TCM treatment of male infertility due to seminal abnormality--a clinical observation of 82 cases.

82 male patients of infertility due to seminal abnormality were treated by Ju Jing Powder with a total effective rate of 85.4%. The sperm density in seminal fluid, the total sperm number in a single ejaculation and the activity rate of sperms markedly improved as compared with those before treatment (P less than 0.01), especially the grading of sperm motility.

Lack of correlation of selenium level in human semen with sperm count/motility.

Considering the importance of selenium (Se) in male fertility, its concentration was measured in 211 semen samples from 211 normozoospermic, oligozoospermic, asthenozoospermic, and azoospermic men using the hydride generation atomic absorption spectrophotometry. No significant correlation of any kind existed between Se level in the seminal plasma and sperm count or motility. In view of the known poor correlation of these two frequently used semen parameters with the incidence of pregnancy, the assessment of the fertilizing potential of normozoospermic ejaculates with low Se levels is warranted.

The clinical application of aspiration deoxyribonucleic acid flow cytometry to neurologically impaired men entering an electroejaculation program.

For the neurologically impaired patient electroejaculation with a rectal probe can furnish sperm for artificial insemination. However, documentation of pregnancies in this patient group has been limited. Deoxyribonucleic acid flow cytometry has been shown to be a reproducible quantitative method with which to evaluate spermatogenesis. We assessed the ability of deoxyribonucleic acid flow cytometry on testicular aspirates to predict the quality of sperm production in 13 men undergoing electroejaculation. Semen analysis was performed on antegrade and retrograde specimens. Deoxyribonucleic acid histograms from testicular aspirates were evaluated for the relative proportions of haploid, diploid and tetraploid cells. These ratios were compared to the means reported for our own series of 25 patients who at vasovasostomy had sperm intraoperatively and to the similar figures from a group of 10 accident victims. Five patients had normal testicular ploidy compartments defined as within 2 standard deviations from control means. Of the 5 patients 4 had normal sperm counts and motilities (30 per cent or greater). Two patients have contributed sperm for artificial insemination; 1 has resulted in pregnancy. Three patients had moderately abnormal (2 to 4 standard deviations) testicular ploidy classes. These patients had adequate sperm counts but low motilities (5 per cent or less). Of the 5 patients with markedly abnormal (greater than 4 standard deviations) histograms 4 remained azoospermic despite repeated attempts at electroejaculation. Our data support the use of deoxyribonucleic acid flow cytometry on testicular aspirates as a predictor of which patients might succeed and those who are unlikely to succeed in an electroejaculation program.

An unforeseen complication of home parenteral antibiotic therapy.

Increasing pressure to cut the length of hospital stay has resulted in a large number of patients receiving home parenteral antibiotic therapy. We present a case of an immediate allergic reaction in a penicillin-sensitive spouse of a patient receiving parenteral mezlocillin sodium therapy. A seminal level of 42 micrograms/mL of mezlocillin was documented by bioassay.

Immunoreactive somatostatin in male reproductive system in humans.

Somatostatin-like immunoreactivity is distributed widely in humans; the highest concentration is in the central nervous system, gastrointestinal tract, and pancreas. To determine if somatostatin is present in the male reproductive system, we analyzed human testis, epididymis, prostate, and semen. Somatostatin-like immunoreactivity was detectable in acid extracts of human testis, epididymis, and prostate (n = 6 each) in concentrations of 4.0 +/- 1.4 (+/- SD), 14.7 +/- 3.2, and 27.5 +/- 5.1 pmol/g wet wt, respectively. Considerable amounts of immunoreactive somatostatin also were detectable in semen; the mean value was 3.8 +/- 1.3 nmol/L (n = 6). This value was 200-fold higher than that in peripheral plasma. The somatostatin immunoreactivity in these tissues was characterized by gel filtration chromatography. Two peaks of somatostatin immunoreactivity, one coeluting with somatostatin-14 and the other with somatostatin-28, were found in the testis, epididymis, prostate, and hypothalamus. The amounts of the two sizes were nearly equal in the testis; somatostatin-14 predominated in the epididymis, prostate, and hypothalamus; whereas only somatostatin-28 was detected in semen. The presence of somatostatin in the male reproductive system suggests that somatostatin may play a role in the regulation of reproductive function in men.

Semen selenium content and sperm mitochondrial volume in human and some animal species.

