Semen Quality In Patients Research Articles

Semen Quality in Patients With Chlamydia trachomatis Genital Infection Treated Concurrently With Prulifloxacin and a Phytotherapeutic Agent

Chronic prostatitis (CP) due to Chlamydia trachomatis (Ct) infection has a significant impact on young male fertility, and eradication of Ct infection after antibiotic therapy does not always result in recovery of semen quality. The study aim was to evaluate the effects on fertility parameters of L-arginine, L-carnitine, acetyl-L-carnitine, and ginseng extracts (FERTIMEV) associated with prulifloxacin in patients affected by CP and oligoasthenoteratozoospermia due to Ct infection. Two hundred and six patients with proven Ct genital infection and oligoasthenoteratozoospermia were enrolled in a prospective, randomized, and controlled study. Prulifloxacin (600 mg) was administered daily for 14 days, and patients were divided into 2 groups: group A: antibiotic therapy alone; and group B: antibiotic therapy and additional therapy with FERTIMEV (1 vial daily for 6 months). Microbiological and semen parameter analyses were performed both at enrollment and after 6 months. National Institutes of Health Chronic Prostatitis Symptom Index and International Prostatic Symptom Score questionnaires were applied. Of the 206 patients, 109 were assigned to group A and 97 to group B. At the enrollment time, no differences were reported with regard to clinical, instrumental, and laboratory data. Six months after treatment, statistically significant differences were demonstrated between both groups in terms of sperm concentration (21.3 ± 13.2 millions/mL vs 11.5 ± 13.2 millions/mL) (Cohen's d = 0.61) (P < .001, df = 2, F = 62.10) and percentage of motile sperm (42.4% ± 5.2% vs 29.3% ± 11.0%) (Cohen's d = 1.52) (P < .001, df = 2, F = 91.48). In this study treatment with FERTIMEV together with prulifloxacin improved semen parameters in patients with Ct genital infection and oligoasthenoteratozoospermia compared to treatment with prulifloxacin therapy alone.

Risk Factors for Progressive Deterioration of Semen Quality in Patients With Varicocele

To assess the risk factors for progressive deterioration of semen quality (PDSQ) in adult patients with varicocele. A total of 32 men with left varicocele and impaired semen quality (group 1) and 30 age-matched patients with left varicocele and normal semen quality (group 2) were recruited for the present study. All the subjects received conservative treatment, and the parameters for evaluation every 12 months included semen quality, peak retrograde flow (PRF) and spontaneous venous reflux by color Doppler ultrasonography, body mass index, serum concentration of follicle-stimulating hormone, luteinizing hormone, prolactin, testosterone, testicular volume and discrepancy, grade of varicocele, and scrotal temperature. The mean follow-up time was 63.2 months (range 60-66). The patients in group 1 had a significantly greater PRF, lower testicular volume, greater testicular volume discrepancy, lower testosterone level, higher scrotal temperature, and greater follicle-stimulating hormone level than those in group 2 at first. The semen quality deteriorated in 28 subjects (87.5%) in group 1, but in only 6 patients (20%) in group 2 during follow-up. Furthermore, the 6 subjects with PDSQ in group 2 had greater PRF and scrotal temperature than those without. The rate of PDSQ was significantly greater in the varicocele patients with an initially abnormal semen quality than in those with initially normal semen quality (87.5% vs 20%). Furthermore, the varicocele patients with initially normal semen quality who had greater PRF and scrotal temperature might have a greater risk of PDSQ.

