Improvement In Sperm Density Research Articles

The Efficacy of Tribulus terrestris and Cumminum cyminium Against Sexual Dysfunction in Diabetic Male Rats

Aim: The aim of the study was to assess the efficacy of Tribulus Terristeris and Cumminum cyminium in a standardized diabetic animal model for various pathological conditions of male sexual dysfunction (i.e., loss of libido, erectile dysfunction, and infertility) and compare these herbs with standard drugs. Background: The prevalence of sexual dysfunction is about 40-45% adult women, and 20-30% of adult men have at least one sexual dysfunction. Sexual dysfunction is more common in men with diabetes compared to non-diabetic peers. Objective: The objective of the study was to evaluate the therapeutic effect of Tribulus Terrestris (TT) and Cumminum cyminium (CC) against male sexual dysfunction with diabetes. Methods: In-vivo animal models were utilized to find out Tribulus terristeris and Cumminum cyminium. Libido study: Sexually active male Wistar rats were divided into 5 groups, i.e., control, fluoxetine treated, fluoxetine with Tribulus terristeris, fluoxetine with Cumminum cyminium and fluoxetine with bupriprion. These rats have treated for 28 days by giving different drug for different group. Erection study: Male Wistar rats were divided in 5 group (six in each) i.e. control, diabetic rats, diabetic rats treated with Tribulus terristeris, diabetic rats treated with Cumminum cyminium and diabetic treated with Insulin. The rat penile tissue was taken by scarifying the rats, and in-vitro contraction and relaxation were carried out in two-chamber student organ bath. Sperm analysis: Sperm were collected from previously scarified rats in erection study, and collected sperm were washed, count (using Neubauer haemocytometer), and studied sperm motility. Results: Cumminum cyminium showed the significant reversal of loss of desire caused by fluoxetine which was comparable to standard drug bupropion. Insulin and Tribulus terristeris treated diabetic group of rats showed the lowest capability to relax, indicating setting up of erectile dysfunction. Diabetic rats exhibited a significant reduction in sperm density, % sperm motility, and % sperm viability. Insulin and C. cyminium treated diabetic rats showed significant improvement in sperm density, % sperm motility, and % sperm viability. Conclusion: Tribulus terristeris at the dose of 100 mg/kg b.w was found to improve erectile function, whereas Cumminum cyminium at the dose of 150 mg/kg b.w was found to improve libido and sperm profile of fluoxetine treated rats.

The role of artery-preserving varicocelectomy in subfertile men with severe oligozoospermia: arandomized controlled study.

There is wide agreement nowadays that a clinical varicocoele should be ligated to treat male factor infertility. However, the significance of testicular artery preservation in patients with severe oligozoospermia has not been addressed before. To assess the outcome of varicocelectomy in infertile men with severe oligozoospermia and clinical varicocoeles and to compare internal spermatic artery preservation vs. artery ligation. This prospective randomized study included 302 infertile patients with severe oligozoospermia and clinical (grade II/III) varicocoeles. Patients were randomized into two groups: group A (150 patients) underwent artery-preserving varicocelectomy (APV) and group B (152 patients) underwent artery-ligating varicocelectomy (ALV). The primary outcome was to assess the changes in sperm density and motility at 3 and 6months postoperatively in both groups. The secondary outcome was to compare the natural pregnancy rate at 1-year of follow-up. Univariate and multivariate analyses were performed to determine factors affecting pregnancy rate. In both groups, there was a statistically significant improvement in sperm density and motility at 3 and 6months postoperatively. In group A, there was a greater improvement in sperm density (p<0.001) and motility (p<0.001) compared to group B. At 1-year follow-up, overall 35.1% achieved a natural pregnancy. Group A achieved a significantly higher natural pregnancy rate (40% vs. 30%, p value=0.03) compared to group B. Smaller testicular volume and ALV were the independent predictors of lower pregnancy rate ((HR=3.2, 95% CI 1.2-8.3, p=0.01) and (HR=3.2, 95% CI 1.4-7.1, p=0.003), respectively). In men with severe oligozoospermia and a clinical varicocoele, APV results in improved outcomes as compared to ALV with respect to semen parameters and natural pregnancy rates. Therefore, all attempts should be made to preserve internal spermatic arteries (ISA) during varicocelectomy in men with severe oligozoospermia.