Selenium (Se) and glutathione peroxidase (GSH-Px) were determined from the seminal plasma samples and spermatozoa of human and four different animal species. The human sperm Se concentration was 1.8 +/- 0.8 micrograms/g dry weight, which was about half of that in the bull. Abnormal sperm morphology and motility correlated with low sperm Se content. The volume of sperm mitochondrial sheath in human, bull and stallion was measured using transmission electron microscopy. In these species the sperm Se content was highly correlated with the volume of mitochondria. Among the five species studied, the seminal plasma level of Se was lowest in human male and stallion, while the highest levels were encountered in the bull. No correlation was obtained between human semen quality and seminal plasma Se concentration. The seminal plasma GSH-Px activity was low in man and ram, absent in boar and stallion but very high in the bull. The amount of structural sperm Se as well as seminal plasma Se and GSH-Px activity appears to be highly variable in different species.

Human seminal plasma cadmium: comparison with fertility and smoking habits.

Cadmium, selenium and zinc were determined in seminal plasma and serum of 64 men by atomic absorption spectrometry (AAS). The mean (+/- SD) cadmium concentrations in seminal plasma and serum were 0.22 +/- 0.22 micrograms and 0.28 +/- 0.10 micrograms, respectively, but they did not correlate with each other. Smokers (n = 31) had significantly (p less than 0.01) higher serum cadmium concentrations than non-smokers (n = 31). Also seminal plasma cadmium in smokers was elevated, but a significant difference to non-smokers was only found if more than 20 cigarettes were consumed daily. No differences were found in semen quality and fertility between smokers and non-smokers. The seminal plasma cadmium had no correlation to selenium or zinc which, however, displayed a positive correlation (r = 0.852, p less than 0.001) to each other. It is concluded that smoking increases the exposure to cadmium. Although no obvious reproductive suppression was observed, heavy smoking may possibly enhance toxic effects in men under other detrimental exposures.

PIP: Cadmium, selenium, and zinc were determined in seminal plasma and serum of 64 men by atomic absorption spectrometry (AAS). The mean (+or- SD) cadmium concentrations in seminal plasma and serum were 0.22 +or- 0.22 mcg and 0.28 +or- 0.10 mcg, respectively, but they did not correlate with each other. Smokers (n=31) had significantly (p0.01) higher serum cadmium concentrations than nonsmokers (n=31). Also, seminal plasma cadmium in smokers was elevated, but a significant difference to nonsmokers was only found if 20 cigarettes were consumed daily. No differences were found in semen quality and fertility between smokers and nonsmokers. The seminal plasma cadmium had no correlation to selenium or zinc which, however, displayed a positive correlation (r=0.852, p 0.001) to each other. It is concluded that smoking increases the exposure to cadmium. Although no obvious reproductive suppression was observed, heavy smoking may possible enhance toxic effects in men under other detrimental exposures. (author's)

[Use of an anti-H extract of elder berries in the absorption-elution reaction during the examination of blood stains, saliva and sperm]. / Primenenie v reaktsii absorbtsii-éliutsii èkstrakta anti-H iz plodov buziny travianistoi pri issledovanii piaten krovi, sliuny i spermy.

Parameters of using anti-H extract from elder berries in absorbtion-elution reaction in order to detect H antigen in blood and excretion stains were established.

Selenium, rubidium and zinc in human semen and semen fractions.

The levels of selenium, rubidium and zinc were determined in samples of semen, seminal plasma and spermatozoa from men with suspected infertility, together with several parameters of semen quality. The proportion of whole semen selenium present in sperm increased with increasing sperm count from 0 to 40%. For rubidium 98 +/- 4% and for zinc 95 +/- 8% of the total amount in semen was contained in seminal plasma. In seminal plasma a positive correlation was found between the levels of zinc and selenium, and between the levels of zinc and rubidium, indicating that, like zinc, selenium and rubidium in seminal plasma also derive mainly from the prostate gland. Semen quality parameters, such as sperm motility, vitality, speed and morphology, were not correlated with the contents of the three elements in either whole semen or seminal plasma. As the seminal content of selenium is dependent on the proportion of prostatic secretion in seminal plasma and on the sperm count, and both factors can vary considerably, the selenium level of whole semen does not appear to be a suitable parameter for investigation of the relationship between selenium and semen quality. Provisional measurements suggest lower sperm selenium levels at abnormally low or high sperm counts.

Selenium and glutathione peroxidase in seminal plasma of men and bulls.

