Sperm Concentration Values Research Articles

Environmental and occupational exposure to toxicants and sperm parameters of men investigated for infertility

<strong><em>Objective:</em></strong> The study aimed to determine the association between environmental and occupational exposure to toxicants and semen parameters of men investigated for infertility. <strong><em>Methods: </em></strong>Exposure information was obtained using interviewer administered questionnaire with informed consent. WHO guidelines and cut off values were used in analyzing the sperm parameters. The parametric and non-parametric data were analysed using t- test and chi-square test respectively. Mean semen parameters between groups exposed to different toxicants were compared using one way ANOVA. <strong><em>Results: </em></strong>In the study population, 53.9% of men were exposed to toxicants through environmental or occupational sources. Exposures were mainly to petroleum products (30.2%), industrial chemicals (16.9%) and agrochemicals (6.8%).The mean values of sperm concentration, progressive motility, normal forms and viability of subjects exposed to petroleum products were lower compared to non exposed group with significant differences in normal morphological forms [31.1 (18.46)%] vs. [38.1 (17.90)%] (p=0.02) and viability [46.6(22.26)%] vs. [55.2 (19.50)%] (p=0.02). All the sperm parameters were lower in the exposed group, with a significant difference in sperm morphology [33.5 (17.1)%] vs. [38.1(17.9)%] (p=0.03) and sperm viability [49.3 (19.4)%] vs. [55.2 (19.5)%] (p=0.02) compared to non exposed group. <strong><em>Conclusion:</em></strong> Occupational and environmental exposure to reproductive toxicants is associated with poor semen quality with significant reduction in normal forms and viability of sperm. <p class="p0">DOI: <a href="http://dx.doi.org/10.4038/sljog.v36i2.7452">http://dx.doi.org/10.4038/sljog.v36i2.7452</a> <p class="p0">Sri Lanka Journal of Obstetrics and Gynaecology 2014; 36: 32-36

Inflammatory bowel disease in subfertile men and the effect of mesalazine on fertility

This study aimed to examine the effect of mesalazine on fertility. In this retrospective analysis of 1,225 male subfertile patients, we reviewed the cases of inflammatory bowel disease (IBD) in the medical records and evaluated the prevalence of the disease in our reproduction center. Specifically, we examined IBD patients who ceased mesalazine during male infertility treatment, and compared the seminogram of these patients before and after discontinuation of mesalazine. We also analyzed pregnancy outcome after discontinuation. The prevalence rate of Crohn’s disease and ulcerative colitis in our male infertile patients was 163 per 100,000 men and 490 per 100,000 men, respectively. Seven patients had taken mesalazine and six of them subsequently stopped the medication. The mean values of sperm concentration, sperm motility, percentage of normal formed sperm, semen volume, and total motile sperm count taken before discontinuation increased after discontinuation of mesalazine. Among these parameters, the sperm motility and total motile sperm count were significantly improved (p < 0.05) after discontinuation. Of the six patients who stopped the drug, four achieved pregnancy with their partners, with two of the four men showing significant improvement not only in the percentage of normal shaped sperm but also sperm motility and total motile sperm count. This study provides further insight into the rarely investigated relationship between male fertility and mesalazine.

Paper-based diagnostic devices for evaluating the quality of human sperm

Male infertility, which amounts to half of all infertility cases, is a serious problem worldwide. The percentage of fertility-related patients in sub-Saharan African countries is higher than that for the developed countries. In low-resource countries, examination of sperm characteristics for male infertility cannot be undertaken because of poor clinical access. To evaluate male fertility in assisted reproductive medicine laboratories, the numbers of motile human sperm, the degree of sperm motility, and sperm morphology have been commonly analyzed using a microscope. It is challenging to monitor the health status of human sperm in resource-limited or remote settings for two primary reasons: (1) high capital cost (equipment for currently accepted procedural standard), and (2) complexity of the currently accepted procedural standard used to simultaneously measure human sperm concentration and motility by skillful embryologists. Determining the health status of human sperm in order to evaluate fertilization capacity using various types of low-cost, easy-to-use, and rapid devices (or systems) is a longstanding but interesting biotechnologically relevant issue in various scientific communities such as male reproduction. Furthering such efforts will inherently influence birth rate in both developed and developing nations. We have demonstrated an inexpensive but robust and easy-to-handle device for monitoring the health status of human sperm made by patterning a piece of paper and measuring the activity of a specific enzyme—a simple and elegant solution. After applying semen to the hydrophilic center circle of our patterned paper, a thiazine assay can be used to suggest sperm concentration in semen, and a tetrazolium-based colorimetric assay (MTT assay) data can be used to help estimate the percentage of motile human sperm (sperm motility) in semen based on the character that motile human sperm moved in and on the paper. Using this paper-based device, we can evaluate fertility levels without consulting doctors and use our assay to compare results with World Health Organization (WHO) reference values for sperm concentration (>2×107) and motility (>50 %). The duration and cost of one entire test are 30 min and 0.1 USD, respectively. We believe that this paper-based assay system would be useful for fertility checks based on WHO references, without need of a microscope, at home. Using this assay method, males in developed or developing countries who are reluctant or unable to consult assisted reproductive technologies clinics can self-analyze their sperm characteristics. We further note that our approach adheres to WHO regulations, especially in regard to in vitro diagnostic device performance with an associated diagnostic algorithm to enhance diagnostic accuracy (compared with just one diagnostic output), and we wish to emphasize that our research could significantly advance a broad range of diagnostic developments including paper-based diagnostic devices, in vitro diagnostic devices, and diagnosis of other diseases in various divisions of translational medicine. These results, we believe, will be of interest to a wide scientific audience working in materials science (biomaterials), chemistry (analytical and clinical), lab-on-a-chip technologies (the development of diagnostic tools), reproductive medicine, bioengineering, and translational medicine.

