Xiaokang Liuwei Dihuang decoction ameliorates the immune infertility of male rats induced by lipopolysaccharide through regulating the levels of sex hormones, reactive oxygen species, pro-apoptotic and immune factors.

Male immune infertility is a kind of disease that damages family life and happiness. The development of novel methods treating male immune infertility is of great significance. This study aimed to investigate the therapeutic effects of Chinese medicine Xiaokang Liuwei Dihuang decoction on immune infertility of male rats and explored the involved mechanisms. Model rats were established by lipopolysaccharide (LPS) injection. Anti-sperm antibody (AsAb) was detected by ELISA assay and testicular cell apoptosis was evaluated by TUNEL staining to verify the successful model establishment and screen suitable doses of Xiaokang Liuwei Dihuang decoction. Thirty rats were then divided into five groups (n = 6 per group): Control, LPS, Xiaokang Liuwei Dihuang decoction (15.12 g/kg, 30.24 g/kg and 45.36 g/kg). Results of HE staining showed that compared with LPS group, Xiaokang Liuwei Dihuang decoction treatments gradually improved the morphology of seminiferous tubules and elevated the number of spermatogenic cells as the doses increased. The sperm number and the levels of testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) in the serum of 15.12 g/kg, 30.24 g/kg and 45.36 g/kg Xiaokang Liuwei Dihuang decoction groups were much higher than those in LPS group. Results of TUNEL staining, ELISA assay and western blot showed that compared with LPS group, the testicular cell apoptosis and the levels of interleukin 1ß (IL-1ß), tumor necrosis factor α (TNF-α), AsAb, malondialdehyde (MDA) and toll-like receptor 2 (TLR2) in the testicular tissue significantly decreased in three Xiaokang Liuwei Dihuang decoction groups. Compared with LPS group, Bax expression in the 30.24 g/kg and 45.36 g/kg Xiaokang Liuwei Dihuang decoction groups was significantly down-regulated as well. In conclusion, Xiaokang Liuwei Dihuang decoction might ameliorate the immune infertility of male rats induced by LPS through regulating the levels of sex hormones, reactive oxygen species, pro-apoptotic and immune factors.

[Influence of immunocorrection on the inflammatory process in the urogenital tract in men with infertility].

We studied the concentration of metalloproteinases, pro-and anti-inflammatory cytokines, lymphocyte activation markers in seminal plasma of men with oligosymptomatic forms of chronic inflammation of the urogenital tract complicated with infertility. It was shown that chronic inflammation of the urogenital tract shifts the levels of cytokine profile, reduces the concentration of metalloproteinase-2 (576.4 +/- 89.3 ng/ml, P < 0.001), chemokines - fractalkine (16.3 +/- 1.3 pg/ml, P < 0.001) and chemmmokine regulated by activation, expression and secretion of normal T-cells (RANTES (12.7 +/- 1.0 pg/ ml, P < 0.001). Additionally, we observed a sharp increase in IL-8 (215.5 +/- 7.8 pg/ml, P < 0.01), MCP-1 (926.4 +/- 30.2 pg/ml, P < 0.001) and elevation of the CD25 + / CD95 + ratio. These observations point for alterations in apoptotic mechanisms in pathological forms of the generative cells and their accumulation in the sperm. Prolonged inflammation of the genital area is accompanied by depletion of the local immune system resulting in the development of infertility. The multidirectional shifts in IL-10/IL-12 index have been established: an increase in the group of patients with elevated level of hypercapitated spermatozoa and its reduction in microsomatic morphotype of spermatozoa. These data emphasize the importance of the microenvironment in maturation of gametes. It was shown that an inclusion of alfagin and gepatomax in immunorehabilitation of men with oligosymptomatic forms of urogenital infections improves leukocyte subpopulation content of sperm and concentrations of pro-and anti-inflammatory cytokines, and therefore, results in an increase in fertilizing potential.

[Influence of phytotherapy on pro- and antioxidant status in spermatozoa, seminal plasma and immunologic status of sperm in men with chronic inflammation of the urogenital tract complicated by infertility].