High levels of selenium and glutathione peroxidase (GSH-Px) were found in bull seminal plasma but low concentrations in human seminal plasma. In man the seminal plasma selenium was associated with two macromolecules separable by gel filtration, but no GSH-Px was found in the same fractions. Selenium in bull seminal plasma was associated with two proteins, which could be separated by gel filtration and anion exchange chromatography. Both macromolecules coeluted with GSH-Px activity and had identical optima at pH 7.0. Their responses to thermal treatment, however, differed. Seminal vesicle secretory fluid in the bull contained both these proteins, while the larger molecule was also found in fractionations of ampulla, prostate and Cowper's glands. The larger enzyme form is evidently a tetramer of the smaller one. Both enzyme forms were extremely sensitive to heavy metals and some divalent metal ions. GSH caused an activation while other reducing agents were suppressive. Triton X-100 had no effect, while sodium deoxycholate was inhibitory. These properties are typical for a phospholipid hydroperoxide GSH-Px. It is concluded that this selenium-dependent enzyme may be important in the protection of bovine spermatozoa against damage caused by oxygen radicals, while in man such a mechanism is not functional.

Lead, magnesium, selenium and zinc in human seminal fluid: comparison with semen parameters and fertility.

The concentrations of lead, magnesium, selenium and zinc in seminal fluid from men with variable semen quality (sperm morphology, density and motility) and fertility were determined by atomic absorption spectrometer without or with Zeeman background correction. The mean (+/- SD) concentration of selenium in the samples (n = 142) was 28.8 +/- 9.5 micrograms/l, which was about a third of the corresponding serum value (77.8 +/- 13.3 micrograms/l, n = 140). The serum selenium level was significantly (P less than 0.001) higher in infertile than in fertile men, but the seminal fluid did not show such a difference. No correlation was obtained between selenium values in seminal plasma and sperm density or motility. The levels of lead in seminal fluid were very low with no correlation to the levels of magnesium, selenium and zinc or the semen qualities. The seminal fluid lead concentration was significantly (P less than 0.001) higher in infertile (3.6 +/- 3.2 micrograms/l, n = 79) than in fertile men (1.7 +/- 1.0 micrograms/l, n = 39). Magnesium (103.5 +/- 49.2 mg/l, n = 90) and zinc (141.1 +/- 71.7 mg/l, n = 157) concentrations in seminal fluid were comparable with previous reports. Both minerals showed a positive correlation to the seminal fluid selenium, while only zinc displayed a borderline correlation with sperm density. The present findings indicate that the determination of seminal fluid selenium may not offer any advantages over zinc and magnesium measurement in the fertility assessment and its role in human semen remains obscure. The low lead concentrations in the present material is a clear indication of low industrial exposure.

Experience in vibratory and electro-ejaculation techniques in spinal cord injury patients: a preliminary report.

More than 90 per cent of complete spinal cord injury patients have major fertility problems, depending upon the site and type of injury. During the last 5 years 34 patients were treated by vibratory and/or electrostimulation at our center, and semen was produced in all but 5. In 8 patients ejaculation was attempted by vibratory stimulation alone and in 22 electrostimulation also was used. Vibratory stimulation is the easier and less cumbersome of the 2 methods. No major side effects were noted with either technique. Stimulation was performed by a rectal electrode incorporated in a silicone finger glove with a current of 0.1 msec. in duration, a frequency of 30 Hz. and an average of 60 volts. Vibratory stimulation was applied to the frenulum and/or glans penis with a specially constructed vibrator at a frequency of 80 Hz. and a peak-to-peak oscillation of 1.6 to 2.4 mm. Semen obtained during the first 6 months after injury was not of a quality consistent with successful fertilization owing to poor motility. However, semen quality and motility were better in patients who had been injured for more than 6 months. Repeated electro-ejaculation did not improve the quality of semen. The effects of bladder outlet surgery and autonomic blockers were noted in 5 patients.

Rectal probe electrostimulation in the treatment of anejaculatory spinal cord injured men.

This paper reviews our experience with rectal probe electroejaculation (RPE) which is part of a larger effort to determine the correlates of successful ejaculation and fertility in SCI men. RPE is performed in the outpatient clinic using specially designed rectal probes. Over the past 18 months, we have attempted RPE on 38 occasions in 12 subjects (eight paraplegics and four quadriplegics) with an age range of 23-38 years and 0.5-18 years since onset of injury. Anterograde ejaculation occurred in nine subjects with improvement in percent motility and total live sperm count on repeated stimulations in five subjects. Significant retrograde ejaculation occurred in one person and sperm acceptable for artificial insemination (AI) was obtained from four subjects. The major side effects were mild dysreflexia (three subjects) and disruption of a normal bowel program (one subject). We conclude that RPE is a safe, relatively brief outpatient procedure and, with repeated stimulations, has a good potential for producing sperm acceptable for AI in selected patients.

Effect of serum sources and colostral whey on bovine semen quality and spermatozoa immunoglobulin G immunofluorescence.

