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[Detection of sexual hormone in semen of patients with idiopathic azoospermia or oligospermia and its significance].

OBJECTIVES: To detect the sexual hormone level in semen of patients with idiopathic azoospermia and oligospermia, and further analyze the relationship between sexual hormone and idiopathic azoospermia and oligospermia. METHODS: 50 male patients with idiopathic azoospermia, 50 in idiopathic oligospermia and 50 male controls with normal sperm density were selected. The sperm density and sexual hormone in semen were detected respectively by routine semen analysis and chemical luminescence technique. RESULTS: The values of LH were (5.19 +/- 0.67) IU/L and (4.77 +/- 0.68) IU/L, and those of FSH were (1.90 +/- 0.79) IU/L and (2.27 +/- 0.25) IU/L in idiopathic azoospermia and oligospermia respectively, and the values of LH and FSH were (2.19 +/- 0.22) IU/L and (1.61 +/- 0.14) IU/L in normal control group respectively. There were significant differences in the values of LH and FSH between idiopathic azoospermia and normal control group(P < 0.01 or P < 0.05). The values of PRL were (6.25 +/- 0.51) ng/ml and (6.33 +/- 0.34) ng/ml, and those of T were (1.51 +/- 0.12) ng/ml and (1.68 +/- 0.71) ng/ml in idiopathic azoospermia and oligospermia respectively, and the values of PRL and T were (6.36 +/- 0.32) ng/ml and (1.83 +/- 0.09) ng/ml in normal control group respectively. There were no significant difference in the values of PRL between idiopathic azoospermia, oligospermia and normal control group, but there were significant differences of T between idiopathic azoospermia and normal control. Compared with 0.84 +/- 0.20 in normal control, the values of T/LH were 0.35 +/- 0.09 and 0.29 +/- 0.04 in idiopathic oligospermia and azoospermia respectively and there were significant differences(P < 0.05). CONCLUSIONS: The changes of LH, FSH and T values may be one of the reasons that cause the dysfunction of spermatogenesis and sperm maturation in patients with idiopathic azoospermia and oligospermia. The study of semen hormone may lead to new strategies in the treatment to azoospermia and oligospermia.

Adult↗

[Detection of free testosterone in the serum and semen of idiopathic oligospermia patients and its significance].

OBJECTIVE: To detect free testosterone (FT) in the serum and semen of patients with idiopathic oligospermia, and further analyze the relationship between FT and idiopathic oligospermia. METHODS: Blood samples were collected from the males of a normal control group (n = 44) and an idiopathic oligospermia group (n = 44) at 8:00-10:00 a.m.. Semen samples were collected from the males of a normal control group (n = 30) and an idiopathic oligospermia group (n = 37) at the same time. Sperm density was detected by routine semen analysis, and FT in the serum and semen was detected by RIA. RESULTS: There was no significant difference in the serum concentrations of FT between the groups of normal control [(97.50 +/- 46.96) pmol/L] and idiopathic oligospermia [(94.88 +/- 42.04) pmol/L], P > 0.5. But the difference was significant in the semen concentrations of FT between the groups of normal control [(2.01 +/- 0.32) pmol/L] and idiopathic oligospermia [(0.52 +/- 0.44) pmol/L], P < 0.01. CONCLUSION: Measurement of semen FT concentration could early reflect the function of the testis, which contributes to the early diagnosis and treatment of idiopathic oligospermia.

Adult↗

[Administration of natural anthocyanins derived from chokeberry (aronia melanocarpa) extract in the treatment of oligospermia in males with enhanced autoantibodies to oxidized low density lipoproteins (oLAB). The impact on fructose levels].