The lipid peroxidation and antioxidant enzymes in the blood of men with oligosymptomatic forms of chronic inflammation of the urogenital tract complicated by infertility are studied. Studied cytokine status of sperm in infertile men. The positive effect of imupret in combination with gepatomax on the oxidative activity systems, which leads to an improvement of leukocyte subpopulations of sperm, to normalize the concentrations of pro- and anti-inflammatory cytokines, and therefore, an increase in fertilizing are shown.

[Studying the dynamics of the levels CD4+CD25+, CD4+ HLA-DR4 + and CD4+CD95+ cells in the semen of men with oligosymptomatic forms of chronic urogenital infection complicated infertility under the influence of fortege].

The markers of activating of lymphocytes in sperm of men with the oligosymptomatic forms of chronic urogenital infection depending on fertility. It is set that the increasing of correlation of CD25/CD95 brings to growth of pathological forms of spermatozoa and, consequently, to the decline of impregnating ability of men. Fortege application leads to the normalization of this correlation and a reduction of pathological forms of sperm and thus to the increasing of the fertilizing potential.

[Clinical observation on treatment of male infertility with positive antisperm antibody by self-formulated Xiaokang Zhongzi Recipe].

OBJECTIVE: To observe the therapeutic effect of self-formulated Xiaokang Zhongzi Recipe (XZR) in treating male infertility with positive antisperm antibody (AsAb). METHODS: One hundred and ten male infertility patients with positive AsAb were randomly assigned, according to randomized digital table, to the trial group treated with XZR, and the control group, treated with prednisone, 55 in each group. Clinical therapeutic effect and adverse reactions of the drugs were observed after 3 months of treatment. RESULTS: In the trial group after treatment, 38 patients (69.1%) were cured, 14 (25.4%) improved and 3 treated in vain (5.5%, including 2 dropped out). While in the control group, the corresponding numbers were 12 (21.8%), 11 (20.0%) and 32 (58.2%, including 4 dropped out, 20 remained AsAb positive and 8 with AsAb reverted to positive after negative conversion). The negative conversion rate and average negative conversion time in the trial group and the control group were respectively 94.5%, (45 +/- 14) days and 41.8%, (62 +/- 21) days. Significant difference between the two groups was shown in therapeutic effectiveness and average negative conversion time (P < 0.01). Adverse reactions occurred in 3 cases (5.5%) in the trial group and 8 (14.5%) in the control group. CONCLUSION: XZR is better than prednisone in treating male infertility with positive AsAb, and with fewer and milder adverse reactions.

[Clinical study on the treatment of male immune infertility by Huzhangdanshenyin].

OBJECTIVE: To investigate the efficacy of the Chinese medicine Huzhangdanshenyin on male immune infertility, and provide an effective therapy for this disease. METHODS: Ninety men with immune infertility were selected as the research subjects and randomly divided into two groups, 60 in the treatment group, treated by Huzhangdanshenyin, and the other 30 in the control, treated by prednisone, both for 3 months. The improvement of clinical symptoms, immunologic indexes (antisperm antibodies in serum and seminal plasma) and sperm indexes (semen liquefied duration, motility, viability, density and abnormal morphology rate) were observed and the results analyzed. RESULTS: The total antisperm antibody reversing ratio of the treatment group was higher than that of the control (P < 0.01), especially the serum antisperm antibody reversing ratio. There were significant differences in the clinical cure rate and total validity rate between the treatment group and the control (P < 0.01). After the treatment, the markers of the clinical symptoms (P < 0.01), especially the serum antisperm antibody reversing ratio. There were significant differences in the clinical cure rate and total validity rate between the treatment group and the control (P < 0.01). After the treatment, the markers of the clinical symptoms were lower (P < 0.01), and the improvement of the clinical symptoms was better in the treatment group than in the control (P < 0.01), especially the symptoms of pain in the back and knees, distending and bearing-down sensation of the perineum and testis, hypersexuality and topalgias. Compared with pre-treatment, sperm motility and viability of the treatment group significantly improved (P < 0.01), and so did sperm density (P < 0.05). However, there were no significant differences in sperm density, semen liquefied duration, abnormal morphology rate and pH (P > 0.05) before and after the treatment. CONCLUSION: The Chinese medicine Huzhangdanshenyin works more effectively than prednisone in the treatment of male immune infertility. It could improve the antisperm antibody reversing ratio, clinical symptoms and signs and ameliorate sperm indexes with no obvious advierse effects.