Evaluation of semen quality in patients with malignancies referred for sperm banking before cancer treatment

Different cancer treatments such as chemotherapy and radiotherapy can lead to azoospermia and even sterility for an unknown period. Whether the type of cancer could affect semen quality or not is under debate. In this study, we have reviewed semen parameters of men with cancer who deposited their sperm samples at the Avicenna Research Institute tissue bank before undergoing cytotoxic treatment. This descriptive retrospective study examined 73 cases referred to sperm bank, because of malignancy, prior to initiation of cancer treatments including chemotherapy and radiotherapy. The data recorded were age, marital status, reproductive history, semen analysis reports and cancer history of the patients. Semen samples were analysed according to recommendations of the World Health Organization (1999) before freezing. Results of the analysis showed that 71.2% (52) of patients had oligozoospermia, 93.2% (68) teratozoospermia and 86.3% (63) asthenozoospermia. Different groups of cancer patients did not show any differences in oligozoospermia, teratozoospermia and asthenozoospermia. Impaired spermatogenesis even prior to cancer treatment indicates the importance of fertility preservation. As the majority of patients had suitable specimens for freezing and assisted reproduction, sperm banking is recommended to be performed promptly and before any treatment, especially surgery.

Lack of Impact of Semen Quality on Fertilization in Assisted Conception

Defective semen quality is one of the commonest causes of infertility. The diagnosis of male fertility depends upon a descriptive evaluation of human semen, however a normal semen analysis does not necessarily indicate satisfactory fertility potential. (i) to examine the semen quality of patients undergoing treatment by assisted conception, (ii) to explore relationships between semen quality and treatment outcomes, and (iii) to look at inter-laboratory variation in the assessment of semen quality. Semen quality in patients undergoing assisted conception treatment between 2001 and 2004 was reviewed. Data on female age, egg numbers and fertilization outcomes was obtained by case note review. The thresholds used to direct patients towards IVF or ICSI treatment were comparable with the normal values promulgated by WHO, with the exception of morphology. Semen quality was not predictive of fertilization rates. When the results of independent measurements of the same sample were compared, there was diagnostic disagreement in between 10%-29% of samples. The conventional criteria of semen quality are used to determine treatment strategy for couples undergoing assisted conception but are not reflected in fertilization rates, emphasising the limited utility of the conventional criteria of semen quality in the assessment of sperm function. There remains significant inter-laboratory variation in the results of semen analysis.

Evaluation of semen variables, sperm chromosomal abnormalities and reproductive endocrine profile in patients with chronic hepatitis C

To evaluate reproductive endocrine profile, sperm chromosomal abnormalities, and semen quality in patients with chronic hepatitis C. In all, 82 patients with chronic hepatitis C, aged 18-60 years, were recruited for the study; 76 age-matched healthy male volunteers served as controls. All participants provided a medical history and had a complete physical examination and routine semen analysis. Two blood samples were drawn from each participant at 15-min intervals to determine the resting levels of luteinizing-hormone (LH), follicle-stimulating hormone (FSH), prolactin, testosterone, oestradiol, and sex hormone-binding globulin. The hypothalamus-pituitary-testis axis was assessed using the gonadotrophin-releasing hormone (GnRH) test. All participants also received an injection of human chorionic gonadotrophin (hCG) and serum testosterone was determined before the hCG injection and on the third day afterwards. Conventional karyotype analysis and triple-colour fluorescence in situ hybridization for chromosomes X, Y and 18 were conducted in all patients and controls. The mean basal serum levels for LH, FSH, and testosterone in patients with hepatitis C was significantly lower than the mean for normal controls (P = 0.01). The injection of GnRH analogue did not yield significantly higher FSH and LH levels in the patients than in normal controls (P = 0.001). In patients with chronic hepatitis C, the mean total sperm count, motility and normal morphology was significantly lower than in controls (P = 0.001). There was a significantly greater frequency of disomy in men with chronic hepatitis C than controls for chromosomes 18, X, and Y (P = 0.01). Patients with chronic hepatitis C are at risk of showing sperm chromosomal abnormalities, the incidence of which is higher in patients with more advanced disease. Hypogonadotrophic hypogonadism is caused by the selective loss of pituitary gonadotrophin function. Further studies are needed to replicate our results.

