Increased exfoliation of immature germ cells detected in semen analysis routine and its clinical significance.

To the Editor, Currently, semen analysis is the unique test to evaluate men's fertility potential. Semen analysis provides valuable information on sperm production and quality. In addition to the conventional assessment of the sperm characteristics in a basic semen analysis routine, performing a differential diagnosis of leukocytes and sperm precursors immature germ cells (IGC) is also pivotal, due to adding valuable and clinically suitable information to the semen report [...].

On the Origins of the Semen Analysis: A Close Relationship with the History of the Reproductive Medicine.

The spermatozoa were first seen in ejaculates in the 17th century. However, the basic mechanisms of human fertilization have been only fully understood after the discovery of ovum in 1827. As a result, the interest in developing technologies for semen analysis arose from the early 1900s. Indeed, standard methodologies for semen analysis were designed mostly along the first half of the 20th century. Before the 1930s, semen analysis was nearly unavailable clinically, since there were still no robust methodologies for assessing sperm characteristics, as well as to set up standard references that could be able to assess the reproductive capacity of men. However, joining some methodologies reported from 1910 up to 1930, standardization was attained and thereby semen analysis increasingly assumed its role in laboratory practice for investigating men in barren marriage. This article aims in reviewing historical backgrounds on the semen analysis, up to its insertion in laboratory practice. Emphasis is given to the major studies that contributed either directly or indirectly in developing the earliest routine for the semen analysis.

Temporary impairment of semen quality following recent acute fever.

The impact of an acute fever on semen variables is unclear. This paper reports negative effects and recovery of the sperm quality in a man who had an acute fever of 38°-39°C, due to a throat infection. The study evaluated the sperm quality in semen specimens collected, as follows: 1) one month before the fever; 2) 1-day after the fever; 3) 20 days after antimicrobial therapy. The first and third specimens were quite similar for all semen parameters. However, the second specimen showed unexpected results: not only a decrease in the sperm count, but also an increase of small-head sperm. This study aims to discuss this finding's implications for clinical and laboratory practice.

Colonization of Gardnerella vaginalis in semen of infertile men: prevalence, influence on sperm characteristics, relationship with leukocyte concentration and clinical significance.

AIMS: To determine the prevalence of Gardnerella vaginalis in semen from infertile men and their negative effects on semen quality. RESULTS: Cultures were positive in 24/108 infertile men (22.2%) and negative in controls. Infected semen showed no significant difference compared with non-infected semen. On the other hand, infected and non-infected semen presented significant differences in vitality, rapid and total progressive motility, normal head and mid-piece defects (p < 0.01) and combined anomalies (p < 0.01 and p = 0.03, respectively) in comparison with the control group. Infected semen also presented significant differences in severely amorphous (p = 0.02) and tapered sperm (p < 0.01). Bacteriospermia and cells with attached bacteria (clue cells morphotype) were remarkable features observed. CONCLUSION: G. vaginalis in semen is not associated with either abnormal sperm characteristics or inflammatory response in infected men.

O exame do sêmen na infertilidade masculina: V-exame microbiológico / The microbiological examination of the sêmen to evaluate male infertility

Neste artigo, o autor revisa o papel do exame microbiológico do sêmen para avaliar infertilidade masculina. São descritos os efeitos negativos de bactérias aeróbicas e anaeróbicas, micoplasmas, fungos, Trichomonas sp., Chlamydia trachomatis, Gardnerellavaginalis e Mobiluncus sp. na qualidade do sêmen. A influência de leucocitospermia e bacteriospermia também é revisada. Simultaneamente,também são feitas algumas considerações sobre metodologias atualmente usadas para investigar estes microrganismos no sêmen.

In this article, the author reviews the role of the microbiological examination of the semen to evaluate male infertility.They are described negative effects of aerobic and anaerobic bacteria, mycoplasmas, fungi, Trichomonas sp., Chlamydia trachomatis, Gardnerella vaginalis and Mobiluncus sp. on the semen quality. Influence of leukocytosp.ermia, and bacteriosp.ermia are also reviewed. Simultaneously, they are also made some considerations about methodologies currently used to investigate these microorganismson semen.

Assessment of exfoliated prostate cells in semen: relationship with the secretory function of the prostate.

The percentage of exfoliated prostate cells (EPCs) in 139 semen specimens was determined. A receiver operating characteristic curve showed a cutoff of 17% for EPCs, and specimens were distributed into 4 groups: EPCs 17% or fewer without (group 1; n=44) and with (group 2; n=31) leukocytospermia and EPCs more than 17% without (group 3; n=39) and with (group 4; n=25) leukocytospermia. Acid phosphatase, calcium, and zinc levels; volume and pH of ejaculate; and leukocyte count were assessed. Between groups 1 and 2, the only significant difference was in leukocyte count (P<.001). Between groups 3 and 4, differences were significant in zinc levels (P=.026) and leukocyte count (P<.001). Comparisons of groups 1 and 2 vs 3 and 4 showed lower levels of acid phosphatase activity (P=.017) and calcium (P=.019), and increased seminal volume (P=.019) between groups 1 and 3. Between groups 2 and 4, the difference was significant only in leukocyte count (P<.001). EPCs of 17% or fewer with and without leukocytospermia suggest normal prostate function; EPCs of more than 17% without leukocytospermia suggest abnormal function. EPCs of more than 17% with leukocytospermia were inconclusive.

