respectively) and negative predictive value (64 and 67% respectively) were similar. The kappa index was also calculated for each of the six structures/regions (right/left tube; right/left ovary; peritoneum of pouch of Douglas; posterior uterus), and concordance (0.78 to 0.91) was considered almost complete. CONCLUSIONS: These results confirm fertiloscopy as a minimally invasive safe procedure that may be considered as an alternative to diagnostic laparoscopy in the routine assessment of women without clinical or ultrasound evidence of pelvic disease. On the basis of the additional advantages of fertiloscopy, namely salpingoscopy or microsalpingoscopy, it is considered that fertiloscopy could replace laparoscopy as a routine procedure in such women.

Adult↗
PubMed2005

Survey of the two polymorphisms in DAZL, an autosomal candidate for the azoospermic factor, in Japanese infertile men and implications for male infertility.

The DAZL (DAZ-like) gene is suggested to be an ancestral gene of the DAZ (deleted in azoospermia) gene on the Y chromosome, which is a strong candidate for the azoospermic factor. Recently, it has been reported that the T54A (Thr54-->Ala) polymorphism in exon 3 of the DAZL gene is associated with spermatogenic failure in the Taiwanese population. In this study, to investigate whether this polymorphism is associated with spermatogenic failure in Japanese males, we analysed genomic DNA derived from 234 patients with azoospermia or oligozoospermia and 131 fertile controls. The T54A polymorphism was completely absent in both the patients and the controls. The T12A (Thr12-->Ala) polymorphism in exon 2 of the DAZL gene was found at a similar frequency in the patients and controls, 15.4% and 13.7%, respectively (P = 0.67). However, the frequency of T12A was higher for the azoospermic (20.5%) than oligozoospermic (9.6%) individuals in infertile men without DAZ deletions, although statistical difference was not so apparent (chi2 test: P = 0.037, OR = 2.413, 95% CI = 1.035-5.629; Yate's chi2 test: P = 0.058, OR = 2.319, 95% CI = 0.973-6.166). Our results show that the T54A polymorphism in DAZL has no major role in Japanese males with azoospermia or oligozoospermia. The distribution of the T54A polymorphism may be restricted to the narrow area including Taiwan.

Adult↗
PubMed1996

Smoking reduces fecundity: a European multicenter study on infertility and subfecundity. The European Study Group on Infertility and Subfecundity.

Several studies published within the past 10 years indicate that smoking reduces fecundity, but not all studies have found this effect, and smoking cessation is not used routinely in infertility treatment in Europe. The present study was designed to examine male and female smoking at the start of a couple's waiting time to a planned pregnancy. Two types of samples were used: population-based samples of women aged 25-44 years who were randomly selected in different countries from census registers and electoral rolls, in which the unit of analysis was the couple; and pregnancy-based samples of pregnant women (at least 20 weeks' pregnant) who were consecutively recruited during prenatal care visits, in which the unit of analysis was a pregnancy. More than 4,000 couples were included in each sample, and 10 different regions in Europe took part in data collection. The data were collected between August 1991 and February 1993 by personal interview in all population-based samples and in all but three regions of the pregnancy sample, where self-administered questionnaires were used. The results based on the population sample showed a remarkably coherent association between female smoking and subfecundity in each individual country and in all countries together, both with the first pregnancy (odds ratio (OR) = 1.7, 95% confidence interval (CI) 1.3-2.1, at the upper level of exposure) and during the most recent waiting time to pregnancy (OR = 1.6, 95% CI 1.3-2.1). Results based on the pregnancy sample were similar (OR = 1.7, 95% CI 1.3-2.3). No significant association was found with male smoking (in the population sample, OR = 0.9, 95% CI 0.7-1.1 (first pregnancy) and OR = 1.0, 95% CI 0.9-1.3 (most recent waiting time); in the pregnancy sample, OR = 0.9, 95% CI 0.7-1.1). The fecundity distribution among smokers appeared to be shifted toward longer waiting times without a change in the shape of the distribution. Women who have difficulty conceiving should try to stop smoking or to reduce their smoking to less than 10 cigarettes per day.

Adult↗
PubMed1997

Caffeine intake and delayed conception: a European multicenter study on infertility and subfecundity. European Study Group on Infertility Subfecundity.

The effects of caffeine consumption on delayed conception were evaluated in a European multicenter study on risk factors of infertility. Information was collected retrospectively on time of unprotected intercourse for the first pregnancy and the most recent waiting time episode in a randomly selected sample of 3,187 women aged 25-44 years from five European countries (Denmark, Germany, Italy, Poland, and Spain) between August 1991 and February 1993. The consumption of caffeinated beverages at the beginning of the waiting time was used to estimate daily caffeine intake, which was categorized as 0-100, 101-300, 301-500, and > or = 501 mg. Risk of subfecundity (> or = 9.5 months) and the fecundability ratio, respectively, were assessed by logistic regression and Cox proportional hazard analyses, adjusting for age, parity, smoking, alcohol consumption, frequency of intercourse, educational level, working status, use of oral contraceptives, and country. A significantly increased odds ratio (OR) of 1.45 (95% confidence interval (CI) 1.03-2.04) for subfecundity in the first pregnancy was observed for women drinking more than 500 mg of caffeine per day, the effect being relatively stronger in smokers (OR = 1.56, 95% CI 0.92-2.63) than in nonsmokers (OR = 1.38, 95% CI 0.85-2.23). Women in the highest level of consumption had an increase in the time leading to the first pregnancy of 11% (hazard ratio = 0.90, 95% CI 0.78-1.03). These associations were observed consistently in all countries as well as for the most recent waiting time episode. The authors conclude that high levels of caffeine intake may delay conception among fertile women.

Adult↗
PubMed1995

Clinical value of fine-needle aspiration cytology and biopsy in the evaluation of male infertility. A comparative study of 48 infertile patients.

OBJECTIVE: To evaluate whether fine-needle aspiration cytology of the testis can be considered as a diagnostic parameter in the evaluation of male infertility. PATIENTS AND METHODS: We studied 30 oligospermic and 18 azoospermic patients using 63 fine-needle aspiration samples and 57 biopsy samples obtained surgically (10 cases) or with a spring-loaded biopsy device (47 cases). Cytologic evaluation of spermatogenesis was performed by studying longitudinal segments of seminiferous tubules and cytocentrifuged dissociated cells. RESULTS: Comparison between fine-needle aspiration and the biopsy methods gave concordant results in 72.2% of cases. Discordant findings were recorded in 10 cases (27.8%). In eight cases, significant maturation into spermatozoa was recognized in samples obtained by fine-needle aspiration only, whereas moderate to severe hypospermatogenesis or germ cell aplasia were demonstrated in samples obtained by the spring-loaded biopsy device or by open surgical biopsy. Germ cell aplasia was recognized in samples obtained by both methods in 75.0% of cases. Insufficient specimens were obtained by fine-needle aspiration and the spring-loaded biopsy device in 15.9% and 12.3% of cases, respectively, whereas all surgical biopsy specimens were of good quality. Four bleeding episodes and one case of epididymitis were observed after use of the spring-loaded biopsy device, but no complication was related to either surgical biopsy or fine-needle aspiration. CONCLUSION: The findings show that fine-needle aspiration cytology could represent a more reliable means of identifying significant numbers of the most mature germ cells.

Adult↗