A low intake of antioxidant nutrients is associated with poor semen quality in patients attending fertility clinics

To compare specific nutrient intake between normospermic and oligoasthenoteratospermic patients attending infertility clinics in two Mediterranean provinces of Spain. Case-control study. Private fertility clinics in southeastern Spain. Thirty men with poor semen quality (case subjects) and 31 normospermic control subjects of couples attending our fertility clinics. We recorded dietary habits and nutrient consumption using a food frequency questionnaire adapted to meet specific study objectives. We calculated nutrient intakes by multiplying the frequency of use for each food by the nutrient composition of the portion size specified on the food frequency questionnaire and by addition across all foods to obtain a total nutrient intake for each individual. Semen quality was assessed by measuring volume, concentration, motility, and morphology. Hormones levels were also analyzed in case and control subjects. In the logistic regression, control subjects had a significantly higher intake of carbohydrates, fiber, folate, vitamin C, and lycopene and lower intakes of proteins and total fat. A low intake of antioxidant nutrients was associated with a poor semen quality in this case-control study of Spanish men attending infertility clinics.

The treatment with cabergoline for 24 month normalizes the quality of seminal fluid in hyperprolactinaemic males

Alterations of sperm number and motility are found in hyperprolactinaemic men. Cabergoline treatment reverses alterations in semen. No information is currently available on the quality of seminal tests in hyperprolactinemia in response to cabergoline treatment. To further investigate the effect of hyperprolactinaemia and its treatment with cabergoline on semen quality. Forty-three men with hyperprolactinaemia (32 macro- and 11 micro-prolactinomas); 60 healthy men served as control. Live spermatozoa count, sperm membrane function, kinetic index, nuclear DNA integrity, sperm curvilinear and linear velocity and amplitude of lateral movement of the sperm head were investigated before and after 6 and 24 months of treatment with cabergoline. Open prospective. At study entry, semen functional tests were severely and similarly impaired both in patients with macro- and micro-prolactinomas compared to controls. After 6 and 12 months of treatment there was a significant improvement of semen quality in patients achieving normalization of prolactin levels, although most of the parameters remained lower than in controls. After 24 months of treatment, seminal fluid characteristics were similar to the controls except for live spermatozoa count, sperm membrane function, sperm kinetic index and sperm nuclear DNA integrity, which remained abnormal in 9.3-53% of the patients. Twenty-four months of cabergoline treatment restored gonadal function in 66.7% of men with hyperprolactinaemia.

Human sperm superoxide anion generation and correlation with semen quality in patients with male infertility

To measure levels of reactive oxygen species (ROS) including H(2)O(2) and O(2)(.-) generation in infertile men and determine whether sperm quality is correlated with levels of ROS triggered by the exogenous reduced form of beta nicotinamide adenine dinucleotide phosphate (NADPH). Prospective study. Male infertility clinic at a tertiary healthcare center. Eleven infertile men and six healthy donors. Chemiluminescence assay using luminol and lucigenin as probes before and after incubating sperm samples with 5 mM and 10 mM of NADPH. The ROS generation (10(6) counted photons per minute/10(6) sperm). Baseline levels of O(2)(.-) generation were significantly higher in the infertile patients than in the healthy donors (r = 0.73, 95% confidence interval [median (25th, 75th percentiles): 0.73 (0.5, 5.5) vs. 0.2 (0.0, 0.5)] when lucigenin was used as the probe. Compared with basal levels, O(2)(.-) generation was significantly higher after coincubation with NADPH (5 mM and 10 mM) in the entire combined study population, and patients only but not donors. The O(2)(.-) generation was negatively correlated with sperm concentration (r = -0.75, 95% CI 0.38-1), motility (r = -0.69, 95% CI 0.28-1), and percentage of normal morphology (r = -0.78, 95% CI 0.36-1). Spermatozoa from infertile men produce higher levels of O(2)(.-) in the presence of exogenous NADPH compared to healthy donors. The ability of spermatozoa to generate O(2)(.-) increases as the semen quality declines.