Effects of the Reduced Form of Coenzyme Q10 (Ubiquinol) on Semen Parameters in Men with Idiopathic Infertility: a Double-Blind, Placebo Controlled, Randomized Study

We investigated the effects of the administration of ubiquinol (a reduced form of coenzyme Q(10)) on semen parameters and seminal plasma antioxidant capacity in infertile men with idiopathic oligoasthenoteratozoospermia. A total of 228 men with unexplained infertility were randomly assigned 1:1 into 2 groups. Group 1 (114) received 200 mg ubiquinol daily by mouth for 26 weeks and group 2 (114) received a similar regimen of placebo. After completion of the 26-week treatment phase, all participants were followed for another 12-week off-drug period. Primary outcomes were improvement in sperm density, sperm motility and sperm strict morphology. At the end of the 26-week treatment period mean ± SD sperm density in the ubiquinol and placebo groups was 28.7 ± 4.6 × 10(6)/ml and 16.8 ± 4.4 × 10(6)/ml (p = 0.005), sperm motility was 35.8% ± 2.7% and 25.4% ± 2.1% (p = 0.008), and sperm strict morphology was 17.6% ± 4.4% and 14.8% ± 4.1% (p = 0.01) of normal sperm, respectively. During the treatment period serum follicle-stimulating hormone levels decreased significantly (p = 0.02) and serum inhibin B concentrations increased significantly (p = 0.01). During the off-drug period semen parameters gradually returned to baseline values but the differences were still significant for sperm density (p = 0.03) and sperm motility (p = 0.03). The correlation coefficients analysis revealed a positive association between the duration of treatment with ubiquinol and sperm density (r = 0.74, p = 0.017), sperm motility (r = 0.66, p = 0.024) and sperm morphology (r = 0.57, p = 0.027). Ubiquinol was significantly effective in men with unexplained oligoasthenoteratozoospermia for improving sperm density, sperm motility and sperm morphology.

Obesity negatively influences the outcome of microscopic varicocelectomy in infertile men

OBJECTIVE: Compared to men with normal weight, obesity is associated with a higher incidence and grade of varicocele together with lower serum testosterone, diminished semen parameters, and infertility. We sought to determine if obesity influences the outcome of varicocele repair. DESIGN: A retrospective review of infertile men undergoing microscopic varicocelectomy from 2005-2009. MATERIALS AND METHODS: Inclusion criteria included infertility, presence of a clinical varicocele, and postoperative follow-up more than 4 months. Men were excluded if they had a prior varicocele repair, genetic abnormalities, azoospermia, or an obstructive cause of infertility. Obesity was defined as body mass index (BMI)>30. Multiple variables were analyzed with respect to preoperative and postoperative sperm density, motility, and morphology. Univariate and multivariate analysis was used to analyze variables associated with greater than 50% improvement in sperm density. RESULTS: 245 (71 obese) men were included with mean age of 34.4 years and follow-up of 12.5 months. After varicocelectomy, sperm density, motility, and normal morphology significantly improved (p<0.05). Preoperatively, obesity was associated with low testosterone (p<0.01) and increased seminal reactive oxygen species (ROS) (p=0.03). BMI correlated with increased operative time (r=0.4, p<0.01) and operative complications (p=0.04). Compared to obese men, non-obese men displayed a greater improvement in sperm density (11.6x106/mL vs 5.3x106/mL, p<0.01) and normal morphology (5.6% vs -5.4%, p<0.01), but not motility (3.4% vs 0.1%, p=0.09). On multivariate analysis, only initial sperm density and obesity was negatively associated with a 50% improvement in sperm density (p<0.05). CONCLUSION: As previously reported, obesity is associated with low testosterone and increased ROS. After microscopic varicocelectomy, the seminal parameters of obese men show less improvement then non-obese men suggesting that BMI can influence varicocelectomy success.