Unusual presentation of seminal vesiculitis in an infertile man.

Seminal vesiculitis is generally not investigated in infertile men, since it is uncommon and often nonspecific in signs and symptoms. In this article, the author reports an unusual presentation of seminal vesiculitis, incidentally diagnosed in a man referred for semen analysis to investigate infertility. Analyses of physical properties of the ejaculate (coagulation, liquefaction, volume, viscosity and pH) and of biochemical markers of the prostate (total calcium and zinc) and seminal vesicle (fructose and inorganic phosphorus) detected a dysfunction of the seminal vesicles that was subsequently diagnosed as vesiculitis using transrectal ultrasound. After treatment with a single 500-mg dose of oral ciprofloxacin, the patient was referred again for semen analysis. The analysis showed considerable improvement of the seminal vesicle function. The clinical significance of these findings is discussed.

Semen analysis in an infertile man with seminal vesicles cysts associated with ipsilateral renal agenesis.

A case of an infertile man with bilateral seminal vesicles cysts with ipsilateral renal agenesis is presented with emphasis on the semen analysis. Ejaculates showed very low concentration of fructose, leukocytospermia, teratozoospermia, asthenozoospermia, hyperviscosity, marked sperm agglutination and a poor hypoosmotic swelling test. Clinical value of these findings is discussed.

Physical analysis of ejaculate to evaluate the secretory activity of the seminal vesicles and prostate.

The purpose of this study was to ascertain whether analysis of the physical properties of ejaculate also has any diagnostic potential for evaluating the function of these accessory sex glands. Diverse normal and abnormal states of coagulation, liquefaction, volume, viscosity and pH were studied with regard to the levels of biochemical markers of the seminal vesicles (fructose and inorganic phosphorus) and prostate (calcium, zinc and acid phosphatase). Fructose and inorganic phosphorus were significantly decreased in samples with absent or poor coagulation (p<0.001), volume < 2.0 mL (p=0.009 and p<0.001, respectively), hypoviscosity (p=0.013 and p<0.001), hyperviscosity (p=0.006 and p<0.001) and pH < or = 7.1 (p=0.018 and p<0.001). Also, fructose and inorganic phosphorus were significantly decreased in samples with liquefaction > 120 min (p=0.003) and pH > 8.0 (p<0.001), respectively. Calcium, zinc and acid phosphatase activity were significantly increased in samples with absent or poor coagulation (p<0.001), and significantly decreased in samples with volume > 5.0 mL (p=0.007, p=0.034 and p=0.011) and pH > 8.0 (p<0.001). Also, calcium and zinc were significantly increased in hypoviscous samples (p=0.012 and p=0.003), whereas the zinc concentration was significantly lower in hyperviscous samples (p=0.026). Using receiver operating characteristic (ROC) curve analysis, pH showed the highest predictive power to identify prostate dysfunction (83.6%) and simultaneous prostate and seminal vesicle dysfunction (98.8%). Physical analysis of ejaculate was also found to be clinically useful for evaluating the secretory activity of the seminal vesicles and prostate. Abnormal coagulation, liquefaction, volume, viscosity and pH strongly suggest gland dysfunction.

Ureaplasma urealyticum and Mycoplasma hominis in men attending for routine semen analysis. Prevalence, incidence by age and clinical settings, influence on sperm characteristics, relationship with the leukocyte count and clinical value.

AIM: To investigate the clinical value of the screening of Ureaplasma urealyticum and Mycoplasma hominis in routine semen analysis. MATERIAL AND METHODS: Semen samples of 234 patients with several clinical settings (infertility, varicocele, spontaneous abortion, genital infections, undescended testicles, hemospermia, etc.) were distributed in three study groups: group 1--negative cultures; group 2--normal colonization (< or =10(3) colony-forming units (cfu)/ml), and group --pathogenic colonization (>10(3) cfu/ml). Frequency rates, incidence by age and clinical settings, association with abnormal sperm characteristics (density, vitality, motility and morphology) and with the leukocyte count were investigated. RESULTS: Prevalence of U. urealyticum was higher than M. hominis (< or = 10(3) cfu/ml: 28.2 vs. 24.8%; >10(3) cfu/ml: 20.5 vs. 13.3%). No difference was detected on the incidence of mycoplasmas by age and clinical settings, as well as in regard to the mean values of sperm density, vitality, motility, oval-headed sperm and leukocyte count (p > 0.05). CONCLUSION: In spite of the high incidence of mycoplasmas, not enough information was available regarding the influence of these microorganisms on the sperm quality and their relationship with the leukocyte count. Therefore, screening of U. urealyticum and M. hominis for routine semen analysis is not clinically relevant.

