Median Total Sperm Count Research Articles

Association between post-COVID-19 conditions and male semen quality in Japan: A descriptive investigation

Some reports suggest that coronavirus disease 2019 (COVID-19) may affect male reproductive function. There is also concern in Japan that COVID-19 may contribute to the pre-existing decline in male fertility; however, no studies have investigated the effects of COVID-19 on male reproductive function. In this study, we aimed to analyze the semen quality of men who had recovered from COVID-19. Male patients who had recovered from COVID-19 between February 2020 and September 2021 were recruited for this study. Participants were sent a semen collection kit; they were asked to collect semen at home and deliver it to a laboratory at Osaka University. We used these samples to analyze sperm concentration, total sperm count, and semen volume. In total, 125 participants were included in this study. The median age of all patients was 46 years (interquartile range (IQR): 38–52 years). The severity of COVID-19 was mild in 80 patients; 19 were moderate I, 22 were moderate II, and four were severe. The median semen volume was 2.5 mL (IQR: 1.8–3.1), the median sperm concentration was 98.9 million/mL (IQR: 43.8–162.2), and the median total sperm count was 212.1 million (IQR: 89.7–368.2). In a previous study in Japan, the median sperm count in adult men was reported to be 201 million. Participants in our study did not have lower sperm counts than this, despite their older age. Our results suggest that the long-term effects of COVID-19 on spermatogenesis are minimal.

The association of socioeconomic status with semen parameters in a cohort of men in the United States.

Socioeconomic differences are present within the population of men who experience infertility and seek treatment. To study the association of socioeconomic status with semen parameters in a group of men using mail-in semen analyses. The records of 11,134 men that used mail-in semen analyses from a fertility company were identified. Their demographic information, semen parameters, and ZIP codes were collected. Area deprivation index (ADI) was used as a proxy for socioeconomic status and was calculated for each individual using their ZIP codes in order to measure their level of socioeconomic deprivation. A higher ADI signifies a more deprived area. The association between ADI and the semen parameters of this group was measured using linear regression analysis adjusted for age. 11,134 men were included in the study with a median age of 35 years (interquartile range (IQR): 32-40) and a median ADI of 83 (IQR: 68-97). The cohort had a median sperm concentration of 31 million/mL (IQR: 14-59), median total sperm count of 123 million (IQR: 57-224), median total motile sperm of 35 million (IQR: 9-95), median total motility of 32% (IQR: 15-52), progressive motility of 22% (IQR: 9-38), and morphology percent normal of 4% (IQR: 2-7). Higher ADI, indicating lower socioeconomic status, was negatively associated with various semen parameters, including sperm concentration, total sperm count, total motile sperm, and total and progressive motility. Men who live in more deprived areas are more likely to have worse semen parameters. Further research is needed to thoroughly examine the impact of socioeconomic status on male fertility. A comprehensive approach that targets upstream social, economic, and healthcare factors can possibly alleviate the negative association of socioeconomic status with fertility and semen parameters.

Geographic Differences in Semen Quality among a Cohort of American Men Using Mail-in Sperm Testing Kits.

To evaluate the relationship between regional geography and sperm parameters in a cohort of American men using at-home mail-in semen collection kits with no previous self-reported history of male factor infertility. In this study, 5,822 men from six different regions of the United States (Northeast, Southeast, Midwest, West, Pacific, and Southwest) who self-requested semen analysis between 2019 and 2021 were enrolled. Across the entire cohort, the mean sperm concentration was 43.79±55.43 ×106 sperm/mL; total sperm count 138.93±149.96 ×106 sperm/mL; total motile sperm 54.73±81.90 ×106/ejaculate; total motility 30.18%±22.87%; progressive motility 21.61%±17.32%; sperm with normal morphology 8.79%±8.87%. Patients from the West region displayed lower median sperm concentration, total motile sperm, and total motility than men from the other four regional areas. A lower median total sperm count, and lower median progressive motility were also detected among patients in the Southwest region. Conversely, higher results were detected in patients from the Midwest (higher median total motile sperm, total and motility) and from the Northeast (higher median sperm concentration and total sperm count) regions. Men from the Southeast (OR, 1.3168; 95% CI, 1.1142-1.5563) and Southwest (OR, 1.3145; 95% CI, 1.0735-1.6096) regions were more likely to have oligozoospermia than those living elsewhere. This study provides the most comprehensive and up-to-date report on semen parameter variability among a cohort of men living in six different regions of the continental USA. This study will pave the way into a deeper discussion of the interplay between geography, social determinants of fertility care and semen quality.

