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Testicular torsion: a follow-up study.

Thirty-five patients were examined 6-11 years after operation for torsion of the testis. Loss of testicular tissue was significantly associated with long preoperative duration of symptoms and with low postoperative sperm counts. The sex hormones were normal in the majority of patients but there were significantly higher levels of both FSH and LH in the group of patients with symptoms exceeding 8 hours. There was also a higher prevalence of abnormal semen quality in the same group. Furthermore, FSH and LH levels correlated significantly to the duration of symptoms and correlated inversely to the sperm count and concentration. Measurement of carnitine levels in seminal plasma, as a sign of vas deferens obstruction or dysfunction of epididymis, and of autoantibodies against spermatozoa revealed no significant findings.

Adolescent↗

Effects of Butea superba on reproductive systems of rats.

The effects of Butea superba on the reproductive system in male Wistar rats were investigated. The animals were fed daily with the powdered crude drug suspended in distilled water by a gastric tube at the dose of 2, 25, 250 and 1250 mg/kg body weight for 8 weeks. Rats fed with 1 ml of distilled water were used as a negative control. The weights of all vital organs in all treated groups were not different from the control. The percentage weight ratios of body weights of seminal vesicles and prostate glands were not different from the control, except that the testis of the group fed with 1250 mg/kg was significantly different from the control and the other treated groups. In addition, the sperm counts in this group showed about 16% more than the control group. Hematology as well as the liver and kidney function of all treated groups showed no difference from the control. B. superba, drug at 250 mg/kg which was 100 times more than the Thai FDA recommended dose for humans appeared to be safe in rats. The crude drug has demonstrated an increase tendency on testis weight and sperm counts in rat. The information from the present study can be used to explain the Thai folklore application of this plant in Thailand.

Administration, Oral↗

[Cytologic classification of immature germ cells in the spermatological "syndrome" of increased desquamation of spermatogenic cells].

The spermatological phenomenon of increased exfoliation of immature germ cells (IGC) not commonly known until now, can be defined quantitatively as a number of above 4% IGC in relation to the sperm count. The variable aspect of premature germ cells may be confusing and their degenerative alterations complicate definite classification. Items for the classification of IGC have been elaborated employing comparative cytological studies. Based on these criteria exfoliated IGC within the ejaculate can be grouped into: cells reliably allied to spermatogenesis; cells probably allied to spermatogenesis; cells not exactly classifiable by conventional cytology. Analysing the ejaculates of 20 patients with increased exfoliation of IGC (16-50%), we mainly found cells exfoliated from the adluminal cell compartment of seminiferous tubules (spermatocytes II and spermatids). During conventional light microscopy about one third of the "round cells" in ejaculate smear preparations remained unclassifiable. Pathogenetic reasons of increased output of IGC are unclear so far. This phenomenon, usually accompanied by asthenozoospermia as well and mild to severe teratozoospermia, is very often also combined with decreased sperm counts (5-20 mio/ml ejaculate).

Humans↗

Pulsatile GnRH-therapy in oligozoospermic men does not improve seminal parameters despite decreased FSH levels.

In order to evaluate GnRH administration for the treatment of infertile men with elevated serum FSH levels we administered GnRH in pulses via portable electronic infusion pumps initially to seven patients with low sperm counts and high FSH values over 12 weeks and later to nine further patients over 24 weeks who also underwent testicular biopsies. Fifty microlitres containing 5 micrograms GnRH were infused subcutaneously for 1 min every 120 min in the short-term study and every 90 min in the long-term study. Although FSH levels could be lowered in both groups of patients, none showed any improvement in sperm count or other seminal parameters. Therefore, pulsatile GnRH treatment cannot be recommended for therapy of severe oligozoospermia with elevated FSH levels.

Adult↗

Spermatogenesis after unilateral orchiectomy for testicular cancer in patients following surveillance policy.

