Andrological Examination Research Articles

307 TESTICULAR ULTRASONOGRAPHIC CHARACTERISTICS OF GUZERAT (BOS TAURUS INDICUS) BULLS DURING THE PERIPUBERTAL PERIOD

Recently, ultrasonography has been used to study reproductive tract and testes development in the bull. The testicular ultrasound allows identification of subtle changes in the echotexture of the testicular parenchyma in the different stages of reproductive development. The aim of the present study was to characterize the pixel intensity (echotexture) of testicular ultrasonograms of Guzerat bulls in the peripubertal period to attempt to raise efficiency of sire selection programs and puberty identification. Seventy-five animals from 9 to 30 months of age were evaluated monthly for 6 consecutive months. The testes were examined using a 5-MHz linear array transducer connected to a B-mode ultrasound scanner (Fukuda®, Tokyo, Japan). Images were frozen on the monitor of the ultrasound scanner and recorded on VHS tape. The images were digitalized and the average pixel intensity (PI) of the testes was determined by the J1.58 (National Institutes of Health, Bethesda, MD, USA) software image package. Additionally, all of the bulls were submitted to a complete andrological examination and seminal collection was attempted when males had a scrotal perimeter > 20 cm. Onset of puberty was considered to have occurred when at least one motile sperm cell was detected in the ejaculate. Statistical analysis was performed using the SAS statistical package (SAS Institute Inc., Cary, NC, USA; Student-Newman-Keuls test and Pearson correlation). The PI in pubertal animals (95.0 ± 39.01 cm3) was higher (P < 0.05) than non-pubertal animals (56.5 ± 43.1 cm3). Changes in patterns of testicular echotexture during the peripubertal stage reflect the gradual and significant increase (P < 0.05) of the intensity of pixels observed in animals from 9 months (36.7 ± 22.2 cm3) up to 30 months of age (127.4 ± 46.2 cm3). The correlation between age and intensity of pixels was significant (P < 0.05; r = 0.534). The increase of PI is an important indicator of puberty in bovine males. Nevertheless, it was not possible to establish a pattern of testicular echotexture that characterized the precise time of onset of puberty. Thanks to Fazenda do Rosário, CAPES, and CNPq.

Urinary di(2-ethylhexyl)phthalate (DEHP)—Metabolites and male human markers of reproductive function

Phthalates are suspected to act as endocrine modulators in humans and exert reproductive toxicity. The general population is exposed to phthalates through nutrition, consumer products, medications and medical devices. The aim of the present study is to explore whether internal phthalate exposure represented by metabolites of di(2-ethylhexyl) phthalate (DEHP) can be related to human markers of reproductive function (i.e. semen concentration, motility and morphology). We recruited 349 men who were part of subfertile couples and were referred for fertility work-up between April 2004 and November 2005. Semen analysis was performed according to recommendations of the World Health Organization (WHO). Parameters were dichotomized based on 1999 WHO reference values for sperm concentration (<20million/ml) and motility (<50% sperm with progressive motility), as well as Tygerberg strict criteria for morphology (<4% normal forms). We analyzed internal DEHP exposure in single spot urine samples by determining its secondary metabolites mono(2-ethyl-5-oxo-hexyl)phthalate (5oxo-MEHP), mono(2-ethyl-5-hydroxyhexyl)phthalate (5OH-MEHP) and 5carboxy-mono(2-ethylhexyl)phthalate (5cx-MEPP) next to the monoester metabolite mono(2-ethylhexyl)phthalate (MEHP). Logistic regression was performed for the three semen parameters (concentration, motility, and normal morphology) to estimate their dependence on the sum of the four DEHP metabolites (DEHP-4) under consideration. Adjustment was performed for age, duration of abstinence, and smoking status. DEHP metabolites of n=349 men (age: median=34ys) were analysed. Median concentrations [microg/l] were MEHP (n=337) 4.35, 5OH-MEHP (n=341) 12.66, 5oxo-MEHP (n=341) 9.02, and 5cx- MEPP (n=292) 14.53. Semen parameters of n=349 men were analysed by logistic regression. Semen concentration (<20mio/ml: 35%) or sperm motility (WHO A+B <50%=20%) were not found to be associated statistically significantly with the sum the DEHP metabolites (DEHP-4). Metabolites of DEHP and other phthalates analyzed in urine are very specific for determining recent internal phthalate exposure. According to our evaluation human reproductive parameters from semen analyses do not show significant associations with concentrations of DEHP metabolites determined in spot urine sampled at the day of andrological examination.