PURPOSE: To determinate the influence of anthocyanins from chokeberry on the generation of serous autoantibodies to oxidized low density lipoproteins (oLAB) and fructose levels in semen of males with oligospermia. MATERIAL AND METHODS: Study group consisted of 38 males with oligospermia of who were randomly divided into 2 subgroups: in 22 subjects anthocyanins were administered, while 16 men were on placebo; control group consisted of 25 healthy male volunteers. We examined the level of oxidative stress measured by serum concentration of oLAB, together with fructose levels in semen. RESULTS: In the anthocyanin group oLAB titres decreased from 1103 +/- 34 mU/ml before treatment to 742 +/- 24 mU/ml (1st month) and 724 +/- 23 mU/ml (2nd month), p < 0.01. In the placebo group oLAB titres were as follows--1094 +/- 21 mU/ml before treatment, 1114 +/- 36 mU/ml (1st month) and 1117 +/- 33 mU/ml (2nd month), p > 0.05; oLAB tires in the control group: 601 +/- 40 mU/ml before treatment, 609 +/- 38 mU/ml (1st month) and 609 +/- 38 mU/ml (2nd month), p > 0.05. In the anthocyanin group fructose levels in semen increased from 850 +/- 42 mg/ml before treatment to 1121 +/- 26* mg/ml (1st month) and 1230 +/- 27* mg/ml (2nd month), p < 0.05. In the placebo group fructose levels were as follows--832 +/- 36 mg/ml before treatment, 845 +/- 33 mg/ml (1st month) and 841 +/- 35 mg/ml (2nd month), p > 0.05; fructose levels in the control group: 1376 +/- 40 mg/ml before treatment, 1376 +/- 40 mg/ml (1st month) and 1388 +/- 37 mg/ml (2nd month), p > 0.05. CONCLUSIONS: 1. Our results indicate that natural antioxidants (anthocyanins) can be useful in controlling of oxidative stress in males with oligospermia. 2. Anthocyanins from aronia melanocarpa induce enhanced levels of fructose in semen of males with oligospermia.

Adult↗

[Experimental study on the effects of jujingwan on oligospermia].

OBJECTIVE: To investigate the effects of Jujingwan on the spermatozoal ultrastructure and apoptosis of germ cells in oligospermia patients. METHODS: We treated 50 oligospermia patients with Jujingwan and observed the spermatozoal ultrastructure, the apoptosis of germ cells and the changes in the DNA ploidy proportion of spermatogenic cells by electron microscopy and FCM before the treatment and 3, 6, 9 and 12 months after it. RESULTS: Jujingwan increased sperm acrosome base density 6 months after the treatment and remarkably improved the integrity of acrosome membrane 12 months after it, with no obvious pathological changes in the nuclei and tails. Three months after the treatment, cell debris and apoptotic cells decreased significantly as compared with pre-treatment (P < 0. 05) , and very significantly 12 months after the treatment (P <0. 01). The proportion of haploid spermatozoa increased very significantly (P <0.01) , and the lost primary spermatocytes decreased significantly (P <0. 05) compared with pre-treatment. CONCLUSION: Jujingwan can increase the density of sperm acrosome base and improve the pathological changes of acrosome membrane in oligospermia patients; it can improve the activity of acrosome enzyme and the integrity of acrosome membrane, decrease the apoptosis rate of germ cells and sperm and increase the percentage of haploid spermatozoa; it can also reduce the percentage of apoptotic bodies and diploid sperm cells. It is indicated that Jujingwan can inhibit the apoptosis of germ cells and sperm and improve spermatogenesis in oligospermia patients.

Acrosome↗

Intrauterine insemination as a successful method in the treatment of infertility caused by oligospermia.

Intrauterine insemination combined with controlled ovarian hyperstimulation was used in treating couples with infertility problem caused by oligospermia. We reported 85 cases, with sperm number less than 20.0 x 10(6) per insemination sample. We obtained successful insemination with 0.7 x 10(6) motile sperm cells per insemination sample. We were particularly successful in treating severe oligospermia. Most of the pregnancies in our population of patients ended in delivering singletons. In conclusion, infertility caused by oligospermia may be successfully treated using IUI with controlled ovarian stimulation. Our opinion is that the accuracy of IUI timing is critical, especially when severe oligospermia is concerned.

Female↗

Biochemical parameters in evaluation of oligospermia.

In Pakistan, male infertility constitutes about 35% of all cases of infertility. The dysfunction can be at the level of the central nervous system or somewhere in the male genital tract. A study was conducted to screen cases of male infertility using various biochemical parameters. A total of 81 cases were screened. Oligospermia was seen in 13 (16%) patients. They were divided into severe and mild to moderate oligospermia. In severe oligospermia, there was an increase in serum FSH level with decrease in seminal transferrin and carnitine suggesting damage to sertoli cells. In mild to moderate oligospermia, serum FSH were normal with levels a slight decrease in the levels of transferrin and carnitine in semen indicating that sertoli cells were not significantly defective and the dysfunction could be somewhere else.

Adult↗

Modulation of sperm membrane conformation by pentoxifylline in oligospermia: a biophysical investigation of sperm membrane in vitro.