Heifer, bull, fetal calf sera, and colostral whey were used to evaluate the influence of protein concentrations on percent progressive motility, head-to-head agglutination, acrosomal integrity, and immunoglobulin G immunofluorescence of bovine spermatozoa using ejaculates from 10 bulls. In the first experiment, 10% (vol/vol) addition of undiluted colostral whey resulted in the highest head-to-head agglutination, acrosomal integrity, and immunoglobulin G immunofluorescence. Ten percent (vol/vol) addition of whey diluted to a protein concentration equivalent to fetal calf serum produced significantly lower agglutination, acrosomal integrity, and immunoglobulin G immunofluorescence. Fetal calf serum was unable to produce agglutination and immunoglobulin G immunofluorescence of bovine spermatozoa. Heifer and bull sera produced similar responses for all seminal measurements. In Experiment 2, unheated whey and heifer serum resulted in higher response for all variables than heat inactivated whey and heifer serum. Whey treatment produced greater spermatozoal motility, agglutination, acrosomal integrity; and immunoglobulin G immunofluorescence than treatment with heifer serum. Spermatozoal immunofluorescence indicated antibodies in normal whey, bull, and heifer serum bound to spermatozoal membranes at the acrosomal region. Colostral whey was an effective source of agglutinin factor. Normal unheated whey and heifer serum did not cause sperm damage or immobilization.

Selenium in reproductive organs, seminal fluid and serum of men and bulls.

The concentrations of selenium in the reproductive organs, seminal fluid and serum of human males and bulls were analysed using an atomic absorption spectrometer with Zeeman background correction. The mean (+/- SD) concentration of selenium in human seminal fluid (33.4 +/- 14.1 micrograms/l, n = 70) was less than half the level detected in serum (78.2 +/- 9.9 micrograms/l, n = 32). In bulls, the mean selenium concentration in seminal fluid (457.4 +/- 108.7 micrograms/l, n = 113) was about nine times higher than in human males, while the level in serum (49.1 +/- 5.1 micrograms/l, n = 94) was significantly (P less than 0.001) lower than in human serum. The selenium concentration (500 +/- 244 micrograms/l) in the bovine seminal vesicle secretions were comparable to those in the seminal fluid and this gland appears to be mainly responsible for the high selenium levels in the seminal fluid. The mean selenium concentration in reproductive tissues of both species was highest in the testes. The distribution of selenium in the bovine epididymis was biphasic. The testicular and epididymal selenium are associated mainly with macromolecules of the spermatogenic cells and spermatozoa. It was concluded that studies in farm and laboratory animals do not necessarily form a reliable basis for conclusions with regard to human male reproduction, since selenium may have a different role and importance in the reproduction of various species.

Reproductive biology of paraplegics: results of semen collection, testicular biopsy and serum hormone evaluation.

The fertility and urological status of 30 male paraplegics between 20 and 47 years old with lesions between the T2 and L3 levels were examined by studying serum hormone levels (estradiol-17 beta, testosterone, prolactin, and follicle-stimulating and luteinizing hormones), sperm and semen characteristics via testicular biopsy and rectal probe electrostimulation, and urodynamic evaluation. Of the patients 13 had reflexic, 4 hyperreflexic and 13 areflexic bladders. Nine of the 13 patients with reflexic and all 4 with hyperreflexic bladders had a positive external sphincter electromyogram with detrusor-sphincter dyssynergia. When catheters were not used to collect semen during rectal probe electrostimulation, retrograde semen flow into the bladder was the rule. A total of 22 patients could tolerate rectal probe electrostimulation, while 6 who could not were injured at the T12 level or lower. Seminal emissions were obtained from 35 to 42 studies in these 22 patients. Total sperm count was variable; in 22 studies it was greater than 20 million. Progressive motility usually was low; 77 per cent of the patients had less than 20 per cent motility. Of 13 biopsy specimens obtained 6 suggested normal testicular morphology, with tubule atrophy and spermatogenic activity only mildly reduced in 6 of the remaining 7. Serum testosterone and luteinizing hormone values were significantly higher (p less than 0.05) among the paraplegic patients than among intact male volunteers of the same age range. Other serum hormone levels were unchanged. Outcome of rectal probe electrostimulation and biopsy did not relate to the number of years of patient injury. Thus, the principal deterrent to the use of semen collected by rectal probe electrostimulation from paraplegics for artificial insemination resides in a predominantly low sperm motility. Suggestions for improvement of motility include 1) great care to minimize or prevent urinary tract infections, 2) selection of medications for urinary tract care that do not compromise sperm survival and 3) prevention of sperm stagnation in lower tract storage sites, perhaps by use of periodical rectal probe electrostimulation.