A prospective double blind placebo controlled cross over trial of carnitine therapy in selected cases of male infertility

Objective: Carnitine has been demonstrated in several uncontrolled clinical trials over the past decade to have beneficial effects on semen quality in patients with idiopathic male-factor etiologies. The goal of our study was to determine the efficacy of L-carnitine therapy on semen quality in selected cases of male infertility. Design: Subjects were randomized to therapy or placebo in a double blind crossover trial in a University based tertiary referral center. Materials/Methods: One hundred patients were randomized with male infertility using the following criteria: age (range: 20–40 yr.), infertility duration >2 yr., and 3 baseline semen analysis, each demonstrating the following characteristics: concentration 10–20 × 106/mL; percent motility 10–30%; forward progression <15%; abnormal morphological forms (WHO, 1999) <70%; curvilinear velocity 10–30/sec (normal >50/sec); and, linearity <4 (normal >5). Patients were submitted to a therapy of L-carnitine 2g/day or placebo. All subjects had an initial 2 months run-in period and then randomized to 2 months of carnitine or placebo. Next, both groups had 2 months washout and then crossed over to either placebo or carnitine for 2 months with 2 additional months of follow-up. Results: Eighty-six patients completed the trial. A statistically significant improvement in semen quality, compared to the placebo, was seen after the L-carnitine therapy in sperm concentration (P = 0.01), percentage motility (P = 0.04), and forward sperm progression (P = 0.05). The increase in forward sperm progression was more significant in patients with severe oligo-asthenospermia, <5 × 106 forward motile sperm/ejaculate or <2 × 106 forward motile sperm/mL (P = 0.03, and 0.02, respectively). Conclusions: This is the first report of a double blind placebo-controlled study using L-carnitine in the therapy of patients with male infertility. We demonstrated that L-carnitine supplementation significantly improves two of the most important sperm parameters: concentration and motility. In addition, it also improves these parameters in patients with severe oligo-asthenospermia. Future trials will evaluate its efficacy on pregnancy outcome. Supported by: None.

Dendritic Cell Infiltration In A Patient With Seminomatous Germ Cell Tumor Of The Testis: Is There A Relationship With Infertility And Tumor Stage?

Inflammatory cells, such as dendritic cells, are considered to trigger the antitumoral immune response against tumors, such as testicular cancer. Male infertility associated with cancer may be due to endocrine or immunological factors. We investigated possible associations of antigen expression with dendritic cells, histiocytic cells and seminoma stage as well as with impaired spermatogenesis. From 1992 to 1999, 30 patients with seminoma underwent orchiectomy at our center, including 14 who underwent spermiography before orchiectomy. Streptavidin-biotin immunostaining was performed on paraffin -embedded tumor specimens using antibodies against protein S-100 for dendritic cells and CD68-KP1 antigen. Light infiltration by less than 20 dendritic cells and less than 103 CD68+ cells was associated with tumor size greater than 1.5 cm. in 75% and 80% of patients, respectively. Strong infiltration by greater than 20 dendritic cells and greater than 103 CD68+ cells was associated with negative lymph nodes in 86% of patients. Slight infiltration by dendritic cells was observed in 71% of patients with a sperm count of greater than 8.6 million per ml. and in 100% with more than 45% motile sperm (p not significant and 0.02, respectively). Necrospermia increased with dendritic and CD68+ cell infiltration. No association was noted among preoperative serum tumor marker levels, the sperm count and immunostaining. Sperm autoimmunity is a plausible mechanism of infertility in men with germ cell tumors. Dendritic cells may induce antitumor cell cytotoxic reactions, but may also be cytotoxic to sperm cells or lead to inhibited spermatogenesis. Further studies focusing on tumor rejection antigen and the cloning of specific cytotoxic T lymphocyte against gametes are required to confirm these finding.

What is the benefit of preoperative sperm preservation for patients who undergo restorative proctocolectomy for benign diseases?

