Seminal Fluid Analysis Research Articles

Relationship of hamster ovum sperm penetration assay to seminal fluid analyses in the evaluation of infertile couples.

The males of 279 infertile couples were evaluated with hamster ovum sperm penetration assay (SPA) and seminal fluid analysis. The mean SPA score for the total population was 23.0% penetration with a range of 0-97%. Twenty five percent of the patients demonstrated scores within the abnormal range (0-10%), and 15% were in the "equivocal" range (11-14%). Comparing each individual with the total population using linear regression analysis, it was noted that sperm concentration, percent motility, and percent oval forms varied directly with the SPA, and the slopes of the relationships are positive and statistically significant (p less than 0.0001, 0.002, and 0.0001, respectively). The relationship between SPA and volume is not statistically significant (p greater than or equal to 0.354). To determine whether the SPA could be utilized to establish appropriate normal parameters for various components of SFA, these were analyzed in 169 men who had SPAs of greater than or equal to 15%. Although most SFA values fell within the normal range for this group, there were several exceptions, particularly with respect to percent motility and the presence of leukocytes in the semen. Comparing the percentage of males with abnormal SPA in groups of couples with or without a demonstrable abnormality affecting fertility in the wife, no statistically significant differences could be found. The value of the SPA and SFA in investigating males of infertile couples is discussed.

Testicular function in young men in long-term remission after treatment for the early stages of Hodgkin's disease.

16 young men in long-term remission after standard treatment for the early stages of Hodgkin's disease were examined for testicular function 48 to 125 months after termination of therapy. The patients had received mantle field irradiation, plus either irradiation of infradiaphragmatic lymph nodes (7 patients) or 6 cycles of MOPP (9 patients). 5 patients had almost normal semen quality judged by seminal fluid analysis. 11 patients had reduced semen quality (8 severely reduced) and often elevated FSH values. Semen samples of poor quality were significantly more common in patients treated with MOPP (7/9) than in those treated with infradiaphragmatic irradiation (1/7). One patient showed signs of regeneration of spermatogenesis. None had experienced reduction in libido and sexual performance after therapy; correspondingly, none had below normal testosterone values or elevated LH values. Patients should be informed about the risk of infertility before treatment. If in a given case several treatment options with equal prospective antineoplastic effect are weighed against one another, the patient's possible desire to retain fertility should favour the use of radiotherapy as opposed to chemotherapy, especially including alkylating agents.

Improvement in the sperm penetration (hamster ova) assay (SPA) results after doxycycline treatment of infertile men.

Thirty-two men with abnormal (less than or equal to 11% penetration) Sperm Penetration (hamster ova) Assay (SPA) results were treated with doxycycline and reevaluated by SPA and seminal fluid analysis. Eighteen of the 32 infertile men with initially abnormal SPAs had normal SPAs (greater than or equal to 15% egg penetration) after treatment. None of 30 untreated infertile men with abnormal SPAs had a normal SPA on repeat testing (P less than 0.001). Improvement in SPA results was associated with a decrease in the number of leukocytes/ml in seminal fluid. Seven of the wives of the treated men conceived, while none of the wives of the untreated infertile men conceived during comparable intervals of time.

Elevated serum follicle-stimulating hormone levels in men with normal seminal fluid analyses

Three men who volunteered as normal subjects were found to have abnormally high levels of serum follicle-stimulating hormone (FSH) despite having normal seminal fluid analyses and fertility. Two of the men had a history of previous orchitis, and one had an atrophic testis. Serum luteinizing hormone and testosterone levels were normal. These cases appear to represent compensated primary testicular disease, with normal sperm counts and fertility maintained at the expense of chronically elevated FSH levels. These results imply that in certain situations, the measurement of serum FSH levels may be a more sensitive index of testicular disease than the performance of seminal fluid analyses.

Presumptive Screening Test for Seminal Acid Phosphatase Using Sodium Thymolphthalein Monophosphate

The use of sodium thymolphthalein monophosphate for presumptive seminal acid phosphatase testing is discussed. Recent evidence reveals that the dye (o-dianisidine) used in conjunction with alpha-naphthyl phosphate for seminal acid phosphatase testing is a carcinogenic hazard. Numerous tests for seminal acid phosphatase were conducted with swabs from sexual assault kits to compare both substrates. Results of tests using sodium thymolphthalein or alpha-naphthyl phosphate correlated exactly. Sodium thymolphthalein is an effective alternative for preliminary seminal fluid analysis because of its high degree of selectivity and stability, and because it eliminates the potential health hazard.