Clinical relevance of polymorphonuclear (PMN‐) elastase determination in semen and serum during infertility investigation

The polymorphonuclear (PMN) elastase is secreted by activated granulocytes and is widely used as a marker of male accessory gland infection. However, the clinical value of routine determination of seminal plasma (SP) PMN elastase in asymptomatic patients during infertility investigation has not clearly been established and not much is known about the significance of PMN-elastase levels in serum as a potential biochemical determinant associated with infection/inflammation of the male genital tract. This prospective study included a total of 221 asymptomatic males from unselected subfertile couples, to evaluate the relationship of (i) serum and (ii) same-day SP PMN elastase concentrations with established semen quality parameters, including sperm functional capacity, local antisperm antibodies (ASA), seminal leucocytes, and the outcome of semen cultures including typical sexually transmitted disease pathogens, and a potential association with patients' medical history and results of clinical andrological examination. Furthermore, couples were followed up for subsequent fertility (controlled for female infertility factors). The concentrations of PMN elastase in serum and in SP were not significantly related to semen quality [with regard to microscopic (e.g. count, motility, morphology) as well as biochemical parameters, and also to local ASA of the IgG- or IgA-class]. There was no strong relationship with sperm functional capacity. No significant relationship with the outcome of the microbial screening was found. PMN-elastase levels in serum and SP were not significantly correlated and there was no association with subsequent fertility. Therefore, the value of routine determination of PMN elastase in semen and/or serum samples, particularly when used as a single parameter to screen for subclinical infection/inflammation in males under infertility investigation is limited.

Avaliação andrológica por pontos e comportamento sexual em touros da raça Nelore

Objetivou-se estudar a relação entre dois métodos de avaliação do potencial reprodutivo - Classificação Andrológica por Pontos (CAP) e comportamento sexual de touros da raça Nelore - e verificar a acurácia desses testes em predizer o potencial reprodutivo dos touros, avaliado pela taxa de gestação ao final da estação de monta, com duração média de 90 dias. Foram utilizados 14 touros, todos classificados como aptos à reprodução, após exame andrológico, CAP e observação do comportamento sexual a campo durante 12 horas. Onze touros foram avaliados em manejo individual, com proporção média touro:vaca de 1:46, e os três restantes, em manejo múltiplo, com proporção média touro:vaca de 1:23. A pontuação média obtida pela CAP foi 78,92 ± 8,92 (muito bom) e o escore, 9,85 ± 0,36 (excelente) para libido. Quanto maior o tempo de teste, maiores foram os escores da libido. Na primeira hora de observação, os touros foram classificados como de libido questionável e ao final do teste, como de libido excelente. As correlações da libido com circunferência escrotal (CE), características físicas e morfológicas do sêmen e taxa de gestação foram baixas. A pontuação pela CAP correlacionou-se positivamente com circunferência escrotal e características físicas do sêmen, mas não se correlacionou com características morfológicas dos sêmen. Não foi observada correlação entre CAP e taxa de gestação, nem entre libido e CAP. A taxa geral de gestação após o período de estação de monta foi de 74,69%. Os resultados indicam que tanto a CAP como o teste da libido não são eficientes para predizer o potencial reprodutivo de touros da raça Nelore e devem ser utilizados de forma complementar ao exame andrológico.