Low superoxide anion radical levels, low membrane fluidity and high superoxide dismutase activity are some of the defects existing in oligospermia. The phosphodiesterase inhibitor pentoxifylline has been used as a motility stimulant in the treatment of oligospermia in vitro. The mechanism of its action is unclear. Our results show significant inhibition of superoxide dismutase, increase in lipid peroxidation and membrane fluidity after pentoxifylline treatment. A biophysical modulation of the sperm membrane by an oxyradical mechanism in oligospermia is discussed.

Cell Membrane↗

The limitations of in vitro fertilization from males with severe oligospermia and abnormal sperm morphology.

Thirty-one patients whose infertility was attributed to oligospermia were included for treatment by in vitro fertilization and embryo transfer. Three subgroups were defined: severe oligospermia (less than or equal to 5 million motile sperm/ml), moderate oligospermia (6 to less than 12 million motile sperm/ml), and abnormal sperm morphology (greater than 60% atypical). The fertilization rates were compared to those of a normospermic group managed concurrently. A modified overlay technique of sperm preparation is described for oligospermic samples so that the number of motile spermatozoa inseminated into each tube or culture dish containing a mature preovulatory oocyte was similar in each category, within the range 0.5 to 2 X 10(5)/ml. Significantly fewer oocytes were fertilized in the severe oligospermic group (P less than 0.001), suggesting a reduced capacity for fertilization by spermatozoa from severely oligospermic males. The fertilization rate of oocytes was normal in the moderate oligospermic group and those with abnormal morphology, although in the latter there was a significant delay noted in reaching the pronuclear stage (P less than 0.001), and the embryos were at a less advanced stage of cleavage at the time of transfer (0.001 less than P less than 0.01). Pregnancies were achieved in both the severe and the moderate oligospermic groups, with healthy infants delivered from each.

Embryo Transfer↗

Androgen receptor abnormalities in identical twins with oligospermia. Clinical and biochemical studies.

Identical twin brothers presented with oligospermia, small testes, normal male phenotypes, elevated serum luteinizing hormone levels, and normal or elevated serum testosterone levels. Both men had low to low-normal cytosol androgen receptor binding capacity in cultured fibroblasts from pubic skin biopsy specimens. Qualitative abnormalities of cellular androgen receptors were suggested by low-normal or low nuclear androgen uptake in fibroblasts from both brothers as well as abnormal thermolability and subnormal molybdate stabilization of androgen receptors from one brother. In vivo androgen sensitivity was assessed in one twin following administration of testosterone or the non-aromatizable androgen fluoxymesterone. Fluoxymesterone suppressed serum luteinizing hormone and serum testosterone/estradiol-binding globulin, and although testosterone suppressed both serum luteinizing hormone and serum follicle-stimulating hormone, the suppression of serum luteinizing hormone by testosterone was subnormal. Both subjects showed marked exaggeration of the serum 17-hydroxyprogesterone increase after administration of human chorionic gonadotropin, despite normal serum testosterone increases, suggesting a block in testicular 17,20-desmolase, which converts 17-hydroxyprogesterone to testosterone. These studies suggest that oligospermia and block of the enzyme 17,20-desmolase may be the earliest manifestations of androgen resistance, and the finding of the syndrome of oligospermia, normal male phenotype, and androgen receptor abnormalities in identical twins indicates a genetic etiology of this disorder.

17-alpha-Hydroxyprogesterone↗

Experience with intrauterine insemination for cervical factor and oligospermia.

In the past 100 years, interest in intrauterine insemination for cervical factor has waxed and waned. Recently the advent of in vitro fertilization, with improved methods of sperm washing and preparation, has revived interest in intrauterine insemination as a modality for the treatment of infertility. Twenty-seven couples with infertility resulting from cervical factor and/or oligospermia were entered into our intrauterine insemination protocol. A total of 107 intrauterine inseminations were performed in 85 menstrual cycles. Nineteen couples with a cervical factor as the major factor in their infertility experienced three pregnancies (16%). The remaining eight couples who had oligospermia with or without cervical factor produced no pregnancies. No major complications occurred from this procedure. In view of the low pregnancy rate experienced in this study, we must seriously question the value of intrauterine insemination in the treatment of cervical factors and/or oligospermia.

Adult↗

Over-expression of superoxide dismutase and lack of surface-thiols in spermatozoa: inherent defects in oligospermia.

The infertility associated with oligospermia had been suspected to be a direct consequence of the impairment in fertilizing ability of the spermatozoa rather than the presence of low sperm number per se. This study defines some of these impairments, which include an over expression of superoxide dismutase, poor superoxide anion radical generation capacity and a lack of sperm-surface thiols in oligospermia. The abnormal biochemical make-up of spermatozoa could explain their low fertilizing ability in case of oligospermia.