TCM treatment of male immune infertility--a report of 100 cases.

OBJECTIVE: To observe the therapeutic effect of Yikang Tang (Yikang Decoction) for male immune infertility. METHODS: 100 cases of male immune infertility in the treatment group were treated with Yikang Decoction, while 100 cases treated with prednisone as the controls. Physical exam, routine semen and prostate exams, and exams for presence of anti-sperm antibody (AsAb) and mycoplasma in the serum or seminal plasma were carried out. RESULTS: 1) The serum and seminal plasma AsAb levels decreased significantly (P < 0.01) in both the groups after treatment, with a more remarkable effect in the treatment group. 2) The sperm density and percentage of motile spermatozoa increased significantly in the two groups, but more significantly in the treatment group after treatment. The pregnancy rate of their wives was higher in the treatment group than that in the control group (P < 0.01). 3) The sperm agglutination rate in the two groups decreased, but more significantly in the treatment group after treatment. 4) The improvement rate of the symptoms and the stability of the therapeutic effect were more dramatic in the treatment group than that in the control group (P < 0.01) after termination of drug administration. CONCLUSION: The Yikang Decoction has a more stable effect for male immune infertility than prednisone.

Effects of the combined therapy of acupuncture with herbal drugs on male immune infertility--a clinical report of 50 cases.

UNLABELLED: To study the clinical effects of the combined therapy of acupuncture with herbal drugs on male immune infertility and on antisperm antibody (AsAb), 100 male cases of infertility with positive AsAb were divided randomly into two groups, each consisting of 50 cases. The acupuncture-drug group was treated with acupuncture on Ganshu (BL 18), Shenshu (BL 23), Taichong (LR 3), Taixi (KI 3), Xinshu (BL 15), Geshu (BL 17), Shenmen (HT 7), and Xuehai (SP 10), combined with oral medication of Liuwei Dihuang Wan (Bolus of the Six Drugs Including Rehmanniae). The control group was treated with oral prednisone. The clinical therapeutic effects and the impact on AsAb were observed in the two groups. The results showed that the total effective rate in the acupuncture-drug group was 90%; while that of the control group was 64%, the comparison showing a statistically significant difference (P<0.05). The positive rate of blood serum and/or AsAb in both the two groups decreased in varying degrees, but the negative-turning rate of AsAb in the acupuncture-drug group was more obvious, the comparison showing also a significant difference (P<0.05). CONCLUSION: The combined therapy of acupuncture with herbal drugs has definite therapeutic effects on male immune infertility, which can regulate AsAb and raise the immunity of the patients.

[Clinical observation on effect of combination of zhuanyindan and hormone in treating male infertility with positive antisperm antibody].

OBJECTIVE: To explore the therapeutic effect of combination of Zhuanyindan (ZYD, a self-made Chinese herbal preparation) and hormone in treating male infertility with positive antisperm antibody and its influence on nitric oxide (NO) level. METHODS: Eighty-two patients were randomly divided (according to the digital list) into the WM group (n = 20, treated with prednisone), the TCM group (n = 28, treated with ZYD) and the ICWM group (n = 34, treated with prednisone plus ZYD). The clinical effect, negative converting rate of antisperm antibody, changes of NO level in semen and various parameters of sperm motion before and after treatment were observed. RESULTS: The total effective rate in the ICWM group was 88.2%, that in the TCM group 75.0% and in the WM group 65.0%. Significant difference was seen in the ICWM and TCM group before and after treatment in NO level, sperm motion parameters, including linear motion speed, linearity, propulsion, whip frequency, sperm vitality and mean moving angle, and quality of semen (P < 0.05 or P < 0.01). In the WM group, significant difference in comparison before and after treatment was seen in NO level, propulsion, whip frequency, mean moving angle and quality of semen, including vitality and survival rate (P < 0.01). CONCLUSION: Combination of Chinese herbs and hormone could lower the NO level in semen and improve the quality of sperm.