Sperm Concentration, Testicular Volume and Age Predict Risk of Carcinoma In Situ in Contralateral Testis of Men with Testicular Germ Cell Cancer

We investigated whether semen quality or some easily attainable clinical parameters might be used to estimate the risk of contralateral carcinoma in situ in patients with unilateral testicular germ cell tumors. A total of 264 Danish patients with testicular germ cell tumor with or without contralateral testicular carcinoma in situ were retrospectively investigated. Clinical data included andrological history, physical examination, testis ultrasonography, semen quality and testis histology. Study groups were compared by univariate linear regression analysis and the chi-square test. Associations between contralateral carcinoma in situ and risk factors were modeled in 2 stages: Bayes rule was used to assess the probability of carcinoma in situ; the terms in Bayes rule were estimated using regression models. Significant characteristics of patients with contralateral carcinoma insitu were lower sperm concentration, smaller contralateral testis volume, irregular ultrasonic echo pattern of the contralateral testis and younger age. Cutoff values of sperm concentration and testicular volume were defined. However, according to these only a minority of the noncarcinoma in situ cases could potentially have been spared a diagnostic testicular biopsy. Combining information on age and sperm concentration, secondly age and testis volume resulted in models of the estimated contralateral carcinoma in situ risk, from which patients at particular high risk of carcinoma in situ could be identified. The combined information on sperm concentration, age and contralateral testis volume predict the risk of contralateral carcinoma in situ in patients with unilateral testicular germ cell tumor. The proposed models may facilitate selection of patients with testicular germ cell tumor for contralateral testicular biopsy at the time of orchiectomy if this is not routinely done.

Influence of strict sperm morphology on the results of classic in vitro fertilization

To determine the influence of the concentration of oval spermatozoa according to the strict morphology criterion in men with normal sperm concentration following the World Health Organization criteria on the results of classic IVF. Based on review of patient charts, this study included infertile couples presenting with female causes for infertility or unexplained infertility, in whom men presented with normal spermogram values for sperm concentration, sperm motility, volume of ejaculate and total sperm count after semen processing greater than 20 million. Based on the value obtained in strict sperm morphology, patients were divided into three groups: in Group A, patients with values between 0 % and 4 %; in group B, between 5 % and 14 %, and in group C, patients with sperm morphology greater than 14 %. The outcomes analyzed were oocyte fertilization rate, biochemical pregnancy rate, clinical pregnancy rate and rate of liveborns. A total of 244 cases met the inclusion criteria, 27 of them in group A, 165 in group B, and 52 in group C. The mean fertilization rate and the rate of liveborns were, respectively: 71.9 % and 33.3 % in group A; 80.9 % and 24.2 % in group B, and 78.8 % and 28.8 % in group C. There was no statistical difference among the groups in any of the outcomes analyzed. The values of strict sperm morphology, as proposed by Kruger and adopted by the World Health Organization, had no infl uence on the results of classic in vitro fertilization in the studied sample.