Benefits of the sperm (hamster ova) penetration assay in the evaluation of the infertile couple

The males of 310 infertile couples and 30 control couples (current pregnancy) were evaluated with the sperm (hamster ova) penetration assay (SPA) and seminal fluid analysis (SFA). The SPA was found to have a sensitivity of 100% and a specificity of 97% compared to 41% and 90%, respectively, for the SFA. The highest degree of concordance of the two tests existed when both tests were abnormal and no female factor was identified. The poorest concordance occurred when the SFA was normal and no female infertility factor was identified. In almost all cases of unexplained intertility where no female infertility factor was present, the problem could be assigned to the man, as evidenced by an abnormal SPA. The SFA seemed to have some predictive value with respect to the outcome following treatment of the man.

The relationship of pyospermia and seminal fluid bacteriology to sperm function as reflected in the sperm penetration assay

The relationship of the parameters of seminal fluid analysis (SFA) and seminal fluid leukocyte concentration to the in vitro sperm penetration assay (SPA) was studied in 217 men from infertile couples. Significant positive correlations were found between the SPA and sperm count, sperm motility, and morphologically normal sperm. The total number of leukocytes per milliliter, the number of polymorphonuclear leukocytes per milliliter (PMN), and the number of lymphocytes per milliliter were negatively correlated with the results of the SPA. The strongest correlation with an abnormal SPA (less than 11% of eggs penetrated) was the presence of greater than or equal to 1 PMN/100 sperm (8.17 increased relative risk of an abnormal SPA). The most important predictor variables of the percent penetration of the sperm penetration assay were total numbers of leukocytes per milliliter, sperm count, and sperm motility. Microbiologic studies of semen were not correlated with SPA results or number of leukocytes in the semen.

Possible relationship between in utero diethylstilbestrol exposure and male fertility

Seventeen men who were exposed in utero to diethylstillbestrol (DES), 12 non-DES-exposed volunteers, and 11 fertile control subjects were evaluated by physical examination, seminal fluid analysis, and sperm penetration assay (SPA). Fourteen of the 17 male subjects exposed to DES in utero and two of the 12 non-DES-exposed volunteers had SPAs of less than 14% and qualified as infertile by the criteria of this test. All 11 fertile control subjects had demonstrated SPA values in the fertile range. Thirteen of the 17 DES-exposed male subjects, four of the 12 non-DES-exposed volunteers, and four of the 11 fertile control subjects demonstrated at least one abnormality of the reproductive organs.

Psoriasis, Methotrexate, and Oligospermia

A young man with severe psoriasis was treated intermittently with methotrexate. On two different occasions, severe oligospermia documented by serial seminal fluid analyses was present coincident with methotrexate administration. Discontinuation of methotrexate resulted in normal sperm concentration. Measurements of serum gonadotrophin and testosterone levels were normal during and after methotrexate treatment. It is concluded that methotrexate administration may result in severe oligospermia and that these inhibiting effects on spermatogenesis are reversible.

Correlation of Seminal Fluid Analysis with Mucus-Penetrating Ability of Spermatozoa

The aim of this study was to compare the standard seminal fluid analysis (SFA) with the in vitro sperm penetration test (SP test). Semen from husbands in 100 infertile couples, from 25 fertile donors, and from 25 infertile males with known sperm pathology was examined. In the group of infertile males all of the SP tests were classified as poor. In the group of fertile donors the incidences of poor, inconclusive, and normal SP tests were 8%, 12%, and 80%, respectively. In the group including both normal and infertile male partners, there were 31% poor, 19% inconclusive, and 50% normal SP tests. Comparison of SP tests with different parameters of the SF A revealed that in vitro sperm penetration is mainly influenced by sperm motility and morphology. Sperm count had a limited bearing upon the in vitro penetrating ability of spermatozoa. Among 58 semen samples showing poor mucus penetration in vitro, 39 had both reduced motility and increased concentration of abnormal spermatozoa. On the other hand, this combination of pathologic parameters was not encountered at all among the 92 sperm samples with intermediate or normal sperm penetrating ability. A normal sperm concentration did not necessarily mean good penetration ability. Of 52 samples with a sperm count of more than 60 millionlml, only 53% showed normal sperm penetration.

Chronic asymptomatic genital tract infection and semen quality

Chronic asymptomatic genital tract infection has been postulated to cause infertility in man. This study demonstrates the correlation of positive seminal fluid bacteriological cultures with abnormal parameters of seminal fluid analysis in the male partners of 100 uninvestigated couples presenting with infertility. Gram negative bacteria were cultured only in patients with semen abnormalities while Gram positive bacteria were cultured from both normal and abnormal semen specimens.

