Changes In Semen Parameters Research Articles

Semen quality and age-specific changes: a study between two decades on 3,729 male partners of couples with normal sperm count and attending an andrology laboratory for infertility-related problems in an Indian city

To compare the semen quality and age-specific changes in men between the 1980s and 2000s. Prospective study. Andrology laboratory, University of Calcutta, India. A semen sample was obtained from 3729 men presenting for infertility problems in two distinct decades, that is, between 1981-85 and 2000-2006. Subjects with sperm count >20 x 10(6)/mL without any extreme pathological disorders were selected. Samples having a major liquefaction problem were excluded. A standard World Health Organization procedure for semen analysis was performed that included assessment of volume, sperm concentration, and percentage motility. The motility parameters were further classified into forward progressive motility and nonprogressive motility. The present large-scale study confirms a significant decline in the sperm motility parameters and seminal volume in the present decade. However, no change in overall sperm concentration was noted. A decline was seen in sperm motility with increasing age in both decades. There are significant changes in sperm motility and volume between the two decades, and the age-related changes in semen parameters are also different in the two decades.

Sperm aneuploidies after human recombinant follicle stimulating hormone therapy in infertile males

Errors in sperm chromosome segregation are frequently observed in infertile males. It would therefore be useful to develop methods for reducing the rate of aneuploidy in spermatozoa. Thirty-one males were selected with an elevated frequency of total sperm aneuploidy of sperm chromosomes 18, X and Y by fluorescence in-situ hybridization (FISH): 22 were treated with 150 IU of recombinant FSH on alternate days for 3 months and the other nine (controls) did not receive any hormonal treatment. Before therapy, FISH analysis demonstrated an increased frequency of diploidy (0.663 +/- 0.09%), disomy (0.412 +/- 0.03%) and total aneuploidy (1.30 +/- 0.12%) in the 22 males. Sperm analyses revealed reduced progressive motility (26.73 +/- 2.3%) and a reduced percentage of spermatozoa with normal morphology (23.86 +/- 5.3%). After 90 days of therapy, a significant reduction in aneuploidies (mean total aneuploidy: 0.86% +/- 0.11; P = 0.005) was obtained, as well as an improvement in functional and structural sperm characteristics. In untreated patients, no significant change in semen parameters and frequency of total aneuploidy was observed between baseline (1.054 +/- 0.06%) and 90 days later (1.080 +/- 0.05%). It is therefore suggested that deranged meiotic segregation in spermatozoa could be reduced by FSH treatment.

Varicocelectomy for Male Infertility: A Comparative Study of Open, Laparoscopic and Microsurgical Approaches

We compared the outcomes of 3 techniques of varicocelectomy in infertile patients with varicocele. The study included 298 infertile patients (446 varicoceles) who were randomized to varicocelectomy by an open inguinal technique in 92, laparoscopy in 94 and subinguinal microsurgery in 112. The 3 techniques were compared regarding intraoperative, and early and late postoperative parameters, changes in semen parameters and the pregnancy rate. Patients were followed a +/- mean +/- SD of 21 +/- 9 months (range 4 to 35). Operative time was significantly longer in the microscopic group. Early postoperative complications were comparable in the 3 groups. At followup none of the patients in the microsurgical group had hydrocele, while it was observed in 4 of 143 (2.8%) in the open group and in 8 of 148 (5.4%) in the laparoscopy group, representing a significance difference in favor of microsurgery. The incidence of recurrent varicocele was significantly lower in the microsurgical group than in the open and laparoscopy groups (4 of 155 patients or 2.6% vs 16 of 143 or 11% and 25 of 148 or 17%, respectively). Compared to preoperative values in the 3 groups postoperative semen parameters showed significant improvement in sperm concentration, motility and morphology. The incidence of patients with improved sperm count and motility was significantly higher in the microsurgical group. The pregnancy rate at 1 year was not significantly different among the 3 groups. Compared with open and laparoscopic varicocele treatment microsurgical varicocelectomy has the advantages of no hydrocele formation, a lower incidence of recurrent varicocele, and better improvement in sperm count and motility.