Semen characteristics of fertile and subfertile men in a fertility clinic and correlation with age

BackgroundThe characteristics and semen quality in the men of different populations have been reported, though such data are lacking in Saudis. Objectives(i) To characterize the semen parameters of fertile and subfertile men, (ii) To study the prevalence of abnormality of semen parameters in the subfertile group, and (iii) To identify the relationship between semen parameters and age. MethodsThis study included 49 fertile and 160 subfertile men and 76 men with unproven fertility attending a fertility clinic in Riyadh. Their semen parameters were estimated, statistically analyzed, characterized, and correlation studies were conducted. ResultsThe median age of the fertile and subfertile groups was quite similar. Significant differences were demonstrated in the median values of sperm concentration (98.6 × 106/ml vs 14.5 × 106/ml, P < 0.001), progressive sperm motility (58% vs 40%, P< 0.001), and abnormal sperm morphology (55% vs 75%, P< 0.001) between fertile and subfertile men. The percentage of normal semen viscosity was higher in fertile men, whereas the median semen volume values were nearly similar in the fertile and subfertile men (2.5 vs 2.75 ml). The prevalence of asthenozoospermia (36%) and azoospermia (26%) among subfertile men was the highest among other semen abnormality categories. There was an inverse correlation between the age and both sperm motility and semen volume in the investigated groups. ConclusionThe main semen parameters in the fertile and subfertile subjects in this study differ significantly and the age was demonstrated to be correlated inversely with sperm motility and semen volume. Further studies in other regions of Saudi Arabia are needed.

Seasonal dynamics of sperm morphometric subpopulations and its association with sperm quality parameters in ram ejaculates

Sperm morphologic assessment is considered an irreplaceable part of standard laboratory routine analyses in the diagnosis of male fertility. Thus, in an attempt to quantify the effects of season on sperm morphology and its functional significance in relation to sperm quality parameters, sperm head morphometric traits were analyzed by using an objective computerized analysis combined with principal components analysis (PCA) cluster analysis to establish the relationship between the distribution of the subpopulations found and sperm quality in each season. There were slight variations on sperm motility and sperm membrane integrity indexes (P > 0.05). However, the mean values for sperm concentration substantially changed among seasons in all individuals studied (P < 0.01). There were significant differences in sperm morphometric parameters (P < 0.01) as well as in the distribution of morphometric subpopulations between seasons (P < 0.001). In conclusion, this study confirmed that there was an important seasonal effect on sperm morphometric traits. In addition, the distribution of these subpopulations seems to be related to the season studied and the ejaculate quality which would be a very important indicator of sperm function. The substantial information derived from these morphometric subpopulations has provided new knowledge which can be used in future studies using sperm morphometry as a seasonal indicator in ram ejaculates.

Alleviation of reproductive toxicity of gossypol using selenium supplementation in rams1

The objective of this study was to evaluate the reproductive toxicity of gossypol and the possible counteracting effect of selenium supplementation in rams. Twenty-five mature crossbred (Barki × Rahamni) rams were randomly divided into 5 equal groups. The first group served as a control (no gossypol in diet). The second and third groups received diets containing free gossypol of 9 and 14 mg·kg(-1) BW·d(-1)(low level and high level of gossypol), respectively. The fourth and fifth groups received the same diets given to the second and third groups, respectively, with an oral administration of 1 mg selenium (as sodium selenite) daily for each animal. Results showed reductions in ejaculate volume (P = 0.028), percentage of dead sperm (P = 0.003), total functional sperm fraction (P < 0.001), and blood serum concentration of testosterone (P < 0.001) in the presence of both levels of gossypol inclusion. Furthermore, high level of gossypol reduced forward motility (P < 0.001) and semen initial fructose concentration (P = 0.002) and increased abnormal-head sperm (P = 0.003) and blood serum concentration of triiodothyronine (P = 0.006). Regardless of selenium supplementation, increasing level of free gossypol in diet resulted in a significant decrease in the percentage of forward motility (P = 0.037) and significant increases in the mean values of sperm concentration (P < 0.001), total sperm output (P = 0.002), percentage of total abnormal sperm (P = 0.058), and abnormal-head sperm (P = 0.016). On the other hand, regardless of levels of gossypol inclusion, selenium supplementation resulted in significant increases in libido (P < 0.001), mean values of ejaculate volume (P < 0.001), percentage of forward motility (P = 0.019), total sperm output (P < 0.001), total functional sperm fraction (P < 0.001), semen initial fructose concentration (P = 0.031), and blood serum concentrations of both testosterone and triiodothyronine (P < 0.001). In conclusion, free gossypol in diet induced adverse effects on semen quality in rams, but selenium supplementation successfully counteracts most of the hazardous effects of gossypol on semen characteristics.