Influence of moderate cycling on scrotal temperature

Testicular temperature highly correlates with scrotal temperature. It has been postulated that cycling is associated with increased scrotal temperatures with time and consecutively with impaired semen quality. The aim of this study was to evaluate the influence of moderate cycling on scrotal temperature during highly standardized conditions in an experimental lab. A total of 25 volunteers without a history of infertility and normal andrological examination were included for scrotal temperature evaluation. Scrotal temperatures were measured every minute with a portable data recorder connected with two thermistor temperature sensors, which were attached on either side of the scrotum. A further thermistor sensor was attached on the central surface of the bicycle saddle. Ambient temperature in the study room was adjusted to 22 degrees C throughout the whole experiment. All volunteers started the experiment at the same daytime. Clothing of the volunteers consisted of standardized cotton wool trousers and shirts fitting to body size. After acclimatization to the study room in a sitting posture, each volunteer cycled on an exercise cycle for 60 min with a power of 25 Watt representing a speed of 25.45 km/h respectively. The saddle surface temperature reached in the median 35.59 degrees C after 60 min cycling. Median values of scrotal temperatures increased from 35.75 degrees C at the beginning to 35.82 degrees C after 60 min for the left side and from 35.50 to 35.59 degrees C for the right side. No correlation between cycling duration and scrotal temperatures could be found using multivariate anova for repeated measurements. However, scrotal temperatures during cycling were significantly lower (p < 0.001) compared with the last 10 min in sitting posture before starting cycling with a difference of 1.31 degrees C for the left and 1.46 degrees C for the right side. The present study suggests that moderate cycling under standardized conditions with a power of 25 Watt is not a major genital heat stress factor.

T10-O-29 Male sexual health and prevention

Objective The aim of this study was to assess the knowledge and attitude towards sexual health care among men. Design and methods. A sample of 160 men was interviewed during an andrological examination (experimental group, EG) and data were compared (using Chi square) with a control group (CG) matched for demographic characteristics and absence of medical condition. A structured interview with closed questions was used for data collection. A hierarchical cluster analysis was conducted on the total sample with between-group linkage method to identify a men group with an adequate preventive attitude. Results Significant differences between groups (all α-levels lower than 0.05) were found in the items: “knowledge concerning condom use”, “knowledge of male reproductive system”, “importance of andrological prevention” and “importance of trustworthy specialist”. Conclusion The respondents had poor knowledge of sexual health care, particularly concerning STDs. Men belonging to EG showed significantly higher preventive attitude than CG. Furthermore, the results showed that single, not married men, with a mean age of 37 and without children have better preventive attitudes than elder men with a partner and with children. Since hierarchical cluster analysis is an exploratory method, results should be treated as tentative until they are confirmed with an independent sample.

Myth and reality of the decline in semen quality

Many hormonal and non hormonal hypotheses have been put forward to explain a suspected decline in semen quality. We report on sperm parameter variation from the beginning of the eighties and the nineties in patients requesting an andrological clinical examination (1172 and 1393 respectively) and sperm bank donors selected by the same andrologists (17 and 21 donors, with 170 and 227 semen analyses respectively). We reduced bias to a minimum: all the semen analyses were carried out by the same biologist, using the same methods, the study groups were homogeneous for age, geographic-ethnic origin, residence, monthly-seasonal distribution and abstinence period. Comparing patients from the 80s and the 90s, sperm concentration and motility showed a significant reduction. Furthermore, the decrease in concentration was mainly due to the age classes 26-30 and 31-35. The decline in motility was mainly due to the age class over 40 years. In donors, slight variations without a biological impact were observed. Our results indicate that subjects with higher levels of sperm production remain unaffected, while those with medium and lower levels are experiencing a real decline. This could mean that a selection is taking place in our country in favour of young, healthy, and highly fertile men.

Influence of heating car seats on scrotal temperature

To evaluate the influence of a heated versus an unheated car seat on scrotal temperature under standardized experimental conditions. Controlled clinical study. Healthy volunteers in an academic research environment. Thirty volunteers without a history of infertility and with a normal andrological examination. Scrotal temperatures were measured every minute with a portable data recorder connected to two thermistor temperature sensors, which were attached on either side of the scrotum. All volunteers started the experiment at the same time of day wearing standardized cotton wool trousers and shirts fitting to body size. Each volunteer performed two periods of 90 minutes in a randomized manner on either the heated or unheated car seat. At the end of the sitting periods scrotal temperatures were significantly higher using the heated car seat versus the unheated seat (left scrotal side: 0.5 degrees C; right scrotal side: 0.6 degrees C). Maximum values recorded during sitting alone were exceeded on the heated seat already after one-third of the exposure time. The present study suggests that the frequent use of a heated car seat represents an additional scrotal, and consequently, testicular heat stress factor to that which is present by merely sitting for long periods.

Glycol ethers and semen quality: a cross-sectional study among male workers in the Paris Municipality

Objectives: Apparent increases in human male reproductive disorders, including low sperm production, may have occurred because of increased chemical exposure. Various glycol ether-based solvents have pronounced adverse effects on sperm...