Sequential Use of Clomiphene Citrate and Human Menopausal Gonadotropin in Ovulation Induction

In an effort to diminish the incidence of multiple pregnancy, ovarian hyper-stimulation syndrome, and the excessive cost of human menopausal gonadotropin (HMG) administration, a sequence of Clomid-HMG-human chorionic gonadotropin (HCG) was used in 80 patients with infertility due to prolonged amenorrhea. Criteria for this therapeutic regimen were: (1) normal seminal fluid analysis and postcoital test; (2) lack of withdrawal bleeding from progesterone following amenorrhea of more than 6 months' duration; (3) normal x-ray of the sella turcica and visual fields; (4) low serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels; (5) normal endoscopic examination; and (6) lack of response to clomiphene in excessive dose (200 mg daily for 5 days) or prolonged dose (100 mg daily for 10 days) with or without HCG, or apparent ovulatory response to the above sequence for five or six consecutive cycles without pregnancy. Clomiphene was administered in a dose of 100 mg daily for 7 days. HMG was then given in the following manner: two ampules daily for 4 days, then one ampule daily for 2 days (75 IU of FSH and 75 IU of LH/ampule). After a 24-hour interval without treatment, 10,000 IU of HCG were given and 2000 IU of HCG 4 days later. Twenty-three pregnancies occurred in 80 patients. However, 15 of the first 25 patients became pregnant--in these patients the only abnormality noted was lack of ovulation. Six additional pregnancies occurred subsequent to one or more unsuccessful cycles. Multiple pregnancies occurred in only two patients (twins delivered at 32 weeks in one and an abortion of five fetuses at 20 weeks in another). However, multiple pregnancy did not occur in any patient whose urinary estrogen level was monitored and in whom the level was 100 mug or less when the HCG was given. The ovarian hyperstimulation syndrome did not occur in any patient.

Effect of long-term testosterone oenanthate administration on male reproductive function: clinical evaluation, serum FSH, LH, testosterone, and seminal fluid analyses in normal men.

The effect of long-term testosterone administration on male reproductive function has been investigated in seven healthy young men age 20 to 27 years. Testosterone oenanthate (TOe) was administered in doses of 250 mg per week for 21 weeks. No toxic side-effects were observed. Libido, sexual potency, frequency of sexual intercourse and body hair development generally remained unaffected, but there was a reversible mean weight gain of 3.6 kg during TOe administration. Seminal fluid parameters and radioimmunoassayable serum FSH, LH, testosterone, and androstenedione levels were monitored before, during, and after TOe administration. The serum testosterone rose approximately by a factor of two, while the serum FSH and LH were rapidly suppressed after the initiation of the TOe therapy. The mean sperm concentration fell to values below three million spermatozoa per ml, and changes in sperm motility, the percentage of normal sperm morphology, and seminal fructose concentrations generally paralleled those of the mean sperm concentrations. In contrast, the mean seminal fluid volume and serum androstenedione levels did not change significantly during TOe administration. The mean sperm concentration showed a marked recovery 13 to 16 weeks after TOe withdrawal, but sperm counts remained below pre-treatment levels in three out of seven subjects 25 to 28 weeks after discontinuation of TOe.

Suppression of spermatogenesis and chronic toxicity in men by a new series of bis(dichloroacetyl) diamines

Three bis(dichloroacetyl) diamine compounds (Win 13,099, Win 17,416, Win, 18,446) have been studied for their effects on testicular physiology in human volunteers. These studies show that: 1. 1. Win 13,099, Win 17,416, and Win 18,446 do not inhibit the human pituitary and do not suppress Leydig-cell activity. 2. 2. Each of these compounds suppresses sperm output and motility and alters sperm morphology, as demonstrated by seminal fluid analyses. Histologic study of testicular biopsy specimens reveals suppression of spermatogenesis. The suppressive action of Win 17,416 is, perhaps, incomplete. Win 13,099 and Win 18,446 each reduce the sperm counts to below 4 million per cubic centimeter within 8–11 weeks. There appears to be little other manifestation of metabolic activity. 3. 3. Depression of spermatogenesis appears to be reversible after discontinuance of the drugs. For example, complete recovery occurred after administration of Win 13,099 for as long as 27 weeks. 4. 4. Although the exact mode of action is not known, it is postulated that the effects produced result from a direct action on the process of germinal-cell maturation, at the site of the germinal epithelium, and without concurrent pituitary suppression.

SPERMATOGENIC REBOUND PHENOMENON AFTER ADMINISTRATION OF TESTOSTER ONE PROPIONATE*

The spermatogenic rebound effect was studied in 5 oligospermic males after testosterone-induced azoospermia. The subjects received 3 weekly doses (50 mcg) of testosterone propionate for 2 1/2 - 4 1/2 months. Seminal fluid analysis was conducted every 6-8 weeks after treatment was terminated. In each case, spermatogenic activity gradually increased after the last treatment until the production of mature spermatozoa exceeded pretreatment levels. A marked improvement was also seen in the posttreatment histologic picture when compared with pretreatment specimens. It is not known whether the rebound response is peculiar to androgenic substances.