Association of Dietary Patterns With Testicular Function in Young Danish Men

Diet may play a role in testicular function, but data on how adherence to different diet patterns influences human testicular function are scarce. To determine whether adherence to specific dietary patterns is associated with testicular function in young men. This cross-sectional study included 2935 young Danish men unselected regarding fertility status who were enrolled from April 1, 2008, through May 31, 2017. Data were analyzed from July 1, 2017, to January 30, 2019. Dietary patterns identified with principal component analysis based on responses to a validated food frequency questionnaire. Standard semen quality assessment; serum concentrations of testosterone, free testosterone, estradiol, inhibin B, follicle-stimulating hormone, luteinizing hormone, and sex hormone-binding globulin; and testicular volume measured with ultrasonography. Among the 2935 participants included in the analysis, median age was 19 (interquartile range, 19-20) years and 2290 (78.0%) had normal body mass index. The 4 dietary patterns identified included Western, prudent, open-sandwich (a traditional Danish eating pattern), and vegetarianlike. The greatest adherence to the prudent pattern was associated with the highest total sperm count (median, 167 [95% CI, 146-183] million), followed by adherence to vegetarianlike (median, 151 [95% CI, 134-168] million) and open-sandwich (median, 146 [95% CI, 131-163] million) patterns. Adherence to the Western pattern was associated with the lowest total sperm count (median, 122 [95% CI, 109-138] million), which was significantly lower than sperm count in the other 3 diet patterns. After adjusting for confounders, the median total sperm count for men in the highest quintile of adherence to the Western pattern was 26 million lower (95% CI, -42 to -9 million) than for men in the lowest quintile of adherence to this pattern. Conversely, the median total sperm count of men in the highest quintile of adherence to the prudent pattern was 43 million (95% CI, 23-63 million) higher than that of men in the lowest quintile. Men with the highest adherence to the Western pattern had a lower median ratio of inhibin B to follicle-stimulating hormone (-12 [95% CI, -20 to -3]) and higher median ratio of free testosterone to luteinizing hormone (10 [95% CI, 2-19]) compared with men with lowest adherence to this pattern. In this cross-sectional study, adherence to generally healthy diet patterns was associated with better semen quality, with potentially more favorable fertility potential among adult men.

Semen quality of young adult ICSI offspring: the first results.