Seasonal variation in semen quality of swamp buffalo bulls (Bubalus bubalis) in Thailand

To test the hypothesis that season affects the semen quality of swamp buffalo (Bubalus bubalis) bulls used for artificial insemination (AI) under tropical conditions in Thailand, as it does in Bos taurus and Bos indicus. Clinical and andrological examinations, and monitoring of semen production and quality were carried out on five mature, healthy swamp buffalo AI bulls in Thailand from July 2004 to the end of June 2005. Sperm output, motility, morphology and plasma membrane integrity (PMI) were compared between three seasons of the year (rainy, i.e. July-October; winter, i.e. November-February; and summer, i.e. March-June) with distinct ambient temperature and humidity. All bulls were diagnosed as clinically healthy and with good libido throughout the study. Ejaculate volume, pH, sperm concentration, total sperm number and initial sperm motility did not differ between seasons, whereas PMI and the relative proportion of morphologically normal spermatozoa were highest in summer and lowest in winter (P<0.05). Buffalo age, week of collection and season influenced sperm morphology (P < 0.05-0.001). Among morphological abnormalities, only proportions of tail defects were affected by season, being highest in the rainy season and lowest in summer (P<0.001). In conclusion, climatic changes did not seem to largely affect semen sperm output or viability. Although the proportions of PMI and tail abnormalities were affected by season, they were always below what is considered unacceptable for AI bull sires. Seasonal changes did not appear to cause deleterious changes in sperm quality in swamp buffalo AI-sires in tropical Thailand.

Types of Y chromosome deletions and their frequency in infertile men

Deletions of Y chromosome AZF locus were analyzed during a large-scale andrological and genetic examination of 810 infertile men. The search for Yq microdeletions was carried out according to the standard EAA/EMQN guidelines. The breakpoints were mapped for the deletions in AZF locus. The Y chromosome macro- and microdeletions were detected in 61 (7.5%) infertile men. The frequencies of AZF deletions during azoospermia and severe oligozoospermia amounted to 12.2 and 8.1 %, respectively. On the whole, the frequencies of Yq microdeletions and the genophenotypic correlations characteristic of various AZF deletion types comply with the relevant published data. However, spermatozoids in the ejaculate sediment of men with completely deleted AZFa region or AZFb+c deletions (from solitary spermatozoids to several dozens) were detected for the first time. It was demonstrated that the breakpoints were localized between AZFa and AZFb regions proximally to AZFb+c microdeletions for the majority of cytogenetically detectable deletions in the Y chromosome long arm. This indicates that the mechanisms underlying Yq macro- and microdeletions are somewhat different. The issues related to the role of Y chromosome deletions in the origins of monosomy for X chromosome and X/XY mosaicism are discussed.

Inter/intra investigator variation in orchidometric measurements of testicular volume by ten investigators from five institutions

To perform quality control studies on testicular volume measurements for a multi-center epidemiological study of male reproductive function. We constructed a data matrix with a balanced assignment for 2 consecutive days by ten investigators (andrological career: 4-21 years) from five institutions and 12 male volunteers aged 20-26 years. Testicular volume was measured by Prader's orchidometer. A skilled technician also performed an ultrasound estimate of testicular volume. A statistically significant inter-investigator variation was found for both testes (P < 0.05). In addition, there was a statistically significant investigator-by-volunteer interaction in testicular volume measurement (P < 0.01). However, there was no statistically significant difference in the two measurements performed on consecutive days for either testis. The testicular volumes for both the right and left testes as estimated by ultrasonography were smaller than results using the orchidometer. However, there was no statistical significance (P > 0.05). The difference in experiences of the investigators did not significantly correlate with accuracy of measurements in either testis. The present study revealed significant differences in the results of estimation of testicular volume among the ten investigators, but intra-investigator variation was not considerable. Improved training and proper standardization of the measurement will be necessary before starting a multi-center study based on an andrological examination.