Semen analysis in laboratory practice: an overview of routine tests.

Semen analysis is a basic step in the investigation of several disturbances affecting the male genital tract. Analysis of seminal parameters provides important clinical information on the spermatogenesis and functional competence of spermatozoa, as well as on the secretory pattern of the accessory genital glands. Semen analysis is particularly useful in the evaluation of couples requiring fertility investigation (to detect genital infections and pathologies) and in verifying the influence of environmental factors, drugs, lifestyle, chemical products, and professional activities on several diseases affecting male reproductive health. Measure of semen quality is of substantial interest for diagnoses in clinical urology, andrology, and gynecology. Currently, basic requirements for semen analysis are standardized by World Health Organization (WHO) guidelines that describe several procedures for an objective evaluation of the semen quality with diagnostic purposes. These guidelines include: parameters for the physical and biochemical evaluation of semen; parameters for the analysis of sperm characteristics; and other seminal parameters that can be easily adopted in any laboratory. This report summarizes current concepts on semen analysis and the significance of the seminal parameters for reaching a diagnosis based on the procedures recommended by WHO guidelines.

O papel do exame do sêmen na infertilidade masculina III - testes para função espermática / The role of semen analysis in the male infertility III - Sperm function tests

O autor revisa o papel do exame do sêmen (espermograma) na investigação de infertilidade masculina. Nesta terceira parte aborda o uso de testes para avaliar a capacidade de fertilização dos espermatozóides (testes funcionais), dando ênfase às metodologias disponíveis para esta avaliação. Simultaneamente descreve alguns aspectos estruturais dos espermatozóides e conceitos atuais sobre fertilização humana.

O sêmen como veículo de transmissäo sexual dos microrganismos associados à vaginose bacteriana: Relato de caso / Semen as a vehycle of sexual transmission of microrganismos associated to the bacterial vaginosis: a case report

Gardenerella vaginalis e outros microrganismos associados à vaginose bacteriana foram detectados simultaneamente no sêmen de um paciente e na secreçÝo vaginal de sua esposa. O autor avalia o significado deste achado e mostra evidências que o sêmen é um veículo de transmissÝo sexual destes microrganismos. Discute-se a possibiliade do homem ser um reservatório para infecçÝo e reinfecçÝo da mulher

O papel do exame do sêmen na infertilidade masculina. I - Análise das características dos espermatozóides e de suas células precursoras / The role of semen analysis in the male infertility. I. Analysis of the characteristics of the spermatozoa and of their precursors cells

Os autores revisam o papel do exame do sêmen (espermograma), na investigação de infertilidade masculina, abordando nesta primeira parte, a análise das características dos espermatozóides (contagem celular, viabilidade, motilidade e morfologia) e de suas células precursoras. Dá-se ênfase a conceitos atuais, metodologia de análise e ao significado clínico dos resultados encontrados. Simultaneamente, também são feitas algumas considerações sobre a espermatogênese e sobre a maturação espermática.

Colonizaçåo vaginal pelo Enterococcus faecalis: prevalência e manifestaçöes citológicas e microbiológicas / Vaginal colonizatin by Enterococcus faecalis: prelance and cytologic and microbiologic findings

Os autores estudaram corrimentos vaginais de 113 pacientes (idade entre 2-52 anos), para investigar a prevalência de Enterococcus faecalis e sua associaçåo com achados citológicos. Cinco faixas etárias foram estudadas: 0-12 anos, 13-18 anos, 19-30 anos, 31-40 anos e maior de 40 anos. A prevalência de Enterococcus faecalis foi maior em pacientes com 0-12 anos (22,8 por cento), 19-30 (40,9 por cento) e 31-40 (22,8 por cento) e menor nas faixas de 13-18 anos (9,0 por cento) e maior de 40 anos (4,5 por cento). A presença de Enterococcus faecalis nas secreçöes vaginais analisadas nåo foi associada com aumento de leucócitos polimorfonucleares, de histiócitos, ou de células epiteliais descamativas. Por outro lado, a colonizaçåo de Sthaphylococcus aureus e de Staphylococcus epidermidis foi menor na presença de Enterococcus faecalis, em pacientes com 0-12 anos (p<0,05) e 19-30 (p<0,05 para a colonizaçåo pelo Staphylococcus aureus e p<0,01 para a colonizaçåo pelo Staphylococcus epidermidis). O mesmo ocorreu com a colonizaçåo de Escherichia coli, em mulheres com 19-30 anos (p<0,05). Os significados destes achados såo discutidos