Semen quality remains stable during 96 weeks of untreated human immunodeficiency virus-1 infection

To evaluate semen parameters during the natural course of asymptomatic human immunodeficiency virus-1 (HIV-1) infection. A longitudinal cohort study. HIV outpatient clinic of the Academic Medical Center in Amsterdam, the Netherlands. 55 men infected with HIV-1, with infection of variable duration but without previous or current antiretroviral therapy. Biannual blood and semen analyses. We examined the changes in semen parameters over time using a repeated measurements mixed-effects model. The mean follow-up period was 77 weeks (interquartile range: 39 to 111 weeks). The mean CD4 cell count showed a statistically significant decline from 480 to 400 cells/mm(3), and the mean blood plasma HIV-1 RNA concentration showed a statistically significant increase from 4.1 to 4.3 log(10) copies/mL. None of the semen parameters showed any statistically significant change over time. Prolonged exposure to asymptomatic, untreated HIV-1 infection does not affect semen quality. These findings should be reassuring for untreated men infected with HIV-1 who wish to father a child, and they also provide relevant background information for studies investigating the potential effect of antiretroviral therapy on semen quality.

Semen parameters in men with spinal cord injury: changes and aetiology

To assess the changes in semen parameters in men with spinal cord injury (SCI) and the possible causes of these changes. The study included 45 subjects with SCI. Semen retrieval was done by masturbation (2), vigorous prostatic massage (n = 13), penile vibratory stimulation (n = 13) or electroejaculation (n = 17). The semen of men with SCI showed normal volume (2.3 +/- 1.9 mL) and sperm count (85.0 X 10(6) +/- 83.8 X 10(6)/mL) with decreased motility (11.6% +/- 0.1%), vitality (18.5% +/- 5.2%) and normal forms (17.5% +/- 3.4%), and pus cells has been increased (6.0 X 10(6) +/- 8.2 X 10(6)/mL). Total (13.4 +/- 9.9 vs. 7.1 +/- 6.8) and progressive (4.4 +/- 3.9 vs.2.2 +/- 2.1) motility were significantly higher in subjects with lower scrotal temperatures. There was no statistical significant difference between electroejaculation and penile vibratory stimulation groups as regards any of the semen parameters. Subjects'age, infrequent ejaculation, injury duration and hormonal profile showed no significant effect on semen parameters. The defining characteristics of the seminogram in men with SCI are normal volume and count with decreased sperm motility, vitality and normal forms, and the increased number of pus cells. The most acceptable cause of the deterioration of semen is elevated scrotal temperature.

Beneficial Effect of Microsurgical Varicocelectomy is Superior for Men With Bilateral Versus Unilateral Repair

Varicocele represents the most common correctable cause of male infertility, and most reports indicate that varicocelectomy has a beneficial effect on male fertility and pregnancy outcome. Little is known about the differential effect of bilateral, compared to unilateral varicocelectomy, on male fertility potential. A total of 369 consecutive varicocelectomies were performed for male factor infertility between July 1996 and July 2002. The outcomes measured include postoperative changes in semen parameters, pregnancy rates (assisted and unassisted) and use of assisted reproductive technology (intrauterine insemination and in vitro fertilization with intracytoplasmic sperm injection). There were 157 men who underwent bilateral and 212 who underwent unilateral left varicocelectomy. Both groups had comparable male and female ages, and baseline semen parameters. Semen parameters improved significantly after surgery in the bilateral and unilateral groups. Moreover, the improvement in percent motility was significantly greater in the bilateral compared to the unilateral group (8.0% +/- 1.7% compared to 4.4% +/- 1.5% improvement, respectively, p <0.01). In addition, the spontaneous pregnancy rate was significantly higher in the bilateral compared to the unilateral group (49% vs 36%, respectively, p <0.05). Assisted reproductive technology was comparable in the unilateral and bilateral groups (64% vs 51%, respectively, p >0.05). Our data indicate that bilateral varicocelectomy (for clinically palpable bilateral varicoceles) is associated with a significantly greater improvement in sperm quality (motility) and male fertility potential than unilateral varicocelectomy. The greater improvement in semen parameters and pregnancy outcome associated with bilateral varicocelectomy support the concept of a detrimental dose-effect of varicocele on male fertility potential.