PURPOSE: Only limited information is available on the natural course of spermatogenesis in patients with testicular cancer who underwent unilateral orchiectomy and surveillance. We analyze long-term exocrine function of the remaining testicle in patients following surveillance policy. MATERIALS AND METHODS: Sperm counts and serum follicle-stimulating hormone (FSH) levels were available in 60 nonrelapsing cases approximately 3 weeks (baseline), 1 year and 2 years or greater after orchiectomy. Contralateral testicular cancer subsequently developed in 2 men. RESULTS: At baseline 36 patients were normospermic (10 or greater x 106/ml.), 7 were azoospermic and 17 were oligospermic. After 1 year 45 patients were normospermic. Mean sperm concentrations increased significantly from 26 to 39 x 106/ml. during year 1 after orchiectomy. Elevated serum FSH at baseline was associated with incomplete recovery of spermatogenesis, although sperm counts improved in 3 of 7 patients. Furthermore, in the 2 initially oligospermic patients with subsequent contralateral testicle cancer transient normospermia was observed after 1 year. After orchiectomy fatherhood was recorded in 28 men and was assisted by fertilization using fresh semen in 2. CONCLUSIONS: In nonrelapsing testicular cancer cases on surveillance, initially reduced spermatogenesis recovers during year 1 after orchiectomy especially if baseline serum FSH is normal. Transient recovery also occurs in patients in whom contralateral testicular cancer subsequently develops. In high risk patients and in initially oligospermic patients with plans for future fatherhood, the period of improved spermatogenesis may be used for multiple semen cryopreservations enabling subsequent assisted fertilization.

Adult↗

The treatment with cabergoline for 24 month normalizes the quality of seminal fluid in hyperprolactinaemic males.

BACKGROUND: Alterations of sperm number and motility are found in hyperprolactinaemic men. Cabergoline treatment reverses alterations in semen. No information is currently available on the quality of seminal tests in hyperprolactinemia in response to cabergoline treatment. OBJECTIVE: To further investigate the effect of hyperprolactinaemia and its treatment with cabergoline on semen quality. PATIENTS: Forty-three men with hyperprolactinaemia (32 macro- and 11 micro-prolactinomas); 60 healthy men served as control. METHODS: Live spermatozoa count, sperm membrane function, kinetic index, nuclear DNA integrity, sperm curvilinear and linear velocity and amplitude of lateral movement of the sperm head were investigated before and after 6 and 24 months of treatment with cabergoline. STUDY DESIGN: Open prospective. RESULTS: At study entry, semen functional tests were severely and similarly impaired both in patients with macro- and micro-prolactinomas compared to controls. After 6 and 12 months of treatment there was a significant improvement of semen quality in patients achieving normalization of prolactin levels, although most of the parameters remained lower than in controls. After 24 months of treatment, seminal fluid characteristics were similar to the controls except for live spermatozoa count, sperm membrane function, sperm kinetic index and sperm nuclear DNA integrity, which remained abnormal in 9.3-53% of the patients. CONCLUSIONS: Twenty-four months of cabergoline treatment restored gonadal function in 66.7% of men with hyperprolactinaemia.

Adult↗

Epididymal sperm aspiration in conjunction with in-vitro fertilization and embryo transfer in cases of obstructive azoospermia.

Epididymal sperm aspiration is a new treatment for vasal agenesis. In previous reports, epididymal spermatozoa resulted in pregnancy by utilizing in-vitro fertilization (IVF) or gamete intra-Fallopian transfer (GIFT). We sought to investigate the efficacy of epididymal sperm aspiration in conjunction with IVF in patients with congenital absence of the vas deferens or with secondary extended obstruction of spermatic ducts. Fifty-eight attempts were performed in 23 patients (25-50 years). Eight patients (34.7%) had vasal agenesis and 14 (60.8%) presented with vasal secondary extended obstruction. The sperm count was adequate (greater than or equal 20 x 10(6)/ml) in 13.8% of sperm retrievals and sperm motility of 20% was obtained in 15.5% of sperm retrievals. Fourteen attempts at IVF were performed with epididymal sperm counts of 2-44 x 10(6)/ml and motilities of 0-45%. A mean of six mature oocytes (0-13) were inseminated in each case. Five embryo transfers were performed in five patients' wives (35.7%) and two couples had an early pregnancy loss (14.2%). Epididymal sperm aspiration is an advance in treating such patients, as an adequate number of mature spermatozoa can be obtained and used for IVF. However, spermatozoa directly aspirated from the proximal epididymis and with fertilizing capacity in vitro, gave a high rate of embryo degeneration (greater than 50%) after embryo transfer.

Adult↗

Effects of AMSA, an antineoplastic agent, on spermatogenesis in the mouse.

