The semen of fertile men. II. Semen characteristics of 100 fertile men.

From a population of men applying for voluntary sterilization, 100 consecutive cases were selected according to the following criteria: (1) each man had fathered at least two children; (2) at the time of the request for a vasectomy the man's wife was pregnant; and (3) a complete prevasectomy semen analysis, including sperm morphology, was available. The usual parameters of human semen evaluation are reported: the mean volume of the ejaculates was 3.3 ml +/- 0.84 SD (range, 0.5 to 11 ml); the mean sperm density was 81 million/ml +/- 57 SD (range, 4 to 318); while the geometric mean, which according to the sample distribution is more representative, was 68. The mean percentage of motile sperm was 63% +/- 16 SD (range, 10 to 95%); the grade of forward progression was 3 +/- 0.55 SD (range, 2 to 4); and for sperm morphology the mean number of sperm with oval heads was 75% +/- 6 SD (range, 21 to 90%). Statistical comparison of these findings with those of our previous study of the semen of 1300 fertile men revealed complete agreement; minor statistical differences, on single parameters, with three similar studies are indicated. A positive relationship between the different variables, sperm density and sperm motility (in percentage of motile sperm and degree of forward motion), as well as between the two variables of sperm motility and sperm morphology to the other variables was confirmed.

PIP: In a previous report the characteristics of 1300 consecutive prevasectomy semen specimens of men who had fathered 2 or more children were analyzed. From the same population a group of subjects was selected whose wives were pregnant at the time of the semen analysis. From the files of the Vasectomy Service at the Margaret Sanger Research Bureau, Inc. in New York City, 100 consecutive men whose prevasectomy semen analysis reports fulfilled the following criteria were selected: the man had fathered 2 or more children and his wife was again pregnant at the time of the prevasectomy semen analysis; and the prevasectomy semen analysis was complete, including the evaluation of morphology. Each prevasectomy semen specimen was collected by masturbation. The analyses were made within 90 minutes-3 hours postejaculation. Study results are reported in terms of volume, sperm density, motility, sperm morphology, and semen quality and age. The volume of the ejaculate in the population studied ranged from 0.6-11 ml. The mean volume for these 100 fertile men was 3.31 ml +or- 1.84 SD. The sperm density, or count per milliliter, ranged from 4-318 million. The mean value for these 100 men was 81 million +or- 57 SD. The geometric mean, which is considered to be more accurate, was 68 million. The percentage of active sperm cells ranged from 10-95. The mean number of active cells was 63% +or- 16 SD, with the greatest proportion (70%) in the group having 40-80% motility. The quality of sperm motility was graded according to MacLeod's system of estimating grade of activity and forward motion from 0, or total immobility, to 4. In the 100 semen specimens the quality of sperm motility ranged from grade 2-4. In these 100 specimens the percentage of sperm with oval heads ranged from 21-29; the mean was 73% +or- 6 SD. There was no sound basis for stating whether any difference between different groups was due to the difference in age or whether it merely reflected individual situations, as is most likely the case. The findings are compared to the investigations of MacLeod, MacLeod and Gold, and Falk and Kaufman. A positive relationship between the different variables, sperm density, and sperm mobility, as well as between the 2 variables of sperm motility and sperm morphology to the other variables was confirmed.

The semen of fertile men: statistical analysis of 1300 men.

The prevasectomy semen analyses of 1300 men who had fathered at least two children were studied. The ages of the men ranged from 23 to 64 years, with a mean age of 39.6 years; 84% of the men were Caucasian, 5% were black, and 5% were of other ethnic groups; 32% of the men were Roman Catholic, 26% Jewish, 22% Protestant, and 11% professed no religion; in 9% religion was not recorded. The number of children ranged from 2 (48%) and 3 (30.6%) to 10 (0.1%). The volume of the ejaculate ranged from 0.1 to 11.0 ml, with a mean of 3.2 ml plus or minus 1.4 SD. Sperm density ranged from 1.5 to 375 million/ml, with an arithmetic mean of 79 million/ml plus or minus 57 SD; however, the logarithmic or geometric mean was chosen as being more representative of the asymmetric distribution under study. The geometric mean was 65 million/ml, with standard deviation limits of 30 to 142 million/ml, figures that correspond to the 16th and 84th percentiles. The percentage of motile sperm ranged from 5 to 95%, with a mean of 65% plus or minus 22 SD. The grade of sperm motility, according to MacLeod and Gold's classification (Fertil Steril 2:187, 1951) of 0 to 4, ranged from 1 to 4, with a mean grade of 3. There were 25 men (2%) with a sperm count below 10 million/ml and 26 (2%) in whom the percentage of motile sperm was less than 20%. Polyzoospermy (count greater than 250 million/ml) was found in 15 men (1.2%); one or more spontaneous abortions had occurred in six of the spouses of these men (40%), whereas the over-all spontaneous abortion rate was 7% and the spontaneous abortion rate for wives of men with sperm counts below 10 million/ml was 4%. A positive relationship was found between sperm density and percentage of motile sperm; the relationship between motility and the logarithm of sperm density was represented by a straight line (a 10-fold increase in sperm count was accompanied by an increase of 20.4% in sperm motility); the slope of the line was highly significant, although the correlation coefficient was weak (0.27). A similarly positive relationship was found between sperm density and grade of motility; however, the correlation coefficient was also weak (0.22). The relationship between the grade of motility and the proportion of motile sperm also positive, was reasonably large (0.70), although its significance is questionable because of the crudeness of the scale utilized to assess the grade of sperm motility. A comparison of the findings with those of similar studies was made.