What is the semen quality of young adult men who were conceived 18-22 years ago by ICSI for male infertility? In this cohort of 54 young adult ICSI men, median sperm concentration, total sperm count and total motile sperm count were significantly lower than in spontaneously conceived peers. The oldest ICSI offspring cohort worldwide has recently reached adulthood. Hence, their reproductive health can now be investigated. Since these children were conceived by ICSI because of severe male-factor infertility, there is reasonable concern that male offspring have inherited the deficient spermatogenesis from their fathers. Previously normal pubertal development and adequate Sertoli and Leydig cell function have been described in pubertal ICSI boys; however, no information on their sperm quality is currently available. This study was conducted at UZ Brussel between March 2013 and April 2016 and is part of a large follow-up project focussing on reproductive and metabolic health of young adults, between 18 and 22 years and conceived after ICSI with ejaculated sperm. Results of both a physical examination and semen analysis were compared between young ICSI men being part of a longitudinally followed cohort and spontaneously conceived controls who were recruited cross-sectionally. Results of a single semen sample in 54 young adult ICSI men and 57 spontaneously conceived men are reported. All young adults were individually assessed, and the results of their physical examination were completed by questionnaires. Data were analysed by multiple linear and logistic regression, adjusted for covariates. In addition, semen parameters of the ICSI fathers dating back from their ICSI treatment application were analysed for correlations. Young ICSI adults had a lower median sperm concentration (17.7 million/ml), lower median total sperm count (31.9 million) and lower median total motile sperm count (12.7 million) in comparison to spontaneously conceived peers (37.0 million/ml; 86.8 million; 38.6 million, respectively). The median percentage progressive and total motility, median percentage normal morphology and median semen volume were not significantly different between these groups. After adjustment for confounders (age, BMI, genital malformations, time from ejaculation to analysis, abstinence period), the statistically significant differences between ICSI men and spontaneously conceived peers remained: an almost doubled sperm concentration in spontaneously conceived peers in comparison to ICSI men (ratio 1.9, 95% CI 1.1-3.2) and a two-fold lower total sperm count (ratio 2.3, 95% CI 1.3-4.1) and total motile count (ratio 2.1, 95% CI 1.2-3.6) in ICSI men compared to controls were found. Furthermore, compared to men born after spontaneous conception, ICSI men were nearly three times more likely to have sperm concentrations below the WHO reference value of 15 million/ml (adjusted odds ratio (AOR) 2.7; 95% CI 1.1-6.7) and four times more likely to have total sperm counts below 39 million (AOR 4.3; 95% CI 1.7-11.3). In this small group of 54 father-son pairs, a weak negative correlation between total sperm count in fathers and their sons was found. The main limitation is the small study population. Also, the results of this study where ICSI was performed with ejaculated sperm and for male-factor infertility cannot be generalized to all ICSI offspring because the indications for ICSI have nowadays been extended and ICSI is also being performed with non-ejaculated sperm and reported differences may thus either decrease or increase. These first results in a small group of ICSI men indicate a lower semen quantity and quality in young adults born after ICSI for male infertility in their fathers. This study was supported by Methusalem grants and by grants from Wetenschappelijk Fonds Willy Gepts, all issued by the Vrije Universiteit Brussel (VUB). All co-authors except M.B. and H.T. declared no conflict of interest. M.B. has received consultancy fees from MSD, Serono Symposia and Merck. The Universitair Ziekenhuis Brussel (UZ Brussel) and the Centre for Medical Genetics have received several educational grants from IBSA, Ferring, Organon, Shering-Plough and Merck for establishing the database for follow-up research and organizing the data collection. The institution of H.T. has received research grants from the Research Fund of Flanders (FWO), an unconditional grant from Ferring for research on testicular stem cells and research grants from Ferring, Merck, MSD, Roche, Besins, Goodlife and Cook for several research projects in female infertility. H.T. has received consultancy fees from Finox, Abbott and ObsEva for research projects in female infertility.

Peripubertal blood lead levels and semen quality in a prospective cohort study of Russian men

To assess associations between peripubertal blood lead levels and semen parameters. A prospective cohort study conducted in Chapaevsk, Russia From 2003 to 2005, 499 boys were enrolled at age 8-9 years and their growth and development were assessed annually for ten years. Blood lead levels (BLLs) were measured at enrollment using atomic absorption spectrometry. At ages 18-19 years, 137 young men provided up to two semen samples collected one week apart (264 samples) which were analyzed for volume, sperm concentration and motility according to NAFA and ESHRE-SIGA methods. Total sperm count and total motile sperm count were calculated. Linear mixed models were used to examine the relation between BLLs (<5 and ≥5 mcg/dL, CDC reference for childhood lead exposure) and semen parameters, with random intercepts to account for multiple semen samples per participant. Men had a median total sperm count, total motile sperm count and motility of 126 million, 80 million and 64%, respectively. Higher peripubertal BLLs were associated with lower total sperm count and total motile sperm count. Men who had peripubertal BLLs ≥5 mcg/dl had 30% lower total sperm count (p-value=0.09) and 31% lower total motile sperm count (p-value=0.11) compared with men who had BLLs < 5mcg/dL. BLLs were not associated with motility. This is the first study to examine the association between peripubertal BLLs and semen quality in young adulthood. We observed suggestive evidence that peripubertal BLLs above the CDC reference level could be associated with poorer semen quality, indicating that the peripubertal period may be a sensitive window of exposure. Lead exposure continues to be a major public health problem in the United States and Russia, thus these results add to our understanding of reproductive health risks from childhood lead exposure.

Cryopreservation of lar gibbon semen collected by manual stimulation.