Obesity and Male Reproductive Potential

Obesity and Male Reproductive Potential

P-625: Changes in semen parameters between two successive semen analyses: Results of a prospective cohort study

To study the extent and pattern of changes in a second semen analysis compared to the first semen analysis in a cohort of men attending an academic tertiary referral reproductive endocrine center for evaluation of infertility.

Microsurgical treatment of persistent or recurrent varicocele

To examine the effectiveness of subinguinal microsurgical varicocelectomy in the treatment of persistent or recurrent varicocele. Retrospective chart review. Urban, tertiary care, academic teaching hospital. Fifty-four men who presented for treatment of persistent or recurrent varicocele. A single surgeon using an artery and lymphatic sparing subinguinal microsurgical technique with delivery of the testis repaired all varicocele. Preoperative to postoperative changes in semen parameters (volume of ejaculate, sperm concentration, percent motility, percent morphologically normal sperm, total motile sperm concentration), serum hormone levels, and testicular volume. Pregnancy rates and surgical complications were documented. Postoperative mean serum T and mean testicular volume increased significantly from prevaricocelectomy levels. Median sperm concentration, percent motility, and total motile sperm per ejaculate improved significantly following recurrent varicocelectomy. Among patients with follow-up over 24 weeks (65%, 35 out of 54), the overall pregnancy rate was 40% (14 out of 35), including 23% (8 out of 35) of pregnancies achieved through natural intercourse, 9% (3 out of 35) with IVF/intracytoplasmic sperm injection, and 9% (3 out of 35) with IUI. Complications such as hydrocele, hematoma, wound infection, and testicular atrophy were not observed during the follow-up period. Treatment of persistent or recurrent varicocele using an artery and lymphatic sparing subinguinal microsurgical technique with delivery of the testis improves semen parameters, serum T levels, and testicular volume from preoperative levels without a significant risk of postoperative complications.

AROMATASE INHIBITORS FOR MALE INFERTILITY

Testosterone-to-estradiol ratio levels in infertile men improve during treatment with the aromatase inhibitor, testolactone, and resulting changes in semen parameters. We evaluated the effect of anastrozole, a more selective aromatase inhibitor, on the hormonal and semen profiles of infertile men with abnormal baseline testosterone-to-estradiol ratios. A total of 140 subfertile men with abnormal testosterone-to-estradiol ratios were treated with 100 to 200 mg. testolactone daily or 1 mg. anastrozole daily. Changes in testosterone, estradiol, testosterone-to-estradiol ratios and semen parameters were evaluated during therapy. The effect of obesity, diagnosis of the Klinefelter syndrome, and presence of varicocele and/or history of varicocele repair on treatment results was studied. Men treated with testolactone had an increase in testosterone-to-estradiol ratios during therapy (mean plus or minus standard error of the mean 5.3 +/- 0.2 versus 12.4 +/- 1.1, p <0.001). This change was confirmed in subgroups of men with the Klinefelter syndrome, a history of varicocele repair and those with varicocele. A total of 12 oligospermic men had semen analysis before and during testolactone treatment with an increase in sperm concentration (5.5 versus 11.2 million sperm per ml., p <0.01), motility (14.7% versus 21.0%, p <0.05), morphology (6.5% versus 12.8%, p = 0.05), and motility index (606.3 versus 1685.2 million motile sperm per ejaculate, respectively, p <0.05) appreciated. During anastrozole treatment, similar changes in the testosterone-to-estradiol ratios were seen (7.2 +/- 0.3 versus 18.1 +/- 1.0, respectively, p <0.001). This improvement of hormonal parameters was noted for all subgroups except those patients with the Klinefelter syndrome. A total of 25 oligospermic men with semen analysis before and during anastrozole treatment had an increase in semen volume (2.9 versus 3.5 ml., p <0.05), sperm concentration (5.5 versus 15.6 million sperm per ml., p <0.001) and motility index (832.8 versus 2930.8 million motile sperm per ejaculate, respectively, p <0.005). These changes were similar to those observed in men treated with testolactone. No significant difference in serum testosterone levels during treatment with testolactone and anastrozole was observed. However, the anastrozole treatment group did have a statistically better improvement of serum estradiol concentration and testosterone-to-estradiol ratios (p <0.001). Men who are infertile with a low serum testosterone-to-estradiol ratio can be treated with an aromatase inhibitor. With treatment, an increase in testosterone-to-estradiol ratio occurred in association with increased semen parameters. Anastrozole and testolactone have similar effects on hormonal profiles and semen analysis. Anastrazole appears to be at least as effective as testolactone for treating men with abnormal testosterone-to-estradiol ratios, except for the subset with the Klinefelter syndrome, who appeared to be more effectively treated with testolactone.