The stages of spermatogenic cells killed by the single and fractionated administration of AMSA, an acridine derivative used in cancer chemotherapy, have been identified in the mouse. A wide range of doses, up to a total of 30 mg/kg, which is the LD50 for AMSA given in three daily injections, was employed. Survival of differentiating (types A1 through Intermediate) and stem spermatogonia was measured by sperm counts performed 29 and 56 days after treatment, respectively. The sensitivity of germ cells to AMSA at other stages of differentiation was determined by semiquantitative histologic analysis at 11 days after treatment. Significant killing of differentiating spermatogonia, types A2 through B, but only minor killing of stem cells and no toxicity to post-spermatogonial stages were observed with all treatment schedules. This pattern of differential sensitivity can explain the temporary azoospermia observed in man during AMSA treatment, which was followed by a return to normal sperm counts after cessation of therapy.

Aminoacridines↗

Environmental estrogens: roles in male reproductive tract problems and in breast cancer.

It has been hypothesized that endocrine disruptors and particularly synthetic estrogenic environmental contaminants (xenoestrogens) are etiologic factors in the global decrease of sperm counts and other problems of the male reproductive tract, including cryptorchidism, hypospadias, and testicular cancer. Xenoestrogens might also be linked to an increased incidence of breast cancer in women. These hypotheses have stimulated research addressing the current incidence rates and time-dependent changes in these human health problems, and the results do not support the hypotheses. With the exception of testicular cancer, the evidence does not indicate that sperm counts and other male reproductive tract problems are increasing, and correlations with xenoestrogen exposure have not been made. Moreover, initial observations that the level of certain organochlorine pollutants is higher in breast cancer patients vs. controls have not been duplicated in more recent studies. The results do not preclude an environmental eitology to some of these health problems or to susceptible subpopulations, and these areas require further research and critical scrutiny.

Australia↗

[The effects of cyclosporin azathioprine and mizoribine on male reproduction in rats].

BACKGROUND: The effects of cyclosporin (Cs), azathioprine (AZP) and mizoribine (MZR) on male reproduction in rats were examined. METHODS: Each drug was orally administered every day for 14 days at the following doses; Cs, 10, 20, 40, or 80 mg/kg body weight; AZP, 5, 10, or 20 mg; and MZR, 2.5, 5, 10, or 20 mg. RESULTS: In the sperm count in the cauda epididymis, two weeks after the discontinuation of administration, a significant decrease was observed only in the 80 mg/kg dose group among the Cs-treated groups and in the 5 mg/kg and 20 mg/kg dose groups among the AZP-treated groups. At the end of the administration, a significant dose-dependent decrease was observed in the MZR-treated groups. The degree of the decrease was smaller after Cs administration compared with the other 2 drugs. Sperm motility was significantly decreased in each Cs-treated group immediately after the oral administration of Cs and improved gradually, but was not changed in AZP- and MZR-treated groups. Significant dose-dependent damage of the seminiferous tubules was noted 6 weeks after administration of Cs, AZP and MZR. The serum levels of luteinizing hormone and follicle-stimulating hormone remained the same throughout the experiment. The serum level of testosterone was significantly low immediately after the oral administration of AZP, but was not changed by that of Cs and MZR. CONCLUSION: Cs, AZP and MZR injured the spermatogenesis in rat. However, changes in the sperm count in the cauda epididymis suggested that the degree of impairment by Cs is relatively small, but only Cs injured epididymal function as well.

Animals↗

Clinical correlates of environmental endocrine disruptors.

Endocrine disrupting chemicals (EDCs), such as environmental estrogens, are hypothesized to be associated with a global decrease in sperm counts, other male reproductive tract problems and increasing rates of female breast cancer. Results of human population studies do not support the association between certain organochlorine EDCs and female breast cancer. Moreover, there is minimal evidence linking EDCs or exposure to other environmental chemicals with male reproductive tract problems. With the exception of the increasing incidence of testicular cancer, it is also questionable whether male reproductive tract problems are increasing, decreasing or unchanged. However, several studies report large differences in sperm count and quality and other endocrine-related problems within countries and regions, but the environmental, dietary and/or lifestyle factors responsible remain unknown.

Animals↗

Probing into the mechanism of action, metabolism and toxicity of gossypol by studying its (+)- and (-)-stereoisomers.