Head morphometric changes in cryopreserved ram spermatozoa are related to sexual maturity

The importance of understanding the sperm changes after the cryopreservation process has been emphasized in human and veterinary andrology. In previous studies, we have shown that the morphometric characteristics assessed by computer-assisted analysis following the freeze-thawing process revealed differences in terms of dimension and shape between individuals that may be related to bio-physiologic factors such as sexual maturity. The purpose of this study was to determine if there are differences associated with cryoresistence and sperm head morphometric dimensions in individuals with different sexual maturity ratings (SMRs; 12, 30 and 96 months of age). Ejaculates from nine normospermic fertile rams with different SMRs were analyzed in an attempt to quantify the morphometric dimensions and the shape of sperm heads from each group after the cryopreservation process. The mean values of sperm concentration among individuals with different SMRs were significantly different (P < 0.01). Cryopreservation substantially reduced sperm motility and plasma membrane integrity irrespective of SMR assessed, with young animals being the most affected (P < 0.01). Sperm quality at thawing for all sperm parameters evaluated was significantly higher for old individuals than for middle-aged or young individuals (P < 0.01). There were no significant differences in the sperm head dimension or shape among middle-aged and old individuals (P > 0.05). However, significant differences were detected in area, perimeter and width (lower values) and length, ellipticity and elongation (higher values) in old or middle-aged individuals compared with young individuals (P < 0.01). In conclusion, this study confirms that ram age is related to sperm morphometric dimensions, and sperm size and shape may affect spermatozoa survival, being good indicators of freezability. Therefore, the present study provides information on the morphometric maturation of ram sperm and supports the idea that the dimensions of spermatozoa may be taken as an approximate indication of its relative maturity.

Comparison of the physical characteristics of semen under different collection frequencies in the native and exotic cocks

Twelve native cocks aged 35-40 weeks and twelve Harco cocks aged 38 weeks were ejaculated at three collection frequencies of 30 minutes, 60 minutes and 120 minutes consistently on Tuesday, Thursdays and Saturdays. Ejaculates were collected in the morning (5.00-10.00 a.m.) and in the evening (3.00-9.00 p.m.) at the various frequencies and evaluated for quality for a period of 4 weeks. Results indicated significant effects (P<0.05) of genotype, ejaculation frequency and ejaculation interval (weeks) on ejaculate volume, sperm motility and sperm vigour. Mean values for sperm concentration were significantly highest (P < 0.05) at 60 minutes collection frequency while the means for ejaculate volume, sperm motility and sperm vigour were highest in both genotypes under 120 minutes collection frequency and lowest under the 30 minutes frequency. Total sperm abnormalities as well as total live sperm were not significantly (P.<0.05) affected by genotype. Mean values for all the semen traits studied were significantly (P< 0.05) higher in the native than the exotic cocks at the various collection frequencies. The results apparently indicate that high ejaculation frequencies have negative effect on semen quality in the domestic fowl. Key words: Collection frequency; Genotype, Semen Characteristic, native and exotic cock

Evaluation of shape variability of stallion sperm heads by means of image analysis and Fourier descriptors

This study quantified and evaluated the variability of sperm head shape for 10 different stallions. Sperm head shape characteristics including sperm head length to width ratio, position of the center of gravity, curvature, and degree of roundness were assessed and analysed from images using elliptic Fourier descriptors and inverse Fourier transformation. The first four principal components accounted for 88.46–92.33% of the total variance and provided a good summary of the overall data. In the case of the ejaculate with defective sperm heads the components accounted for 97.35–98.21% of variation. The study was able to quantitatively confirm that head length to width ratio, which contributed 48.63–53.48% and 71.30–73.34% to the total variance for normal and defective sperm, respectively, was the predominant determining parameter of sperm head shape. There were no statistical significant relationships between Fourier descriptors and values of sperm concentration and/or motility.

Urinary di(2-ethylhexyl)phthalate (DEHP)—Metabolites and male human markers of reproductive function