In patients with benign colorectal diseases undergoing a restorative proctocolectomy with an ileal pouch-anal anastomosis, semen cryopreservation seems rational to enable the possibility of procreation in case surgery leads to sexual disorders or impotence. The aim of this study was to determine the preoperative and postoperative semen quality in patients undergoing ileal pouch-anal anastomosis. In addition, the study sought to determine the incidence of surgery-induced sexual dysfunction to evaluate the economic efficiency of semen cryopreservation as compared with alternatives such as microsurgical epididymal sperm aspiration. Preoperative and postoperative semen analyses were offered to 97 patients with ileal pouch-anal anastomosis with benign colorectal diseases since 1989. The direct costs of the semen cryopreservation program were determined and compared with those of alternatives. In 34 of 40 consecutive patients with ileal pouch-anal anastomosis who made use of preoperative semen preservation, normal sperm concentrations, motility, and morphology were found. Mean semen characteristics of all 23 patients who returned for postoperative analysis were not different from preoperative values, but they were for total sperm number. Two patients developed temporary retrograde ejaculation postoperatively. None of the preserved semen samples was used, thus semen cryopreservation benefited none of these patients. The total costs of semen cryopreservation are between 2.2 and 5 times higher than the costs for one microsurgical epididymal sperm aspiration procedure. Preoperative semen cryopreservation in patients undergoing ileal pouch-anal anastomosis because of benign colorectal diseases is quite feasible. However, most likely because of improved surgical techniques and the increasing number of effective alternatives, preoperative semen cryopreservation in patients with ileal pouch-anal anastomosis is no longer cost effective.

Characteristics of cryopreserved semen from men with lymphoma.

This study compared the pretreatment semen quality in patients with Hodgkin's disease and non-Hodgkin's lymphoma with a group of healthy donors. We also examined the differences in prefreeze and postthaw semen quality among the different stages of Hodgkin's disease. The study included 89 patients with Hodgkin's disease, 18 with non-Hodgkin's lymphoma, and 50 healthy sperm donors. In patients with Hodgkin's disease, the prefreeze and postthaw semen characteristics were significantly lower than those of the healthy donors. Similar results also were seen in patients with non-Hodgkin's lymphoma. No significant differences in the prefreeze semen quality were seen in patients with different stages of cancer. Patients with Hodgkin's disease and non-Hodgkin's lymphoma in our study had poor semen quality when compared with healthy donors both before and after cryopreservation. As cancer therapy significantly impairs reproductive potential, sperm banking should be offered to these men before the start of their therapy.

Effect of lipid peroxidation on cryopreserved semen quality in patients with testicular or nontesticular cancer

Although pre-freeze and post-thaw semen quality in patients with cancer is poor, it is not clear whether lipid peroxidation affects semen quality. This study assessed (1) whether poor semen quality in patients with cancer is caused by lipid peroxidation, and (2) whether patient age or sperm motility is associated with lipid peroxidation. Lipid peroxidation was measured by determining malonaldehyde levels using the thiobarbituric acid method. Malonaldehyde levels were measured in cryopreserved semen specimens from patients with testicular (n = 15) or nontesticular cancer (n = 16) and normal men (control subjects, n = 20). A computer-assisted semen analyzer was used to determine the sperm concentration and motility before and after cryopreservation. Malonaldehyde levels did not differ in frozen-thawed semen specimens among patients with testicular (25.90 +/- 1.00 nM/10(8) sperm/hr) or nontesticular cancer (24.48 +/- 1.66 nM/10(8) sperm/hr), and control subjects (24.86 +/- 1.43 nM/10(8) sperm/hr). Malonaldehyde levels did not correlate with post-thaw sperm motility or patient age in patients with testicular or nontesticular cancer. Post-thaw sperm motility from patients with testicular or nontesticular cancer was significantly lower than that in normal subjects. The poor post-thaw semen quality in patients with testicular or nontesticular cancer is not related to lipid peroxidation but may be caused by other factors such as sperm membrane stress induced during the freeze-thaw process.

Creatine kinase level and lipid peroxidation rate in human spermatozoa from patients with cancer.

The present study assessed whether the poor semen quality in patients with cancer results from the inhibition of sperm maturation as indicated by creatine kinase or from increased oxidative stress as assessed by lipid peroxidation of the sperm membrane. Cryopreserved semen specimens from patients with testicular (n = 10) and nontesticular (n = 12) cancer and normal healthy donors (n = 14) were analyzed for lipid peroxidation and creatine kinase levels. The levels of creatine kinase and malonaldehyde did not differ among testicular or nontesticular patients with cancer or normal healthy donors. Poor semen quality in testicular and nontesticular patients with cancer is not related to creatine kinase or lipid peroxidation levels; it may be related to other factors.