Azathioprine treatment and male fertility in inflammatory bowel disease

Background & Aims: Long-term treatment with azathioprine (AZA) is well established in inflammatory bowel disease (IBD). AZA is metabolized to 6-mercaptopurine (6-MP), which interacts in purine metabolism and is therefore considered to have mutagenic potentials. This is the first study to examine the influence of AZA on semen quality. Methods: Semen quality was examined and compared with World Health Organization (WHO) standards regarding sperm density, motility, morphology, ejaculate volume, and total sperm count in 23 IBD patients treated with AZA. In 10 of these patients, a semen sample was assessed before and during AZA treatment; in another 5, semen analysis was performed twice during at least 2 years of AZA therapy. Results: In 18 patients treated with 1.5-2 mg/kg AZA daily for at least 3 months but without sulfasalazine, sperm density was 94 ± 84 Mio/mL (94% within WHO standard), motility was 60% ± 20% (67% within WHO standard), the proportion of sperm with normal morphology was 44% ± 21% (67% within WHO standard), ejaculate volume was 3.4 ± 1.5 mL (89% within WHO standard), and total sperm count was 297 ± 272 Mio (94% within WHO standard). No changes in semen parameters were noted after 11 ± 5 months of AZA administration or during long-term treatment (49 ± 14 months). Sulfasalazine administration in 5 patients was associated with markedly reduced semen morphology. During the study period, 6 patients fathered 7 healthy children. Conclusions: Our data show that AZA does not reduce semen quality and thereby male fertility in IBD.GASTROENTEROLOGY 2001;121:1048-1053

Effect of Subinguinal Varicocelectomy on Sperm Parameters and Pregnancy Rate: A Two–Group Study

Objective: To evaluate the changes in semen parameters and pregnancy rates after varicocelectomy. Methods: We evaluated the results of surgery in 146 men with primary infertility and palpable left varicoceles, compared with 62 men who refused surgery and were treated with tamoxiphene. Patients were selected with strict criteria in order to exclude any other infertility factor in the couple. They were followed up for at least 1 year after treatment. Statistical analyses were performed with the Wilcoxon signed rank test, Kolmogov–Smirnof two–sample test and paired samples t test.. Results: After 1 year, the differences in the median values were significant for all parameters. The partners of 62 of the operated men (46.6%) and 8 of the nonoperated (12.9%) became pregnant within 1 year (p<0.001). Thus, the difference between the true 1–year pregnancy rates was 33.7%. Overall, 83.2% of the operated men improved their semen parameters compared to 32.3% of the nonoperated. Conclusions: Varicocelectomy improves all semen parameters and pregnancy rates significantly. Palpable varicoceles should be operated upon when found in infertile couples.

Evolution of semen quality in North-eastern Spain: a study in 22,759 infertile men over a 36 year period.

A retrospective study was conducted in a large population to determine whether sperm quality has changed in Northeastern Spain between 1960 and 1996. From a total initial population of 22,759 men, two separate groups were studied: men with spermatozoa (n = 20,411) and those with azoospermia (n = 1364). After adjustment for age and sexual abstinence, multiple linear regression analyses were used to assess changes in semen parameters over time. A 0.2% decline was observed in semen volume in the spermatozoa group (P < 0.001). No significant increase (0.04%) in sperm count (x 10(6)/ml) was observed in the spermatozoa group. There was a 0.4% increase in motile spermatozoa in the spermatozoa group (P < 0.001). There was a statistically significant decline in normal spermatozoa (3.6%) in the spermatozoa group (P < 0.001). Of the total population, 1364 men had azoospermia (6.0%). The changes observed in the semen parameters analysed in this large population showed no evidence of a deteriorating sperm quality, although a statistically significant decline was observed in the percentage of normal spermatozoa.

Frequently subnormal semen profiles of normal volunteers recruited over 17 years.