Clinical experience with LEM, an intrauterine contraceptive device.

PIP: The larger model LEM IUD was studied in a group of 464 women of which 63% were nulliparous and 37% were parous. The nulliparous group showed pregnancy rate of 12.5% at 12 months and the parous group showed rates of 5% at 12 months and 9.3% at 24 months. Expulsions in the nulliparous group increased from 5.3% at 3 months to 12.7% at 12 months and the parous group rate increased from 1.2% at 3 months to 5.9% at 12 months eventually reaching 7.3% at 24 months. Removal rates were 19.8% in the nulliparous group and 11.8% in the parous group. Figures for the entire group showed a rate of accidental pregnancy of 13.5%, expulsion 11%, removal 33%, and a continuation rate of 42 per 100 first insertions. Though the LEM is easily inserted and has relatively few complications, the pregnancy and expulsion rates do not recommend the device.^ieng

Sperm-agglutinating antibodies in 236 infertile couples.

PIP: 19 wives of 236 couples had positive sperm agglutination tests. (SPAT) 6 of the 19 belonged to the 70 couples (9.4%) with no no known cause for infertility; 11 belonged to the group of 154 couples (7.1%) with a known cause; and 2 to the 12 couples inadequately investigated (15.7%). 6 of these 19 women (31.6%) became pregnant without condon therapy; of these 6, 3 had no known cause for infertility and 3 had a known cause. 11 husbands had positive sperm aggluatination tests. 4 of these 11 were among the 70 couples (5.6%) with no known cause for infertility, while the other 7 were among the 154 couples (4.5%) with a known cause. 5 of their wives (45.5%) became pregnant without any treatment. Outcomes of 8 of 11 pregnancies were normal deliveries and no abortioons, which showed that positive SPAT had no apparent effect on the pregnancies. There was no relationship between postitive SPAT and history of venereal disease, allergy, autoimmune disease, abortioon, postcoital tests, or ABO imcompatability.^ieng

Vasectomy: a study of psychosexual and general reactions.

PIP: In order to study the psychosexual changes and reactions of the vasectomzied males at the Margaret Sanger Research Bureau, a questionnaire was mailed to the first 236 consecutive clients who had the operation during the period October 1969-September 1970. 189 of the 236 men responded. All the men except 2 reported that their sexual desire was the same as or greater than before the operation. The 2 men reporting less sexual desire also complained of physical discomfort or pain during intercourse which may have been the reason for the decrease in desire. Nearly 2/3 of the total cases indicated an increase in sexual enjoyment; only 1 person reported a decrease. More than 1/3 of the men reported that they had an increase in their sexual frequency following the operation, and the remaining 116 men reported no change in sexual frequency. Regarding men's self-evaluation of ejaculation (volume), 3/4 of the men reported no change, 1/6 reported more, and 1/12 reported less. The sexual desire or enjoyment of wives as perceived by their husbands had either increased or remained the same as before the operation in all but 4 instances. Over 98% of the patients expressed satisfaction and were quite willing to recommend the vasectomy operation to others. All of the patients who responded said that they would still make the same decision again.^ieng

Successful use of the diaphragm and jelly by a young population: report of a clinical study.

In the largest contemporary study of diaphragm use in the United States, the authors examine the experience of 2,168 women who selected this method of contraception at the Margaret Sanger Research Bureau over a recent two-year period. Eight in 10 of the study group were younger than 30 years and three in 10 were aged 21-24. Seven in 10 had never been married and the same proportion had never been pregnant. Accidental pregnancies in the first 12 months of use ranged from a low of 1.9 per 100 users younger than 18 years old to a high of 3.0 among 30-34-year-olds; and more than eight in 10 were still using the diaphragm at the year's end. These rates compare favorably with those reported for the pill and IUD in other clinical studies.