Role of Renospermatic Basal Reflow and Age on Semen Quality Improvement After Sclerotization of Varicocele

To determine the relationship between renospermatic basal reflow at color Doppler ultrasound (CDU) evaluation and the improvement in seminal quality after sclerotization of varicocele, and the role of patients' age. No clear predictive factors are available for selecting patients who will show a better seminal improvement after varicocele correction. Between 2002 and 2008 we selected 113 patients with left unilateral varicocele, meeting the criteria of low sperm density, no endocrinological failures and no varicocele recidivating. Varicocele correction was performed using the retrograde sclerotization technique or, if not possible, the anterograde one. Patients underwent a physical examination, follicle-stimulating hormone assessment, sperm analysis (density, motility, and morphologic analysis), scrotal ultrasound, and CDU evaluation. Patients were divided into 5 groups using the CDU classification (Sarteschi). Three months postoperatively, they were assessed with the same protocol. Mean age was 32.2 years. We found improvement in seminal quality among the entire population. We found no significance in differences among semen quality improvement in patients of different ages. Patients with basal renospermatic reflow at preoperative CDU evaluation (groups 3, 4, and 5) showed a better improvement in sperm density (+139%) than patients with no basal reflow (groups 1 and 2; +61%). The presence of a basal reflow at preoperative CDU is a strong predictive factor of a better seminal quality improvement after varicocele correction. On the contrary, patient's age showed no significant relationship.

Efficacy of Coenzyme Q10 on Semen Parameters, Sperm Function and Reproductive Hormones in Infertile Men

We determined the efficacy of coenzyme Q10 supplementation on semen parameters, sperm function and reproductive hormone profiles in infertile men. A total of 212 infertile men with idiopathic oligoasthenoteratospermia were randomly assigned to receive 300 mg coenzyme Q10 (Kaneka, Osaka, Japan) orally daily (106 in group 1) or a similar placebo regimen (106 in group 2) during a 26-week period, followed by a 30-week treatment-free phase. Two semen analyses, acrosome reaction test, immunobead test for antisperm antibody, and determination of resting levels of luteinizing hormone, follicle-stimulating hormone, prolactin, testosterone and inhibin B were done in all participants. Blood and seminal plasma total coenzyme Q10 was also assessed. Significant improvement in sperm density and motility was evident with coenzyme Q10 therapy (each p = 0.01). Using the Kruger classification sperm morphology evaluation revealed an increase in the percent of normal forms in the coenzyme Q10 group (p = 0.07). A positive correlation was found between treatment duration with coenzyme Q10 and sperm count (r = 0.46, p = 0.03) as well as with sperm motility (r = 0.45, p = 0.04) and sperm morphology (r = 0.34, p = 0.04). The coenzyme Q10 group had a significant decrease in serum follicle-stimulating hormone and luteinizing hormone at the 26-week treatment phase (each p = 0.03). By the end of the treatment phase the mean +/- SD acrosome reaction had increased from 14% +/- 8% and 15% +/- 8% to 31% +/- 11% and 16% +/- 10% in the coenzyme Q10 and placebo groups, respectively (p = 0.01). Coenzyme Q10 supplementation resulted in a statistically significant improvement in certain semen parameters. However, further studies are needed to draw a final conclusion and evaluate the effect of coenzyme Q10 supplementation on the pregnancy rate.

Sperm ultramorphology as a pathophysiological indicator of spermatogenesis in males suffering from varicocele

Summary. Varicocele of spermatic veins is considered to be one of the major causes of male infertility associated with reduction of sperm quality. The pathophysiology of this condition is not yet completely understood. The aim of this study was to shed light on the pathophysiology of varicocele by identifying semen parameters, especially sperm ultramorphology, which improve following high ligation of the spermatic vein. Seventy-five males with diagnosed varicocele were included in this study. Semen parameters were assessed prospectively using light microscopy, semen biochemistry and sperm quantitative ultramorphological analysis, before high ligation and 3–9 months after high ligation. The control group consisted of twenty-five untreated varicocele patients who underwent two semen examinations within 3–9 months. No statistical difference in any of the examined variables was found between the two examinations in the control group. The treated patients exhibited a significant improvement in sperm density, progressive motility, percentage of normally formed spermatozoa, agenesis of sperm acrosome, chromatin condensation and incidence of amorphous heads compared with the pretreatment condition (P≤0.01). In contradiction, no significant improvement was observed following treatment in any of the sperm tail subcellular organelles. It is concluded that varicocele may cause deleterious alterations in early spermatid head differentiation during spermiogenesis and that varicocele patients with a high incidence of sperm acrosome and nucleus malformations are appropriate candidates for varicocele correction.

Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study

Classic therapies are usually ineffective in the treatment of patients with very poor sperm density. The aim of this study was to determine the effect of acupuncture on these males. Semen samples of 20 patients with a history of azoospermia were examined by light microscope (LM) and scanning electron microscope (SEM), with which a microsearch for spermatozoa was carried out. These examinations were performed before and 1 month after acupuncture treatment and revealed that the study group originally contained three severely oligoteratoasthenozoospermic (OTA), two pseudoazoospermic and 15 azoospermic patients. The control group was comprised of 20 untreated males who underwent two semen examinations within a period of 2-4 months and had initial andrological profiles similar to those of the experimental group. No changes in any of the parameters examined were observed in the control group. There was a marked but not significant improvement in the sperm counts of severely OTA males following acupuncture treatment (average = 0.7 +/- 1.1 x 10(6) spermatozoa per ejaculate before treatment vs. 4.3 +/- 3.2 x 10(6) spermatozoa per ejaculate after treatment). A definite increase in sperm count was detected in the ejaculates of 10 (67%) of the 15 azoospermic patients. Seven of these males exhibited post-treatment spermatozoa that were detected even by LM. The sperm production of these seven males increased significantly, from 0 to an average of 1.5 +/- 2.4 x 10(6) spermatozoa per ejaculate (Z = -2.8, P < or = 0.01). Males with genital tract inflammation exhibited the most remarkable improvement in sperm density (on average from 0.3 +/- 0.6 x 10(6) spermatozoa per ejaculate to 3.3 +/- 3.2 x 10(6) spermatozoa per ejaculate; Z = -2.4, P < or = 0.02). Two pregnancies were achieved by the IVF-ICSI procedure. It is concluded that acupuncture may be a useful, nontraumatic treatment for males with very poor sperm density, especially those with a history of genital tract inflammation.

VARICOCELE REPAIR IMPROVES SEMEN PARAMETERS IN AZOOSPERMIC MEN WITH SPERMATOGENIC FAILURE

Purpose We analyzed the efficacy of varicocele repair in improving semen parameters in azoospermic men with spermatogenic failure. Materials and Methods After routine clinical evaluation with confirmatory pellet analysis testicular biopsy and varicocele repair were simultaneously performed in 28 azoospermic men with a primary diagnosis of unilateral or bilateral varicocele and spermatogenic failure. Semen analyses were obtained starting 4 months after varicocelectomy. Results Repair was bilateral repair in 20 men and unilateral in 8. Of the 28 men 12 (43%) had sperm in the ejaculate with a mean postoperative sperm count plus or minus standard deviation of 1.2 +/− 3.6 × 10 6/ml. and an average followup of 24 months. Mean sperm motility was 19 +/− 24% (range 0 to 80). Testicular biopsy was predictive of outcome. Only 9 men with severe hypospermatogenesis and 5 with maturation arrest spermatid stage had improvement in sperm density. No improvement was seen in 3 men with the Sertoli-cell-only pattern or 3 with maturation arrest spermatocyte stage. No pregnancies by natural intercourse resulted. One couple used fresh ejaculate for intracytoplasmic sperm injection and 1 underwent testicular sperm extraction with intracytoplasmic sperm injection. Both pregnancies resulted in live births. No other predictive factors were identified. Conclusions Varicocele repair can result in sperm in the ejaculate of azoospermic men when severe hypospermatogenesis or maturation arrest spermatid stage is present. Select men with spermatogenic failure and varicoceles may be candidates for varicocele repair, rather than resorting to testis biopsy for sperm extraction in preparation for intracytoplasmic sperm injection. However, the couple should be counseled that assisted reproductive technologies will most likely be required to initiate pregnancy.

Male reproductive function in uraemia: efficacy of haemodialysis and renal transplantation.