Cell Membrane↗

Steroid 5alpha-reductase 2 gene melting polymorphisms in male subjects with azoospermia or oligospermia.

OBJECTIVE: This study was designed to test the hypothesis that mutations in the gene for type 2 steroid 5alpha-reductase (SRD5A2) may be the cause of a phenotype characterized primarily by oligospermia or azoospermia. STUDY DESIGN: Deoxyribonucleic acid from control subjects and subjects with oligospermia (n = 12) and azoospermia (n = 6) were evaluated for mutations in SRD5A2. Methods used for mutation analysis included polymerase chain reaction, Southern blotting, and denaturing gradient gel electrophoresis. RESULTS: Denaturing gradient gel electrophoresis of all 5 amplified exons resulted in similar migration patterns in samples from both control and study subjects. Genomic deoxyribonucleic acid subjected to denaturing gradient gel electrophoresis after restriction digest revealed melting polymorphisms. Direct sequencing of the gene in a single patient with a unique melting polymorphism yielded a normal sequence. CONCLUSIONS: Melting polymorphisms for SRD5A2 were detected in a group of patients with oligospermia or azoospermia. Sequence analysis did not demonstrate functional mutations in the coding sequence of this gene.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗

Absence of microdeletions in the Y chromosome in patients with a history of cryptorchidism and azoospermia or oligospermia.

OBJECTIVE: To determine if cryptorchidism is associated with microdeletions of interval 6 of the Y chromosome, we evaluated this locus in men with a history of cryptorchidism with and without azoospermia or oligospermia and in a control group. DESIGN: Clinical study. SETTING: Academic research environment. PATIENT(S): Men in whom surgical treatment of cryptorchidism had been performed in childhood and healthy control male subjects. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Genotyping of interval 6 of the Y chromosome. RESULT(S): Analysis of semen obtained from men treated for cryptorchidism in childhood showed azoospermia or oligospermia in 14 of 38 (37%) men. No microdeletions were identified with polymerase chain reaction amplification of 17 distinct sequence tagged sites located on the long arm of the Y chromosome and the sex determining region on Y (SRY) gene. CONCLUSION(S): Microdeletions of interval 6 of the Y chromosome were not detected in either the formerly cryptorchid or in the healthy subjects. Although we cannot exclude the possibility of point mutations, we conclude that cryptorchidism or cryptorchidism associated with azoospermia or oligospermia is not due to microdeletions involving interval 6 of the Y chromosome.

Cryptorchidism↗

Intracytoplasmic sperm injection: a treatment for extreme oligospermia.

PURPOSE: We evaluated the efficacy of intracytoplasmic sperm injection in patients with extreme oligospermia. MATERIALS AND METHODS: A total of 67 intracytoplasmic sperm injection cycles was attempted in 58 infertile couples in which the husbands had extreme oligospermia (less than 100,000 spermatozoa per ml. ejaculate). RESULTS: Fertilization was achieved in 65 of 67 cycles. Mean fertilization rate per cycle was 66.4%. A total of 18 clinical pregnancies was obtained, for a pregnancy rate of 26.8% per started cycle. There were 4 miscarriages and 8 live births from 5 deliveries. Nine pregnancies are ongoing. CONCLUSIONS: Intracytoplasmic sperm injection in patients with extreme oligospermia is associated with high fertilization rates and offers the chance of pregnancy to these otherwise intractably infertile couples.

Adult↗

Creatine kinase as an indicator of sperm quality and maturity in men with oligospermia.