Alterations of sexual desire and satisfaction in male partners of infertile couples

To clarify the state of sexual desire and satisfaction, with relevant parameters in men, of couples with infertility. Cross-sectional study. University outpatient clinic. Two hundred infertile couples referred to a reproductive health research clinic. Patients were investigated by a self-administered structured questionnaire about demographic data, infertility history, and several relevant psychological variables. In addition, clinical and andrological examinations were completed to find predictors for sexual state. Sexual desire and satisfaction status were scaled, and the relative factors were analyzed statistically. Subjects reported a reduction in sexual desire in 41.5% of cases and reduction of satisfaction in 52.5% compared with recalled sexual satisfaction before diagnosis of infertility. No relationship was found between andrological findings and the present status of sexual desire (P>.05). Education level, mutual understanding between couples, and recalled state of sexual satisfaction had a direct influence, but the duration of infertility and duration of desire for a child showed a significant inverse impact on sexual satisfaction (P<.05). Less than 50.0% of patients mentioned a reduction in sexual desire and satisfaction after infertility diagnosis, and the frequency of coitus could be regarded as an acceptable indicator of sexual satisfaction in male partners of infertile couples.

Influence of the type of undertrousers and physical activity on scrotal temperature

Testicular temperature correlates highly with scrotal temperature. The aim of this study was to evaluate the influence of the type of undertrousers on scrotal temperature during standardized periods of sitting and walking. Fifty volunteers without a history of infertility and normal andrological examination were included for scrotal temperature evaluation. Temperatures were measured every minute with a portable data recorder connected with two thermistor temperature sensors, which were attached on either side of the scrotum. Ambient temperature in the study room was adjusted to 20 degrees C throughout the whole experiment. All volunteers started the experiment at the same time of day. Clothing of the volunteers consisted of standardized cotton wool trousers and shirts fitting to body size. Each volunteer performed six periods of 45 min, either walking on a treadmill (3.0 km/h) or sitting, and wearing in a standardized and randomized manner either tight, loose fitting or no undertrousers respectively. The following interactions were demonstrated by means of multivariate analysis of variance for repeated measurements: scrotal temperatures were significantly higher for tight versus loose fitting versus absent undertrousers. Furthermore, significantly lower scrotal temperatures were identified for walking versus sitting as well as for the right versus the left scrotal side. The present study suggests that wearing tight fitting undertrousers is associated with higher scrotal and consequently testicular temperatures than wearing loose fitting undertrousers or none.

Quantificação dos estádios do ciclo espermatogênico em touros de raças sintéticas com e sem alteração na qualidade seminal

O objetivo deste estudo foi avaliar qual a freqüência dos túbulos seminíferos nos diferentes estádios do ciclo espermatogênico em touros de duas raças sintéticas, sendo 12 Braford e 8 Brangus-Ibagé, classificados em aptos (grupo A) e inaptos (grupo B) à reprodução, de acordo com o exame andrológico. Os estádios avaliados foram representativos das fases proliferativa (estádio I), meiótica (estádio II) e de maturação (estádio III) da espermatogênese. Os touros Braford apresentaram freqüências diferentes entre os grupos A e B nos estádios II e III. Os touros Brangus-Ibagé apresentaram diferenças entre os grupos apenas para o estádio II. Os resultados indicam que nas fases iniciais do ciclo espermatogênico (estádio I), os touros de raças sintéticas, classificados quanto à qualidade seminal, apresentam gametogênese semelhante. Nas fases em que ocorrem as divisões meióticas (estádio II) e a maturação das espermátides (estádio III), manifestam-se as alterações na espermatogênese que respondem pela classificação diferencial dos touros. O uso do presente agrupamento de estádios do ciclo espermatogênico proporciona uma prática maneira de avaliar a cinética do epitélio germinativo em touros aptos e inaptos à reprodução.

Prevalence of Chlamydia trachomatis in subfertile couples

Prevalence of Chlamydia trachomatis in subfertile couples

Analysis of the polymorphic CAG repeat length in the androgen receptor gene in patients with testicular germ cell cancer.