To evaluate the impact of maintenance haemodialysis and live-related renal transplantation on the reproductive potential of men with end-stage renal disease. The plasma levels of testosterone, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were determined, and semen analysed, in 19 men (22-41 years old) with advanced uraemia after 6 months of dialysis and again 6 months after renal transplantation. Eight patients who had azoospermia or severe oligospermia underwent testicular biopsy after 6 months of dialysis and again 6 months after the transplant. Following dialysis, levels of testosterone were low in 17 patients and levels of LH and FSH were elevated in 15 and eight patients, respectively. Four patients each had azoospermia and severe oligospermia. The testicular tissue was hypospematogenic in three patients, showed late-maturation arrest in four and germ cell aplasia in one. After renal transplantation, testosterone and LH levels returned to normal in 15 and 13 patients, respectively, while FSH levels became normal in only two patients. The recovery of testosterone and LH levels after transplantation was statistically significant. Semen quality improved in 13 patients, with the improvement in sperm density and motility being statistically significant. Testicular histology revealed normal spermatogenesis in four patients, while three continued to show late-maturation arrest. The wives of five of the transplanted patients conceived. The impairment of testicular function seen in advanced uraemia is not reversible by maintenance haemodialysis. In contrast, after successful transplantation, steroidogenic function became almost normal while spermatogenic function showed a striking if incomplete recovery.

Relationship between grade of varicocele and the response to varicocelectomy.

Although several studies indicate that larger varicoceles are associated with greater impairment of spermatogenesis, others suggest that the response to surgery is independent of varicocele size. In order to elucidate these seeming contradictions, correlations between the preoperative evaluation of varicoceles and improvement in semen quality after varicocelectomy were investigated. Forty men with left unilateral varicocele, followed for at least 6 months after varicocelectomy, were included in this study. The relationships between the grade of varicocele by palpation, Doppler examination, ultrasound, or scintigraphy were correlated with a postoperative improvement in sperm density or sperm motility. Greater improvement in sperm density was observed in the patients with a large varicocele graded by palpation or measured by ultrasound, and greater improvement in sperm motility was observed in the patients with high uptake of radioactivity in the left side by scrotal scintigraphy. An improvement in semen quality after varicocelectomy is greater in patients with a large varicocele than in the patients with a small one. The significance of surgical repair of a small varicocele should be reconsidered.

Laparoscopic internal spermatic vein ligation: report of a new technique

Over the past 22 months, 51 laparoscopic internal vein ligations have been performed to determine its application and practicality in treating the infertile male with varicoceles. Of the 33 cases available for a follow-up of greater than 6 months, 16 pregnancies are reported. Five patients reporting pregnancies refused to submit a postoperative semenogram. Of the reportable series, 17 of 33 had significant improvement in sperm density (51%), 15 of 33 (45%) in sperm viability, and 15 of 33 (45%) in sperm motility. No major complications were seen and minor complications were few and transient. Morbidity was extremely low. Laparoscopic internal spermatic vein ligations would appear to be a reasonable, practical, and effective method to correct varicoceles.

Clinical versus subclinical varicocele: improvement in fertility after varicocelectomy

To assess the fertility after varicocelectomy in men with subclinical varicocele. We define subclinical varicocele as the varicocele detected by Doppler examination of the scrotum, in which no varicocele was found on clinical examination. Varicocelectomy was performed on subclinical varicocele, and fertility was assessed. We reviewed the records of 54 men who underwent unilateral varicocelectomy at the Department of Urology, Wayne State University, between 1986 and 1987. Records of 54 men were analyzed. Thirty-eight (70%) of the varicocele were diagnosed clinically (confirmed by Doppler examination) in group 1. In 16 (30%) men, the varicocele was diagnosed by Doppler examination only, with no varicocele detectable clinically, subclinical varicocele (group 2). Spermiograms improved in 76% of the patients in group 1 and in 81% of the patients in group 2. Fertility was assessed after 2 years of varicocelectomy. Eighteen (47%) of 38 patients in group 1 and 8 (50%) of 16 men in group 2 managed to impregnate their partners. Statistical analysis by chi 2 shows similar improvement in fertility potential between the two groups (P = 0.86). Multivariate repeated measure analysis showed significant improvement in sperm density (P = 0.0006) and sperm morphology (P = 0.0016) after varicocelectomy. These data suggest that varicocelectomy, in infertile men with subclinical varicocele, leads to fertility in 50% of the patient population as compared with 47% in clinical varicocele group. We suggest that the use of sophisticated, noninvasive techniques such as Doppler may have a place in the management of male infertility to detect subclinical varicocele.