We confirmed ejaculation as a result of manual stimulation in a lar gibbon, and attempted to cryopreserve the semen using TES-Tris-egg yolk-based (TTE) extender. After measuring the amount of semen (g), we first diluted the semen with TTE extender, and calculated sperm concentration (sperm/ml), total sperm count (sperm), and progressive sperm motility (%). Then, we cooled diluted semen slowly to 4°C over 2h, and added an equal volume of secondary extender containing glycerol over 30min. Finally, we flash-froze the semen solution by plunging into liquid nitrogen. In addition, we freeze-thawed the solution to determine the recovery rate of the motile sperm. Collection of semen was successful on four of the five occasions. The median (min-max) quantity of ejaculate was 0.19g (0.09-0.26g), the median sperm concentration was 1.38×10(9)sperm/ml (1.20-1.53×10(9)sperm/ml), and the median total sperm count was 0.26×10(9) sperm (0.11-0.40×10(9) sperm). Moreover, the median sperm motility immediately after ejaculation was 65% (60-75%), the median sperm motility after freeze-thawing was 30% (25-35%), and the median recovery rate was 42.3% (40.0-58.3%). We were able to (1) collect semen from a lar gibbon by manual stimulation, (2) reveal andrological findings regarding semen characteristics, and (3) preserve the genetic resource using TTE cryopreservation.

Semen quality of 4480 young cancer and systemic disease patients: baseline data and clinical considerations.

BackgroundExcept for testicular cancer and Hodgkin’s disease, baseline data on semen quality in case of cancers as well as systemic pathologies of the young adult are scarce or based on low sample size.MethodsSemen quality in patients having testicular cancer (TGCT, n = 2315), Hodgkin’s disease (HD, n = 1175), non-Hodgkin’s lymphoma (NHL, n = 439), leukemia (L, n = 360), sarcoma (S, n = 208), brain tumour (BT, n = 40), Behcet’s disease (Behcet’s, n = 68) or multiple sclerosis (MS, n = 73) was studied and compared to that of 1448 fertile men candidates for sperm donation (CSD) and 208 partners of pregnant women (PPW). All samples were studied following the same methodology in a single laboratory. Post freezing and thawing semen characteristics were also studied.ResultsThe percentage of normozoospermic men was only 37 % for L patients and lower than 60 % for TGCT, NHL, S and BT. The level of sperm production was differently decreased according to pathologies, the median total sperm count in TC and L patients being four times lower (p < 0.01 when compared to CSD and PPW). The lowest percentage of progressively motile spermatozoa was found for L and BT patients (both, p < 0.01 compared to CSD and PPW). The percentage of morphologically normal spermatozoa was also reduced in cancer patients, especially in BT patients. Progressive motility after thawing in patients was about half that observed among candidates for sperm donation. In almost half of the semen of patients with testicular cancer or leukemia, the total number of motile spermatozoa per straw was less than 0.5 × 106 compared to 4.3 × 106 in CSD.ConclusionsThe present data confirm on large series the deleterious impact of various cancers of the young adult on semen quality, establishing thus baseline data for future studies. Owing to the post-thaw quality of the frozen straws, future fertility projects for the majority of the patients studied (in case there is no post-treatment recovery of spermatogenesis) should necessitate an ICSI to provide the best chance of paternity whatever the fertility check-up in the female partner.

Anogenital distance and reproductive parameters in young men.

The purpose of this study was to assess the relationship between anogenital distance (AGD) measures and semen quality and serum reproductive hormone levels in Caucasian young men from southern Spain. Two variants of AGD [from the anus to the posterior base of the scrotum (AGD(AS)) and to the cephalad insertion of the penis (AGD(AP))] were assessed in 215 university students. Semen parameters (semen volume, sperm concentration, total sperm counts, motility and morphology) and serum reproductive hormones (follicle stimulating hormone, luteinising hormone, inhibin B, testosterone, calculated free testosterone, oestradiol and sex hormone-binding globulin) were also determined. Associations between AGD measures and the semen quality and reproductive hormone levels were tested using multiple regression analyses. Overall, median sperm concentration was 44.0 × 10(6) ml(-1) (5th-95th percentiles: 8.9-129 × 10(6 ) ml(-1)), median total sperm count was 121 × 10(6) (18.0-400 × 10(6)), and mean (SD) testosterone level was 21.7 nmol/l (6.9). Mean (SD) AGD(AS) and AGD(AP) measures were 48.3 mm (11.6) and 128 mm (12.0) respectively. In the multivariable analysis, AGD measures were not associated with any semen parameters or any of the reproductive hormone levels, which is in contrast to results of studies of US young men or infertile men. Further research is warranted to confirm these findings.