Varicocele testis and testicular temperature.

To evaluate whether there is an association between scrotal skin temperature and impaired semen quality in patients with varicocele testis. Two groups of men (all newly enlisted soldiers), 39 with an asymptomatic varicocele testis and 38 normal control subjects, were compared for semen quality and scrotal skin temperature. The semen quality in the men with varicocele was significantly lower than that in the control subjects; however, there was no significant difference in scrotal skin temperature between the groups. This study confirmed previous observations showing a possible relationship between varicocele testis and impaired sperm quality, but there was no apparent difference in scrotal skin temperature in men with or without a varicocele.

Early Treatment of Cryptorchidism, Semen Quality and Testicular Endocrinology

Purpose We evaluated the effect of patient age at treatment of cryptorchidism in relation to subsequent semen quality. Materials and Methods Semen analyses and hormonal evaluations were performed in 51 men who were treated for cryptorchidism at ages 10 months to 12 years. Results Sperm concentration was normal in 90 percent of the patients with unilateral and 50 percent with bilateral cryptorchidism. No patient treated before age 4 years had severe sperm defects. Elevated follicle-stimulating hormone levels indicated severe testicular damage. Conclusions Fertility is better in patients with bilateral cryptorchidism if treated before age 4 years. Age at treatment did not have a significant effect on semen quality in patients with unilateral cryptorchidism.

Semen Parameters Before and After Transurethral Surgery for Ejaculatory Duct Obstruction

Purpose We examined how transurethral resection of the ejaculatory ducts, performed for infertility, affects semen quality in patients with azoospermia and oligo-asthenospermia. Materials and Methods A retrospective review was done of 46 cases of transurethral resection of the ejaculatory ducts for ejaculatory duct obstruction, confirmed by transrectal ultrasound. Clinical course and semen quality were assessed by semen parameter indications. Results In 65 percent of the patients transurethral resection of the ejaculatory ducts improved semen quality (greater than a 50 percent increase in total motile sperm count) and 20 percent initiated a pregnancy an average of 6.1 months postoperatively. Statistically significant increases in total motile sperm count were achieved in men with azoospermia and those treated for oligo-asthenospermic indications; the improvement also was shown to be sustainable. Complications occurred in 20 percent of the men. Conclusions Significant and durable semen quality improvement can be achieved after transurethral resection of the ejaculatory ducts for all surgical indications. In most unsuccessful cases the reason for failure is unclear.

Effect of cryopreservation on semen quality in patients with testicular cancer

Objectives Current techniques in cryopreservation of human semen substantially decrease sperm quality. In addition, the pregnancy rate using cryopreserved sperm obtained from testicular cancer patients is lower than when sperm from normal fertile men is used. However, it is still unclear whether cryopreserved sperm from these patients is inherently defective or if the sperm loses its motility after thawing. This study was undertaken to assess the effect of cryopreservation on the quality and motion characteristics of semen from patients with testicular cancer before definitive therapy compared with semen from normal volunteers. Methods We compared the sperm quality before and after cryopreservation in samples from 34 patients with testicular cancer and 30 normal volunteers who were referred for sperm banking over a 7-year period. The effects of cancer stage and histologic type on various semen parameters were also examined. A computer-assisted semen analysis was performed before and after cryopreservation on each specimen. The nitrogen vapor technique using Test yolk buffer with glycerol as a cryoprotective agent was used for cryopreservation. The motile sperm count and motion characteristics (motility, velocity, linearity, amplitude of the lateral head movement, motility index) were analyzed before and after cryopreservation and compared between the groups. Results Semen quality did not significantly differ among patients with Stage I, II, or III cancer. However, semen quality tended to be poorer at higher cancer stages. In general, semen quality was better among patients with pure seminomas than with pure embryonal tumors; quality was worst among patients with mixed germ cell tumors. However, 71.4% of patients with mixed tumors presented with Stage III disease, whereas all patients with seminomas presented with Stage I disease. Significant differences were also seen in prefreeze motility (median, 42% [interquartile range, 24 to 51] versus 60.5% [range, 49 to 73]; P = 0.0004) and motile sperm count (6.7 × 10 6/mL [range, 3.4 to 14.4] versus 50.0 [range, 24.6 to 72.0]; P = 0.0001) in patients compared with controls, respectively. The motile sperm count and percent motility significantly decreased in both patients and controls after cryopreservation ( P = 0.0001). However, the percentage decline in motile sperm count and motion characteristics after cryopreservation did not differ significantly between patients and controls ( P > 0.01). Conclusions We conclude that the effect of cryopreservation on sperm quality in patients with testicular cancer is identical to its effect on sperm from normal fertile men. Differences in values after preservation are explained by poor semen characteristics before freezing; semen quality declines with more extensive disease. Stage I patients also had poorer quality than control subjects. Thus, we recommend that routine sperm banking be encouraged among all patients with testicular cancer before the initiation of specific medical treatment. We also recommend that future efforts be focused on improving the technique of sperm banking.