Spermiometrics: the method and its clinical application

Objective and reproducible determinations of sperm motility and morphology are achieved using a semi-automatic image analysis system under optomanual control. The method was used to evaluate the short-and long-term effects of the operative treatment of varicocele on sperm density, motility and velocity in 27 men with left-sided varicosities. Whereas a significant improvement (p=0.0001) in sperm density was found within 3 months after surgery, almost no increases in sperm motility and velocity occurred. The actual post-operative improvement in sperm density did not correlate with the preoperative sperm counts (r=0.291). Between the preoperative values of motility and velocity and the postoperative improvement, however, a negative correlation of −0.431 and −0.759, respectively, was found. Considering the 21 patients, who were followed up for a minimum of 9 months, a sustained increase in sperm density, motility and velocity of at least 50% was observed in 14 (66.7%), 7 (33.3%) and 5 (23.8%), respectively. In general, the better results were obtained in the group with the poorer preoperative semen characteristics. However, only 4 patients (19%) showed a lasting improvement in all 3 parameters. Even more interesting was the sustained decrease in sperm velocity observed in 9 men (42.9%), who had rather good preoperative values. It is concluded, that a timely operative treatment of varicocele might prevent further impairment of semen quality. However, more research on the natural course of varicocele is necessary.

Hormonal parameters in incidental varicoceles and those causing infertility

The gonadotropin responses to a 4-hour infusion of gonadotropin-releasing hormone (GnRH), the prolactin (PRL) responses to a bolus injection of thyrotropin-releasing hormone (TRH), and seminal plasma dihydrotestosterone (DHT) levels were assessed before and 6 to 12 months after varicocelectomy was performed in 56 infertile men with varicoceles and sperm densities less than 30 X 10(6)/ml. The men were divided into four groups, determined by their sperm densities and hormonal parameters. Groups I (18 men) and II (12 men) had sperm densities less than 10 X 10(6)/ml, and groups III (16 men) and IV (10 men) had sperm densities of 11 to 30 X 10(6)/ml. The men from groups I and III had excessive preoperative gonadotropin and PRL responses, and lower-than-normal seminal plasma DHT levels. The men in groups II and IV had normal hormonal values. After operation, 12 of the men from group I and 11 from group II had improvements in seminal and hormonal parameters. The other men in these two groups and all of the men in groups II and IV had no changes in seminal and hormonal parameters after operation. This study indicates that an assessment of these hormonal parameters may be useful in predicting which men with varicoceles are likely to have an improvement in sperm density after varicocele repair.

Investigation and Treatment of the Infertile Male

The investigation of 117 infertile couples in a clinical practice is reported. Results of testicular biopsies were categorized as follows: Type 1 normal testis; Type 2 germinal cell aplasia; Type 3 germinal cell arrest; and Type 4 sloughing effect. A diagnosis of block in the epididymis or vas was made by injecting saline up the vas toward the urethra and by finding inspissated spermatozoa in the distended tubules of the epididymis. (This method was later replaced by radiologic evidence of the patency of the vas by vasography and epididymography.) 2 men were found to have Klinefelters syndrome. Local surgical conditions associated with infertility were noted in 7 cases. There were 36 infertile men with seemingly normal semen. A strongly positive Kibricks macroagglutination test was found in the plasma of 9 of these men and similar antibodies were noted in 5 of their wives. Of the 22 men with aspermia an obvious explanation existed in 8 cases (e.g. Klinefelters syndrome retrograde ejaculation mechanical obstruction). The sloughing effect was noted in 11 of the 14 men without an obvious cause for aspermia. Oligospermia was diagnosed in 60 men. Testicular biopsies in 21 of these cases revealed the sloughing effect in 10 specimens germinal cell arrest in 3 and aplasia in 8. Of the 29 oligospermic men treated with fluoxymesterone 14 showed improved sperm density and all showed improved motility. Sustained improvement in sperm density was observed in 11 of the 25 men treated with clomiphene. Only patients who showed sloughing off in the biopsy had improvement with either treatment method; however sloughing did not always predict an improvement in sperm density. The persistently oligospermic man may be helped by artificial insemination of centrifuged semen or by pooling concentrated sperm. Plasma antisperm antibodies can be washed off spermatozoa and a concentrated specimen of semen injected directly into the cervix. Pregnancy has been achieved in 3 of the 12 cases where this method was tried. Finally in cases with a positive Kibricks reaction in the wifes plasma prednisone can be administered to the woman over the period of artificial insemination with washed spermatozoa. This has achieved 1 pregnancy to date in this series.