The chemistry of gossypol is very relevant to its unique actions. The two aldehyde groups can easily bind to proteins via aldehyde-amino group linkage. Gossypolone, the in vivo oxidation product of gossypol, may form a redox system with its corresponding hemiquinone, leading to free radical generation. There are marked differences in the disposition and metabolism between (+)- and (-)-gossypol. The elimination half life of (+)-gossypol was much longer than that of (-)-gossypol. The higher rate of elimination of (-)-gossypol may be due to its lower rate of binding to tissue proteins, since the Vd of (-)-gossypol was much smaller than that of the (+)-isomer. A single intratesticular injection of 200 micrograms of (-)-gossypol caused a 70.4% decrease of the sperm count along with marked atrophy of the testes. However, neither a significant decrease in sperm count nor atrophy of the testes was observed after a similar injection of (+)-gossypol, suggesting that there is a strict stereochemical requirement for the interaction between gossypol and the testicular target molecules. Racemic gossypol stimulated superoxide free-radical formation when incubated with either rat liver or kidney microsomes, but not with those of the heart or testes. Pretreatment with phenobarbital potentiated this effect in liver microsomes, while incubation with metyrapone decreased in renal microsomes. Both (+)- and (-)-gossypol exhibited similar potencies in renal or hepatic microsomes in vitro. At 100 mg/kg, both (+)- and (-)-gossypol were able to cause increases in SGPT in rats 12 and 24 h following the administration. The equipotency between the two isomers in causing toxic effects to some of the somatic tissues and the stereo-selectivity of (-)-gossypol to induce antispermatogenic effects indicate that gossypol may actually exhibit two categories of cytotoxic effects to different organs and tissues. This suggests that one may be able to eliminate one effect while keeping the other.

Animals↗

Gonadal hormones and semen quality in male runners. A volume threshold effect of endurance training.

Eleven high mileage runners (HR) (108.0 +/- 4.5 km.wk-1), 9 moderate mileage runners (MR) (54.2 +/- 3.7 km.wk-1) and 10 sedentary controls (SC) of similar age (28.3 +/- 1.5 yr) were studied to evaluate the effects of volume of endurance training on reproductive function in male runners. Levels of reproductive, adrenal and thyroid hormones were measured during a 1-hr period of serial blood sampling (q20 min) and urinary excretion of 24-hr luteinizing hormone (uLH) was determined on two separate days. Semen exams and sperm penetration of standard cervical mucus (Penetrak) were performed 2-5 times. Levels of total testosterone (TT) and free testosterone (FT) were significantly lower in HR (15.3 +/- 1.3 nmol.l-1 and 60.2 +/- 5.1 pmol.l-1) compared to MR (21.4 +/- 1.6 nmol.l-1 and 86.0 +/- 6.1 pmol.l-1) and SC (19.5 +/- 0.9 nmol.l-1 and 75.9 +/- 3.6 pmol.l-1). No differences (p > 0.05) were found in uLH, serum LH, follicle-stimulating hormone (FSH), and prolactin (PRL) among the three groups. No other hormonal differences (p > 0.05) were observed among the groups. Total motile sperm count and density were lower (p < 0.05) in HR than SC. Decreased (p < 0.0006) sperm motility and an increased (p < 0.004) population of immature sperm and round cells were observed in HR compared to MR and SC. Sperm penetration of bovine cervical mucus was also decreased (p < 0.024) in HR compared to SC. Volume of training, defined by km.wk-1 run, was significantly correlated to sperm motility, density and number of round cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Varicocele and antisperm antibody: fact or fiction?

OBJECTIVE: To study the level of antisperm antibodies (ASAB) in the serum and semen of infertile men with varicocele before and 6 months after varicocelectomy. MATERIALS AND METHODS: We performed a prospective study of 81 infertile men undergoing microsurgical inguinal varicocelectomy. Female factor was excluded. Semen analysis and seminal and serum ASAB (direct and indirect IgG and IgA), as measured by SpermMar test, were performed before and after surgery at 6 months. A control group consisting of idiopathic infertile patients was evaluated for ASAB. RESULTS: Eighty-one patients with a mean age of 28.7 years (23 to 42) completed our study. Mean sperm count, motility, and abnormal forms were improved after surgery and were statistically significant for sperm density and morphology (P < 0.05). Before surgery, 21 patients (26%) had a low positivity for ASAB (10 to 40%). Six months after surgery, the ASAB titer was reduced in 15 (A group), increased in 3 (B group), and reduced in another 3 (C group). The C group also had an increase in other titers. In the A group sperm count, motility and normal forms improved after surgery (P < 0.05). In the B group, motility was reduced after surgery. In the C group, motility and normal forms were reduced after surgery. Sixty patients were negative for ASAB before surgery. Of these, 48 showed an increase in at least one of the ASAB types to some degree that had no significant effect on semen parameters. In the control group, two patients (7%) were weakly positive for ASAB. CONCLUSIONS: Varicocelectomy may reduce the ASAB level, and this reduction has a good effect on semen parameter quality. Also, it may raise the ASAB level in some patients. This positive conversion has no adverse effect on semen parameters.