Reproductive parameters in young men living in Rochester, New York

To describe semen quality and reproductive hormone concentrations of young men living in Rochester, New York, and to compare these with published data from similar European and Japanese populations. Cross-sectional study. University and college campuses in the Rochester, New York, area. Unselected young college students (n = 222). A physical examination, blood and semen samples, and completion of a brief questionnaire. Semen parameters and serum reproductive hormone levels. Subjects were aged 18-22 years (median age, 19.5 years), predominantly Caucasian (81%), and nonsmokers (79%), with a mean (SD) body mass index of 25.5 (4.2) kg/m(2). Overall, median sperm concentration was 52 × 10(6)/mL (5th-95th percentiles: 7-181 × 10(6)/mL), median total sperm count was 158 × 10(6) (14-587 × 10(6)), and 23.1% and 15.8% of men had a sperm concentration below 20 × 10(6)/mL and 15 × 10(6)/mL, respectively. Few men had serum hormones falling outside clinically normal ranges. Median sperm concentrations and reproductive hormone levels were comparable to those seen in young men in Denmark, Finland, and Japan. Our study provides the first data in 70 years on semen quality and reproductive hormones in young men in the United States with unknown fertility. These data suggest that, overall, reproductive parameters in our study population of young college students from the northeastern United States are similar to those of young European and Japanese men.

Are serum levels of vitamin D associated with semen quality? Results from a cross-sectional study in young healthy men

To examine the association between low serum vitamin D concentration and estimates of male reproductive function. Cross-sectional study. University hospital. From a Danish pregnancy cohort established in 1984-1987, 347 sons were selected for a study conducted in 2005-2006. Semen parameters and reproductive hormones were related to vitamin D concentrations in 307 men. Semen characteristics and reproductive hormones. A high vitamin D level was unexpectedly associated with lower crude median total sperm count and percentage of normal morphology sperm and a high level of crude median sex hormone-binding globulin and FSH. After adjustment, the associations attenuated to nonsignificant associations, except for sex hormone-binding globulin. Additionally, adjusted free androgen index was lower at higher vitamin D levels, and men with high vitamin D had 11% (95% confidence interval, 1%-20%) lower free androgen index compared with men with low vitamin D. These results do not indicate that low vitamin D is a risk factor for poor semen quality in a population of young healthy men, but we may not have enough men with low vitamin D levels to detect an effect. New studies should include a larger proportion of vitamin D-deficient men.

Gonad evaluation in male systemic lupus erythematosus

To assess gonad function in male patients with systemic lupus erythematosus (SLE). Thirty-five consecutive male patients with SLE according to the criteria of the American College of Rheumatology were prospectively evaluated for demographic and clinical features as well as previous and current treatment. Patients underwent urologic evaluation and testicular Doppler ultrasound. We obtained a hormone profile and performed a semen analysis including morphology and testing for the presence of antisperm antibodies. Patients were compared with 35 age-matched healthy controls. Compared with controls, SLE patients had lower median testicular volumes in both testes, a lower median total sperm count, and a lower median total motile sperm count. The mean sperm volume and percentage of normally formed sperm were lower in SLE patients than in controls. Since all SLE patients had semen alterations, they were further subdivided into 2 groups according to the severity of these abnormalities (group 1, with teratozoospermia [n = 18], and group 2, with azoospermia or teratozoospermia in combination with oligozoospermia and/or asthenozoospermia [n = 17]). The frequency of treatment with intravenous cyclophosphamide (IV CYC) after the first ejaculation was higher in group 2 than in group 1. The median testicular volumes measured by ultrasound in both testicles were lower in group 2 than in group 1. Follicle-stimulating hormone levels were higher in group 2 than in group 1. The overall frequency of antisperm antibodies in SLE patients was 40%. The apparent higher frequency of antisperm antibodies in group 1 than in group 2 did not reach significance. SLE patients have a high frequency of sperm abnormalities associated with reduced testicular volume. Postpubertal IV CYC treatment was the major factor in potential permanent damage to the testes.

