Subfertile Semen Research Articles

Über den therapeutischen Wert der homologen Insemination*

After examination of ovarian and tubal function 246 women underwent 1238 AIH in 847 menstrual cycles. During the treatment period 74 patients became pregnant once or several times; altogether 99 pregnancies were observed. Whereas only 22 pregnancies occurred in cycles with AIH, the other 77 occurred in cycles without AIH. The ratio of pregnancies after AIH and those occurring without insemination decreases in relation to the degree of deterioration of the semen quality. With normal semen the ratio of pregnancies with AIH and those without AIH was 1:2.5. With semen of grade I this ratio became 1:4 and with grade II 1:10. On the basis of these results the following conclusions can be drawn: (1) with more or less normal semen quality and disturbance of the cervical mucus penetration AIH appeared to be reasonable; (2) with severe or even moderate subfertile semen findings AIH is not indicated; (3) an indication for AIH is the impossibility of cohabitation or ejaculation.

The varicocele: New experimental and clinical data

Numerous reports have shown that serotonin (5-HT) has a detrimental effect on spermatogenesis and androgen synthesis. Serotonin has two mechanisms of action on the testicle: (1) vasoconstrictive changes possibly causing premature sloughing of spermatozoa, and (2) alteration of androgen metabolism. The data in our animals with the experimental varicocele clearly mimic the human situation. All seminal parameters except volume are decreased after the varicocele is created. In many infertile patients with a varicocele, serotonin may be the inciting factor which results in subfertile semen. This is corroborated by the presence of elevated serotonin levels in spermatic vein plasma of most patients with a varicocele who undergo surgery. More data, comparing the relationship between spermatic vein and peripheral blood serotonin levels in patients with and without a varicocele, are needed. This investigation is being pursued in patients undergoing inguinal surgery for other lesions.

Size and Size Distribution of Subfertile Human Spermatozoa

An improved apparatus for measuring the electrical size (shape factor times volume) of particles based on the Coulter counter principle was used to characterize 110 subfertile semen specimens; size distributions were attainable in the 97 cases with a count above 1 × 10 6 spermatozoa/ml. The typical size distribution was unimodal and positively skewed. Spermatozoa maintained a constant profile during their passage through the orifice of the sizing apparatus, with an effective shape factor of 1.28. Two groups of cells were found. The larger one consisted of 68 specimens with a modal volume of 18.1 ± 2.0 cu μm and a cell count of 27.5 ± 92 × 10 6 spermatozoa/ml (mean ± 1 SD). The smaller group contained 29 cases and had a modal volume of 6.6 ± 0.9 cu μm and a count of 10.2 ± 7.8 × 10 6 . Samples with cell counts below 10 × 10 6 spermatozoa/ml tended to have low modal volumes (less than one-half the normal), but those above showed no particular trend.