Adult↗

Effect of ultrasound on testicular electrolytes (sodium and potassium).

The testes of 50 rats were placed in a cup filled with water and received 1 W/cm2 of ultrasound for 15 min. Fluid was collected from the seminiferous tubules and rete testis of the treated and control groups at 1, 8, 12, and 24 hr intervals. Ultrasound increased the sodium concentration in the fluid of the seminiferous tubules, decreased the sodium concentration in the fluid of the rete testis, increased the potassium concentration in the fluid of the rete testis, and decreased the potassium concentration in the fluid of the seminiferous tubules. Fourteen, slightly sedated, monkeys (Macaca fascicularis) were treated with 1/2 W/cm2 of ultrasound for 30 min. Water was used as the coupling agent for seven monkeys and 3% NaCl was used as the coupling agent for the other seven monkeys. The efficacy of ultrasound treatment in reducing sperm count to zero and achieving zero motility was increased when 3% NaCl was used. Sperm count was at the level of presonication after 20 weeks when water was used as a coupling agent.

Animals↗

Semen characteristics of tobacco users in India.

Qualitative analysis of semen samples have been compared between 79 different types of tobacco addicts (smokers, chewers, and multiple addicts) with 21 nonaddicts (never consumed any form of tobacco). The percentage of motile sperm and total sperm count of the tobacco chewers are significantly low (p < .05). The frequency of abnormal sperm is also significantly high (p < .001) for smoking and multiple addict groups. Differential effects of smoking and chewing tobacco on sperm characteristics are discussed.

Adult↗

Interleukin-2 in seminal plasma of fertile and infertile men.

The role of cell-mediated immunity in the etiopathogenesis of male infertility is far from being defined. The cytokine interleukin-2 (IL-2) has a key role in T-cell mediated immune responses. The aim of this study was to confirm the presence of IL-2 in human seminal plasma, to show eventual differences between IL-2 concentrations in fertile and infertile subjects, and to show potential relationship between IL-2 amounts in semen and spermiogram parameters. Forty-three subjects entered the study, 20 with proven fertility and normal semen quality (fertile group) and 23 with male infertility of at least 2 years and poor semen quality (infertile group). IL-2 levels of seminal plasma in infertile subjects (444.3 +/- 40.5 fmol/mL) were significantly higher than those in fertile subjects (251.3 +/- 42.7 fmol/mL). There was a significant negative correlation between IL-2 levels and sperm count, motility, and morphology. No correlation was found between IL-2 levels and leukocyte count. These findings confirm IL-2 to be in seminal plasma, show increased IL-2 secretion in the infertile group, demonstrate negative correlations of IL-2 levels with main spermiogram parameters, and indicate no correlation with leukocyte count. IL-2 concentration in seminal plasma may therefore be considered as a potential marker in male infertility.

Biomarkers↗

[Semen analysis results and air pollution in the group of men from infertile couples in the Lower Silesia in 1977-2000].

OBJECTIVES: To evaluate the relation among the concentration of selected air pollution and seminal parameters, examined from 1977 to 2000. DESIGN: Semen analysis and air pollution results were retrospectively evaluated. MATERIALS AND METHODS: We have analysed semiograms from 1363 men from infertile couples inhabiting Lower Silesia. Seminal volume, sperm concentration, percentage of pathologic sperms were measured in all men. Estimation of mean seminal volume, total sperm number, sperm motility, and percentage of pathologic sperms per year was performed. Average values for NO2, CO, SO2 and dust concentrations during the study were taken from official sources. RESULTS AND CONCLUSIONS: We showed the statistically significant increase in the percentage of pathological sperms (R2 = 0.9, p < 0.05), the slight increase in the semen volume(R2 = 0.4, p < 0.05). The total sperm count in the semen samples revealed a slight increase (R2 = 0.25, p < 0.05). The sperm concentrations and the percentage of motile sperms remained relatively stable and relatively constant. Statistically important decrease in NO2 (R2 = 0.85, p < 0.05), SO2 (R2 = 0.96, p < 0.05) and dust concentration (R2 = 0.89, p < 0.05) and no change in CO concentration was revealed. There is no correlation among concentrations of dust, NO2, SO2, CO and the increase in percentage of pathologic sperms.

Adult↗