Post-ejaculatory urinalysis in fertile and infertile men

Objective: Standard criteria for the interpretation of a postejaculatory urinalysis (PEU) do not currently exist. The purpose of this study was to assess a population of fertile and infertile men in order to determine the prevalence of sperm within postejaculatory urine and develop a cutpoint for interpretation of this test.Design: Prospective, university-based study.Materials/Methods: Both semen analysis and postejaculatory urinalysis was performed upon 15 men undergoing elective vasectomy (fertile group) and 80 patients attending an infertility clinic (infertile group). The percentage of sperm present in the urine as compared to that in the semen was calculated. A variety of criteria for a positive PEU were assessed including any sperm present and various percentages of sperm in the urine. IRB approval was obtained for this study.Results: The mean age of the fertile men (37 years) was not different from the infertile patients (40 years). As expected, the median total sperm count of the fertile men (128 million) was significantly higher (p <0.001) than the infertile patients (8 million). The median total urine sperm count for the fertile group (26.6 million) was greater than the infertile group (2.5 million) but was not significantly different (p = 0.234). Using a cutpoint of the urine containing greater than 5% of the total semen sperm count, the prevalence of a positive PEU in fertile controls (60%) was no different from the infertile patients (50%). Similar findings were observed using all other cutpoints for a positive PEU. The median semen volume for men with a positive PEU (1.4 ml) was significantly lower than for those with negative PEU (2 ml) (p = 0.048).Conclusions: Although we ultimately chose 5% as the cutpoint for this study, a variety of criteria may be used to define a positive PEU. Whatever criteria are used, the prevalence of a positive PEU in the fertile population is similar to infertile patients suggesting that a great deal more information is needed to interpret this test in the management of these patients. Moreover, it is unclear from this study whether the sperm found in the urine is coming from the bladder urine or simply being washed out of the urethra.Supported by: U54 HD36209 from NICHD. Objective: Standard criteria for the interpretation of a postejaculatory urinalysis (PEU) do not currently exist. The purpose of this study was to assess a population of fertile and infertile men in order to determine the prevalence of sperm within postejaculatory urine and develop a cutpoint for interpretation of this test. Design: Prospective, university-based study. Materials/Methods: Both semen analysis and postejaculatory urinalysis was performed upon 15 men undergoing elective vasectomy (fertile group) and 80 patients attending an infertility clinic (infertile group). The percentage of sperm present in the urine as compared to that in the semen was calculated. A variety of criteria for a positive PEU were assessed including any sperm present and various percentages of sperm in the urine. IRB approval was obtained for this study. Results: The mean age of the fertile men (37 years) was not different from the infertile patients (40 years). As expected, the median total sperm count of the fertile men (128 million) was significantly higher (p <0.001) than the infertile patients (8 million). The median total urine sperm count for the fertile group (26.6 million) was greater than the infertile group (2.5 million) but was not significantly different (p = 0.234). Using a cutpoint of the urine containing greater than 5% of the total semen sperm count, the prevalence of a positive PEU in fertile controls (60%) was no different from the infertile patients (50%). Similar findings were observed using all other cutpoints for a positive PEU. The median semen volume for men with a positive PEU (1.4 ml) was significantly lower than for those with negative PEU (2 ml) (p = 0.048). Conclusions: Although we ultimately chose 5% as the cutpoint for this study, a variety of criteria may be used to define a positive PEU. Whatever criteria are used, the prevalence of a positive PEU in the fertile population is similar to infertile patients suggesting that a great deal more information is needed to interpret this test in the management of these patients. Moreover, it is unclear from this study whether the sperm found in the urine is coming from the bladder urine or simply being washed out of the urethra. Supported by: U54 HD36209 from NICHD.

Time to pregnancy in relation to semen quality assessed by CASA before and after sperm separation

In order to provide a reference for infertile men, we defined normal values of semen quality in a population of fertile men, using computer-assisted semen analysis (CASA) before and after sperm separation. Additionally, we investigated the relationship between semen quality and time to pregnancy (TTP). Semen samples were obtained from 315 proven fertile men. The median sperm concentration in fresh samples was 107 x 10(6)/ml (5-95 percentiles: 16-322 x 10(6)/ml), the median percentage of motile sperm cells was 65% (14-87%) and the median percentage of progressively motile cells was 37% (5-64%). After density gradient sperm separation, the median total sperm count was 46 x 10(6) (4-350 x 10(6)), the median percentage of motile sperm cells was 77% (16-95%) and the median percentage of progressively motile cells was 63% (11-84%). No significant associations were found between TTP and sperm counts or sperm motility, either before or after sperm separation. This may be due in part to the fact that the study comprised couples with proven fertility. We have defined semen parameters, including the results of density gradient separation, in a population of normal fertile men which may be of interest in the evaluation of semen samples from infertile men.