OBJECTIVES: To determine the differences among the creatine kinase (CK) levels in the spermatozoa of subfertile men with mild, moderate, or severe oligospermia and to examine the differences in CK activity between infertile patients with various clinical diagnoses and a group of normal healthy donors (control). CK is a marker of sperm maturity that correlates with the sperm fertilizing capacity. Elevated levels are associated with an increased rate of functional abnormalities and increased cytoplasmic retention. METHODS: We compared the CK levels in 51 oligospermic men who could not initiate a pregnancy. Patients were categorized according to their degree of oligospermia as defined by the total sperm count: mild (greater than 10 to 40 x 10(6); n = 30), moderate (5 to 10 x 10(6); n = 11), and severe (less than 5 x 10(6); n = 10). These patients were further classified according to their diagnosis (ie, varicocele, n = 24; unexplained infertility, n = 17; vasectomy reversal, n = 9; and unknown diagnosis, n = 1). A separate group consisting of 25 healthy donors was included as a control group. A computer-assisted semen analyzer assessed the sperm characteristics, and the CK levels were measured using a CK test kit after the enzyme was extracted with Triton-X. RESULTS: The CK levels were significantly higher in the sperm of the severely oligospermic group (8.8 +/- 6.5 IU/10(8) sperm) than in the moderate (0.50 +/- 0.19 IU/10(8) sperm) and mild (0.49 +/- 0.15 IU/10(8) sperm) groups (P <0.0001). The mean CK level in the severely oligospermic group was 18-fold higher than that in the moderate (P = 0.03) and mild (P <0.001) groups. The CK levels were significantly higher in all three infertile groups compared with the donor group (0.06 +/- 0.01 IU/10(8) sperm). Patients with varicocele had the highest CK level (3.42 +/- 2.56 IU/10(8) sperm) compared with patients in the vasectomy reversal group (1.73 +/- 0.98 IU/10(8) sperm) and the idiopathic infertility group (0.26 +/- 0.08 IU/10(8) sperm). CONCLUSIONS: Elevated CK levels are associated with severe oligospermia, irrespective of the clinical diagnosis. CK may be a sensitive indicator of sperm quality and maturity in the follow-up of patients treated for male factor infertility.

Creatine Kinase↗

Homologous artificial insemination and oligospermia.

Of approximately 339 patients evaluated at a private infertility service over a 5-year period, 24 couples underwent homologous artificial insemination (AIH). Nineteen of these were performed to circumvent the problem of oligospermia, and only one pregancy was achieved in this group; conceivably this pregnancy could have occurred by chance. The difficulty in controlling the numerous variables in a clinical fertility study and the limitations of the present methodology are also discussed. It would appear that the use of AIH to circumvent oligospermia has not been successful. However, the present series is rather small. AIH should continue to be offered to couples who have a well-defined indication such as impotence, premature ejaculation, or any anatomical defect which prevents successful intromission. The use of AIH for patients with mild oligospermia but excellent sperm motility probably deserves a limited trial, since it is less expensive and may offer some chance for success.

Adult↗

[Analysis of Yq microdeletions in idiopathic infertile males with azoospermia and oligospermia in Shaanxi Province].

OBJECTIVE: To evaluate the frequency of microdeletions in the long arm of Y chromosome of idiopathic infertile males with azoospermia and oligospermia in Shaanxi province in China and to investigate the relevance of sperm count to Y microdeletion frequencies. METHODS: According to the sequence of sequence-tagged sits (STS) AZFa, AZFb, AZFc and SRY, 4 of the azoospermic factor regions on Y chromosome long-term supplied by GenBank, 5 sets of primers were synthesized. The Y microdeletions in AZF regions were screened by polymerase chain reaction (PCR) in 64 idiopathic cases of azoospermia and oligospermia and 20 men of known fertility. RESULTS: No microdeletion was detected in the 20 normospermic subjects. Deletion of the AZFc/DAZ was detected in 11 individuals and one patient had both AZFb and AZFc deletion; no deletion of AZFa and SRY region was found. The frequency of Y microdeletions in the subgroups with different sperm count showed the highest value among azoospermic men (3 cases, 21.4%). The percentage progressively decreased with the deletion frequency (20.0%, 17.9% and 8.3%) in the subgroups with sperm counts of < 1 x 10(6)/ml, < (1-5) x 10(6)/ml and < (1 to approximately 10) x 10(6)/ml, respectively. CONCLUSION: Y chromosome microdeletions are specifically associated with severe spermatogenic failure. The rate of deletion involving AZF region of the Y-chromosome is higher in infertile men with azoospermia and oligospermia. PCR amplification of AZF locus is useful for the diagnosis of microdeletions in the Y-chromosome.

Adult↗

Simultaneous treatment of the wife in infertile couples with oligospermia.

Poor ovulation was found to be common in infertile couples with oligospermia. When the sperm count was less than 5 x 10(6)/ml, 33% of wives had poor ovulation. When the sperm count was between 5 x 10(6)/ml and 20 x 10(6)/ml, 78% of wives had poor ovulation. Improvement in sperm count was most likely to increase the chances of conception when the pretreatment sperm count was less than 5 x 10(6)/ml. Pregnancy in infertile couples with oligospermia cannot be related simply to treatment or improvement in the husband's oligospermia but can only be viewed in the context of the wife's fertility, which is quite frequently also impaired in infertile couples with male factor problems.

Clomiphene↗