Changes in the length of a polymorphic trinucleotide (CAG) repeat in the androgen receptor (AR) gene, which may lead to altered transactivation of the AR gene, have been implicated to play a role in the pathogenesis of several forms of endocrine cancer and certain reproductive disorders. Subjects with reproductive disorders that are associated with a relative deficiency of androgen function carry an increased risk for testicular cancer, therefore we have examined the (CAG)n in the AR gene in DNA isolated from peripheral blood cells of 102 patients diagnosed with testicular germ cell neoplasia and compared them with a control group of 110 healthy men with proven fertility. All patients and control subjects underwent comprehensive andrological examination that included reproductive hormone profiles and the analysis of the (CAG)n in the AR gene that was done by means of PCR and DNA sequencing. There was no difference in the distribution of (CAG)n between the subjects and controls, no association of (CAG)n and the tumor type and no association with severity of the disease. We conclude that the high risk of testicular germ cell cancer in the Danish population is not associated with the (CAG)n polymorphism in the AR gene.

Inter-observer variation in the results of the clinical andrological examination including estimation of testicular size.

Inter-observer variation in andrological examination by 10 clinical investigators from five Nordic and Baltic countries was investigated. In addition, information on intra-observer variation was obtained for six of the 10 investigators. Testicular size was measured using Prader's orchidometer and one of the investigators also performed an ultrasound estimate of testicular size. A highly significant difference (p < 0.001) between observers was found with an inter-observer error of 16% in estimating testicular size in 23 young men. The difference in the estimate tended to increase with increasing testicular size. There was no significant intra-observer difference in two measurements performed on consecutive days. Only differences in median testis size, which were greater than 31% between measurements by two investigators, were found to be significant at the 5% level. The ultrasound estimate of testicular size was significantly lower than the orchidometer estimate, with a mean difference of 3.6 mL for the left testis and 4.3 mL for the right testis. Tanner staging of genitalia and diagnosis of a varicocele was subject to great inter-observer variation, and for the diagnosis of varicocele only one-third of the investigators was able to reproduce their results on a second examination. In conclusion, it was found that the clinical andrological examination of young men is subject to great inter-observer variation. This should be kept in mind when results from different studies are compared as well as in daily clinical practice.

Avaliação técnico-científica da utilização do sedém em bovinos de rodeio

o presente trabalho objetivou estudar os efeitos do sedém nos seguintes aspectos: l-possíveis lesões nas áreas contactadas pelo sedém, por meio de biópsias; 2-possíveis alterações na espermatogênese, mediante exame andrológico; 3- comportamento sexual relacionado ao cortejo e à libido;4- comportamento alimentar referente à ingestão de alimentos e ruminação. Foram utilizados 12bovinos mestiços zebu que já eram submetidos ao uso do sedém há pelo menos quatro anos. Em seis deles, procedeu-se a coleta de pele por meio de biópsia e de sêmen para o exame andrológico. Nos outros seis, foram registradas as frequências cardíaca e respiratória, antes e após os saltos, disposição para ingestão de alimentos, ruminação e comportamento sexual, ainda com a presença de sedém. Os resultados dos exames histopatológicos e andrológicos não revelaram qualquer alteração atribuível ao uso do sedém. As frequências cardíaca e respiratória foram consideradas normais para esta espécie. Não foram observados qualquer tipo de alteração de comportamento com relação à ingestão de alimentos, à ruminação e à disposição sexual. Os resultados sugerem a ausência de desconforto restritivo diante do uso do sedém.

Accidental radiation exposure and azoospermia.

Seven Georgian male soldiers (19-25 years old) had accidentally been exposed to radiation by Cs-137 between April 1996 and May 1997. No information about the exact time and duration of exposure was available. All patients presented with the subacute stage of Cutaneous Radiation Syndrome with deep painful ulcers on different body sites, predominantly on the legs. Semen analyses showed complete azoospermia in 4 patients, with elevated follicle-stimulating hormone (FSH) in 3 and elevated luteinizing hormone (LH) in 2 of them. One patient had severe oligozoospermia of 7 million sperm per mL, with normal sperm motility and morphology; his FSH and LH levels were elevated. One patient had complete normozoospermia, and the seventh patient had polyzoospermia of 340 million per mL; both of these patients had normal serum hormone levels. Only the patient with oligozoospermia reported a history of delayed testicular descent; his physical examination showed relatively soft and small testicles and a varicocele with considerable reflux. The physical andrological examinations were normal in the other 6 patients. It is very likely that the azoospermia in the 4 patients can be attributed to the radiation accident. In conclusion, it is essential to perform andrological examinations in patients who have been exposed to radiation even if there are only cutaneous injuries detectable, as a high percentage of them can show azoospermia.