INVESTIGATION OF FERTILIZING CAPACITY OF CRYOPRESERVED SPERMATOZOA FROM PATIENTS WITH CANCER

Purpose There are few published reports concerning fertilization and pregnancy outcomes achieved with cryopreserved spermatozoa from cancer patients. Controversy exists regarding the value of sperm banking for these patients before therapy, whether the spermatozoa are viable after long-term storage and whether they can fertilize the ovum. We assess fertilization and pregnancy outcomes achieved with cryopreserved spermatozoa from cancer patients using assisted reproductive techniques. Materials and Methods We studied 10 cancer patients who transferred cryopreserved semen specimens from our sperm bank to outside in vitro fertilization programs for assisted reproductive technique. Of these patients 5 had Hodgkin's disease, 2 testicular cancer, 1 leukemia and 2 prostate cancer. The length of specimen storage ranged from 14 to 135 months (median 49, interquartile range 24 and 82). Results The median pre-freeze motility was 44% (interquartile range 36 and 55%) and the median total sperm count was 31.1 × 10 6 (interquartile range 6.3 and 53.9 × 10 6). At 24 hours after banking the median post-thaw motility was 11% (interquartile range 6 and 35%) and the median total sperm count was 6.6 × 10 6 (1.2 and 17.1 × 10 6). A total of 18 cycles of assisted reproductive technique were performed among 10 couples with an overall pregnancy rate of 50% per couple, with 2 deliveries, 1 ongoing pregnancy and 2 miscarriages. The pregnancy rate per cycle of in vitro fertilization and intracytoplasmic sperm injection was 36.4% with an implantation rate of 13%. Conclusions These results indicate that poor quality cryopreserved spermatozoa from cancer patients, irrespective of the length of storage, may provide successful results with the latest micromanipulative techniques such as intracytoplasmic sperm injection.

Pregnancy after assisted ejaculation procedures in men with spinal cord injury

Objective: To present the results of fertility treatment in 28 men with spinal cord injury (SCI) and their partners. Design: Retrospective analysis. Setting: University hospital outpatient clinic and home. Patients: Twenty-eight anejaculatory men with SCI and their partners seeking treatment for infertility. Intervention: Penile vibratory stimulation and electroejaculation as semen, retrieval methods. Assisted reproductive techniques used: vaginal self-insemination at home, intrauterine insemination, in vitro fertilization with or without intracytoplasmic sperm injection. Main Outcome Measures: Ejaculation rate; sperm count and motility; pregnancy rates. Results: All of the men were able to ejaculate either by penile vibratory stimulation (79%) or electroejaculation (21%). Median total sperm count was 65 million (range, 0.1 to 480) with a median motility of 13% (range, 1% to 60%). Overall, 9 of 28 couples (32%) achieved 10 pregnancies (4 self-insemination, 3 intrauterine insemination, 1 in vitro fertilization, and 2 intracytoplasmic sperm injection). Conclusions: An ejaculation rate of 100% was achieved using penile vibratory stimulation as a first treatment option with electroejaculation as a second option. Motivated couples with adequate semen quality may be offered penile vibratory stimulation combined With self-insemination at home. Together with intrauterine insemination or fertilization techniques used in vitro, the pregnancy rate per treatment cycle for SCI couples may approach that of natural procreation in healthy and fertile couples.

Collection and analysis of semen from the common marmoset (Callithrix jacchus).

The authors examined the seminal characteristics of 16 male common marmosets (Callithrix jacchus) to provide baseline data for future studies of the reproductive biology of this species. Semen samples were collected by electroejaculation. There was considerable inter- and intra-male variation in all seminal characteristics. The median seminal volume was 30 microliters (range 8 to 85 microliters), and the median total sperm count was 5.1 x 10(6) sperm (range, 0.1 to 43 x 10(6]. The median progressive sperm motility was 48% (range, 10% to 76%), and 49% of the sperm exhibited normal morphology (range, 24% to 81%). Three types of sperm head abnormalities and eight types of tail defects were noted. Tail defects were common (median, 50%; range, 17% to 76%), whereas head defects were relatively rare (median, 4.5%; range, 0% to 24%). The results indicate that semen samples can be routinely collected from this species, but considerable inter- and intra-male variation can be expected. It is therefore important to examine several semen samples from each male marmoset to obtain an accurate seminal picture.