[A microcomputerized pulsed water-sac massage with drug penetration instrument for treatment of male patients with immunity infertility accompanied by chronic seminal vesiculitis].

This article describes the development of an innovative microcomputerized pulse-water-sac massage with drug penetration instrument and reports its effectiveness in the patients with immunity infertility accompanied by chronic seminal vesiculitis. The instrument was developed on the basis of the pathological characteristics of immunity infertility accompanied by chronic seminal vesiculitis, and along the lines of our practice in integrating the modern theory of traditional Chinese medicine, with multiple techniques of biomedical engineering sciences. 181 male patients with immunity infertility accompanied by chronic seminal vesiculitis received the treatment. Of these cases, 135(74.6%) were cured, 37(20.4%) were treated with significant therapeutic effects and 9(5.0%) with improved effects. The results of antisperm antibody (AsAb) tests became negative in 85.6% of the patients after treatment, and the pregnancy rate of their wives was 49.1%. No mild adverse effects were observed in all cases.

[The effect of Chinese medicine yiqihuoxuetang on T-lymphocyte subpopulation in peripheral blood of infertile men with antisperm antibodies].

OBJECTIVES: To study whether Chinese Medicine Yiqihuoxuetang(YQHXT) could inhibit antisperm antibodies in infertile men, and to explore the therapeutical mechanism of YQHXT. METHODS: Thirty infertile men with antisperm antibodies took YQHXT continuously for 60 days. Indirect immuno-fluorescence technique (IFT) was used to detect the levels of CD3, CD4, CD8 and CD4/CD8 ratio before and after treatment. RESULTS: CD4 value and CD4/CD8 ratio after treatment were significantly lower than before treatment (P < 0.05); CD8 value became significantly higher(P < 0.05). CONCLUSIONS: The results indicated that YQHXT could inhibit antisperm antibodies by keeping the balance of T-lymphocyte subpopulation in immunoinfertile men.

[Chinese traditional medicine yi kang ling to treat immunity infertility caused by anti-sperm antibody: the experimental research II].

OBJECTIVE: To observe the effects of Chinese traditional medicine Yi Kang Ling (YKL) on immunity infertility caused by anti-sperm antibodies (AsAb). METHODS: With the AsAb infertile rabbit as the experimental model, seventy-five pairs of New zealand rabbits were divided into three group including YKL treatment group (sub-divided into mini-, midi- and maxi-dosage groups), prednisone treatment group and non-treatment group. Rabbits of the YKL treatment sub-groups were further divided into M+F- (male positive, female negative), M-F+, (male negative, female positive) and M+F+ (male positive, female positive) pairs according to their initial AsAb detection results. The control group consisted of five pairs of normal rabbits. When the expected AsAb reversing ratio was achieved, the rabbits were matted and observed for the number of the pregnant and the weight of the newborn. RESULTS: Statistics showed that in M+F- pairs both the midi-dosage of YKL and prednisone treatment groups had fertility, in the mini- and maxi-dosage of YKL treatment groups, 20% of the female rabbits failed to be pregnant, while in the non-treatment group, 60% female rabbits remained sterile. The sterile ratios of the M-F+ pairs in the mini-, midi- and maxi-dosage of YKL and prednisone treatment groups were 0, 20%, 25% and 25%, respectively, while the sterile ratio in the non-treatment M-F+ group was 40%. In M+F+ groups, the sterile ratios of the three YKL sub-groups, prednisone treatment and non-treatment groups were 20%, 20% and 60% respectively. In the control group the sterile ratio was 20%. The weight of the newborn rabbits were around 50 grams with no visible malformation. CONCLUSIONS: YKL can effectively reverse the AsAb positive results, and restore the fertility of female rabbits. Mini-dosage of YKL for 45 days produced the best results and maxi-dosage of YKL had no negative effects on the weight of the newborn rabbit.

Effect of antibiotic therapy in asthenozoospermic men associated with increased agglutination and minimal leukospermia.