Cryopreservation and semen quality in patients with Hodgkin's disease.

Cryopreservation of semen from patients with Hodgkin's disease yields fewer motile sperm than from fertile men without Hodgkin's disease. However, although poor sperm quality and subfertility have been associated with Hodgkin's disease, whether the disease adversely affects sperm quality is not clear because many studies evaluated semen quality after chemotherapy or radiation therapy had begun. Furthermore, the effect of cryopreservation on semen quality in these patients is unknown. This study investigated pretreatment sperm quality and the effect of cryopreservation on semen quality in patients with Hodgkin's disease. Specimens from 39 patients with Hodgkin's disease and 30 normal volunteers who underwent sperm banking over a 5-year period were analyzed. No patient had undergone chemotherapy or radiation therapy before sperm banking. The nitrogen vapor technique, using Test-Yolk buffer with glycerol as a cryoprotective agent, was used for cryopreservation. Prefreeze and postthaw motile sperm count (MSC) and motion characteristics, namely motility, curvilinear velocity (VCL), linearity, amplitude of lateral head movement (ALH), and motility index, were compared between the two groups. Prefreeze values for MSC (P = 0.0001), motility (P = 0.0001), motility index (P = 0.0001), and VCL (P = 0.0019) differed significantly between patients and donors. Except for linearity and ALH, postthaw sperm MSC, motility, VCL, and motility index decreased significantly (P = 0.0001) in both groups. However, the percentage decline in semen quality from prefreeze to postthaw values did not differ significantly between donors and patients. The pretreatment semen quality in patients with Hodgkin's disease is poor compared with that of normal fertile men. However, half the patients had a normal MSC, so a clinical diagnosis of Hodgkin's disease does not predict cryopreservation outcome adequately. Semen cryopreservation should be encouraged as a routine part of the therapeutic management of men of reproductive age who will undergo chemotherapy or radiation therapy for Hodgkin's disease.

Exocrine and endocrine functions in unilateral testicular disease

Exocrine testicular function was determined in 30 prepubertal and pubertal patients who had undergone detorsion and fixation for unilateral torsion of the testis, in 46 men who had undergone unilateral orchidopexy, and in 16 patients with unilateral absence of the testis. In 42 patients with seminomas and non-seminomatous testicular tumors, sperm analyses were performed before orchiectomy. The semen analyses in patients with unilateral cryptorchidism were normal in 13, doubtful in 23 and pathological in 10. The semen quality in patients with torsion was normal in 15, doubtful in 3 and pathological in 12. Of the 16 patients with monorchidism, 14 had normal sperm analyses. Of the 42 patients with seminomas and non-seminomatous testicular tumors, only two patients with HCG-negative seminomas had normal sperm analyses before orchiectomy. In patients with doubtful and pathological sperm analyses after testicular torsion and unilateral orchidopexy, elevated follicle-stimulating-hormone levels were observed. HCG-positive testicular tumors showed decreased FSH levels but elevated 17-β-estradiol and prolactin levels.