In order to establish semen profiles for men in the general population, we analysed the semen parameters of 187 men attending the Institute of Reproductive Medicine between 1977 and 1993 as volunteers for clinical studies. If several ejaculates were obtained from the volunteer, only the first ejaculate was used for analysis. More than half of the ejaculates of these healthy men showed at least one abnormal parameter, so that only 46% of the volunteers could be classified as being 'normozoospermic' according to WHO guidelines. Aside from a decrease in the proportion of motile spermatozoa, no change in semen parameters could be detected with advancing age of the volunteers. No negative influence of the presence of a varicocele, the grade of varicocele on a history of maldescended testis on semen parameters was detected. The serum levels of FSH, LH and testosterone showed no significant age-related change over the period of investigation. Follow-up analysis of the fertility on the volunteers revealed a proportion of unwanted barrenness similar to or even lower than that in the general population. The analysis demonstrates that the limits of normality for semen parameters may require redefinition.

Evaluation of the semen quality and reproductive performance of trypanotolerant Djallonké rams following an artificial infection with Trypanosoma congolense

Following an experimental infection with Trypanosoma congolense, the semen quality and reproductive performance of 17 mature Djallonké rams was studied during a period of 26 weeks. The rams were randomly divided into three groups, namely one control group (G1) and two infected groups (G2 and G3). During the 5 weeks pre-infection the normal semen parameters were assessed. Following infection, moderate clinical symptoms associated with trypanosomosis were seen among the infected rams. Thirteen weeks post-infection, diminazene aceturate was administered to group 3. Both the treated group and the control group had significantly better weights than the infected group in the period following the trypanocidal treatment. The impact of trypanosomosis on the reproductive performance of the rams was seen in reduced libido with a higher rate of refusals and on semen quality with some temporary effects on mass motility, percentage live sperm cells and minor sperm cell abnormalities. However, these temporary changes in semen parameters were not significant when analysed as impact of infection. From the present study it was concluded that reproductive performance was not significantly impaired following artificial T. congolense infection. In addition, the Djallonké rams also showed an important clinical tolerance. However, significant differences between rams indicated a large variation in clinical response and reproductive performance following trypanosome infection.

Data from men in greater Seattle area reveals no downward trend in semen quality: further evidence that deterioration of semen quality is not geographically uniform

To determine whether there has been a decline in semen quality in a group of healthy men during the past 21 years. Retrospective analysis of the relationship between time and changes in semen parameters over 21 years using regression analysis. A tertiary university center. Five hundred ten healthy, normal men who donated multiple semen samples as participants in clinical studies between 1972 and 1993. Sperm concentration, semen volume, total numbers of sperm per ejaculate, and percent spermatozoa with normal morphology. There was no decrease in sperm concentration, semen volume, total number of sperm per ejaculate, and percent normal sperm morphology in 510 healthy men studied between 1972 and 1993. We conclude that in this population of healthy young men there has not been any decline in semen quality in the past 21 years.

Male infertility and its treatment: A review of over 4700 patients treated for male related infertility

Changes in semen parameters are presented for 4708 patients treated for infertility. The largest group comprised patients with oligoasthenozoospermia of various grades (57.7%). Improvement in the seminal state was noted in 70.3%. The percentage of achieved normospermia increased proportionally to the initial semen state. Pregnancy rate also increased proportionally to the initial seminal state. Among the patients' wives 20.4% conceived: 28.2% of these pregnancies had occurred after having achieved normospermia, while in 71.8% the seminal states were still below the accepted normal values.

Radiozinc Spermatogenesis Test: Follow-Up Semen Analysis

Semen analysis was performed on 8 men, every 2 months, for a period of 8 months, after the application of the radiozinc spermatogensis test. Semen was examined for volume, cell count, motility, and abnormal forms. Results showed no evidence of any changes in semen parameters. Student's test was used to compare the data before the test with the data after the test, and no significant differences were seen. The radiozinc spermatogensis test seems safe, from a radiologic point of view, does not have an adverse effect on semen, and unlike testicular biopsy, saves the patient from surgical exposure. The radiozinc spermatogensis test can be applied as an important adjuvant measure in the diagnosis and prognosis of male infertility.