Thirteen patients with asthenozoospermia and semen analysis suggestive of infection were studied and divided at random into 2 groups according to the antibiotic treatment they received: (I) ciprofloxacine 250 mg every 12 hours by 14 days per os (n = 7) and (II) trimethoprim 160 mg and sulfamethoxazole 800 mg every 12 hours by 14 days per os (n = 6). Their couples received the same treatment. Changes in sperm density, morphology, viability, motility, agglutination, pH, and presence of leukocytes were analyzed before and after treatment. The average of morphologically normal sperms significantly decreased after treatment in the ciprofloxacine group; sperm with grade III motility increased in the trimethoprim-sulfamethoxazole group, but without statistical significance. With these preliminary results, it can be concluded that antibiotic administration modifies some of the spermatic parameters, particularly motility and morphology, in patients whose semen analysis parameters suggested infection.

[Treatment of immunological infertility with Chinese medicinal herbs of ziyin jianghuo].

According to the microcosmic Syndrome Differentiation, immunological infertility is recognised as Kidney Yin Deficiency-Hyperactivity of Fire Syndrome. Zhibai Dihuang Pills, a recipe of Chinese medicinal herbs, was used to treat the infertile couples with antisperm and/or antizona pellucida antibodies in their blood serum. It was found that after the treatment, the antibodies were converted to negativeness in 81.3% of immunological infertile couples. All 8 cases of successful pregnancy occurred in 1-9 months after antibodies negative conversion and the negative status was maintained throughout the course of pregnancy.

Auto-immunity to spermatozoa and quality of semen in men with spinal cord injury.

OBJECTIVE: To determine the presence of anti-sperm antibodies in serum, and on spermatozoa, in men with spinal cord injury. DESIGN: Thirty men whose injury occurred 1 to 18 years ago compared with 30 men with normal semen. PATIENTS AND INTERVENTIONS: Eighteen tetraplegic and 12 paraplegic patients were treated with vibrator or rectal electrostimulation, yielding a total of 25 ejaculates. RESULTS: Semen analyses (WHO): volume low, with concentration > 100 million/mL in 80%; 8/30 exhibited sperm agglutinating antibodies, but with low titres. CONCLUSIONS: Low titres of serum antibodies and absence of attached IgA antibodies indicate autoimmunity is not the cause of low sperm motility and penetration capacity in these patients.

Determination of sperm antibodies in human genital secretions by an ELISA technique.

Sera and genital secretions of 178 infertile men and 40 infertile women were evaluated for antibodies against spermatozoa by an enzyme-linked immunosorbent assay (ELISA). It was shown that circulating sperm antibodies are not usually transudated into genital secretions and, on the other hand, that local antibodies found in cervical mucus or seminal plasma are not detectable in serum. Furthermore it was demonstrated that the solubilization of cervical mucus by bromelain almost completely removes antibody activities detectable by ELISA, whereas sonication of mucus does not affect the immunoglobulins. Sonication should thus be applied for liquefaction of cervical mucus in order to assess its antibody properties.

Male hypogonadism--current concepts and trends.

Important advances have been made recently in our knowledge of hypothalamic-pituitary-testicular functions. Current understanding of the hypothalamic control of pituitary gonadotrophin secretion and the mechanisms of testicular feedback is beginning to yield benefits in the clinical management of certain reproductive disorders. But much remains to be learned about the neuroendocrine control of hypothalamic GnRH secretion--an area which encompasses the mechanisms regulating the onset of puberty. Spermatogenesis is a highly complex process involving subtle interactions between endocrine, paracrine and autocrine regulators acting on different cell populations within and without the testis. Until basic research can advance the very limited knowledge in this area, we cannot expect to improve the currently unsatisfactory management of infertile men. It is not surprising that only limited information can accrue from conventional semen analysis and measurement of systemic hormones. Nor is it unexpected that empirical or seemingly rational treatments for male infertility are of dubious benefit. In future, assessment of the infertile man should be improved by studying sperm functional capacities and testicular synthesis and metabolism of gonadal steroids and by the definition of representative markers of Sertoli cell and epididymal functions. Reversible male contraception is another objective that remains beyond our reach at present. Hormonal disruption of spermatogenesis is often incomplete and invariably suppresses Leydig cell function, so that androgen replacement for sustaining sexual function is mandatory. Alternative approaches to male contraception aimed at the epididymis and sperm-egg interaction seem more promising avenues for future exploration.