Phthalates are suspected to act as endocrine modulators in humans and exert reproductive toxicity. The general population is exposed to phthalates through nutrition, consumer products, medications and medical devices. The aim of the present study is to explore whether internal phthalate exposure represented by metabolites of di(2-ethylhexyl) phthalate (DEHP) can be related to human markers of reproductive function (i.e. semen concentration, motility and morphology). We recruited 349 men who were part of subfertile couples and were referred for fertility work-up between April 2004 and November 2005. Semen analysis was performed according to recommendations of the World Health Organization (WHO). Parameters were dichotomized based on 1999 WHO reference values for sperm concentration (<20million/ml) and motility (<50% sperm with progressive motility), as well as Tygerberg strict criteria for morphology (<4% normal forms). We analyzed internal DEHP exposure in single spot urine samples by determining its secondary metabolites mono(2-ethyl-5-oxo-hexyl)phthalate (5oxo-MEHP), mono(2-ethyl-5-hydroxyhexyl)phthalate (5OH-MEHP) and 5carboxy-mono(2-ethylhexyl)phthalate (5cx-MEPP) next to the monoester metabolite mono(2-ethylhexyl)phthalate (MEHP). Logistic regression was performed for the three semen parameters (concentration, motility, and normal morphology) to estimate their dependence on the sum of the four DEHP metabolites (DEHP-4) under consideration. Adjustment was performed for age, duration of abstinence, and smoking status. DEHP metabolites of n=349 men (age: median=34ys) were analysed. Median concentrations [microg/l] were MEHP (n=337) 4.35, 5OH-MEHP (n=341) 12.66, 5oxo-MEHP (n=341) 9.02, and 5cx- MEPP (n=292) 14.53. Semen parameters of n=349 men were analysed by logistic regression. Semen concentration (<20mio/ml: 35%) or sperm motility (WHO A+B <50%=20%) were not found to be associated statistically significantly with the sum the DEHP metabolites (DEHP-4). Metabolites of DEHP and other phthalates analyzed in urine are very specific for determining recent internal phthalate exposure. According to our evaluation human reproductive parameters from semen analyses do not show significant associations with concentrations of DEHP metabolites determined in spot urine sampled at the day of andrological examination.

Urinary Bisphenol A concentrations and human semen quality

OBJECTIVE: Bisphenol A is used to manufacture polymeric materials and can be found in a wide variety of consumer products. These include polycarbonate plastic baby and water bottles, epoxy resins which may be used as the lacquer lining of food and beverage cans and some dental sealants and composites. Recent data from the CDC found BPA in 93% of urine samples from a reference population of U.S. citizens (NHANES 2003-2004). Because of demonstrated widespread human exposure and reproductive and developmental effects at low levels in experimental animals, there has been an increase in concern over potential adverse effects of BPA on human health. Rodent studies have shown an association between exposure to environmentally relevant low doses of BPA and decreased semen quality. In these animal studies, daily sperm production and sperm count decreased by up to 40%. Sperm motility decreased and abnormal spermatids increased. DESIGN: A prospective cohort study. MATERIALS AND METHODS: The study population included 71 male partners of couples from the Massachusetts General Hospital Fertility Center. Each man provided at least one semen and urine sample; thity nine men (55%) provided more than one urine and semen sample. Ninety-six percent of the urine samples were collected within 7 days of the semen sample, with only six urine samples collected within 8 or more days (maximum was 27 days) of the semen sample. RESULTS: The mean total urinary BPA level for the 142 urine samples was 2.41mg/L (range <0.4 (below LOD) – 18.70 mg/L). Analysis of the association of urinary BPA with semen parameters (sperm concentration, motility and morphology) is in progress. The semen parameters will be analyzed as both a continuous variable and dichotomized using WHO reference values for sperm concentration (<20million/mL) and motility (<50% motile) and Strict criteria for morphology (<4% normal).As expected, there was high intra-individual variability of both urinary BPA concentrations and semen parameters. In preliminary analyses, there were not strong associations of BPA with semen quality parameters. CONCLUSIONS: The lack of an association of urinary BPA concentrations with semen parameters should be interpreted cautiously due to the small sample size. Future statistical analyses will include additional men.

Impact of a second semen analysis on a treatment decision making in the infertile man with varicocele

To evaluate the impact of second semen analysis (SA) on a treatment decision in infertile men with varicocele and abnormal first SA. Retrospective chart review. University hospital. None. Standard clinical semen analysis. A total of 160 infertile men with varicocele and abnormal first SA were evaluated. Two SA were performed in the same andrology lab 3 to 8 weeks apart. Exclusion criteria were azoospermia, low semen volume, leukocytospermia, febrile illness within 3 months, and habitual heat exposure. Despite fluctuation in absolute values of sperm concentration, motility, and morphology, the second SA remained abnormal in 111 out of 112 men (99.1%) with abnormal first SA. Initial abnormal SA is a sufficient indication for varicocele treatment because in most patients the second SA remains abnormal and does not change treatment decision. This approach will expedite treatment of infertile men with varicocele and increase its cost effectiveness.

Impact of a second semen analysis on a treatment decision making in the infertile men with varicocele: minimalist approach

Clinically diagnosed varicocele and abnormal semen parameters are required indications for the varicocelectomy in the infertile male. Numerous studies revealed large within-subject variation in sperm concentration, motiltiy and morphology in the infertile and healthy men. Multiple semen analyses (SA) are necessary to estimate true individual homeostatic setting point of each sperm parameters. Since practical value of such approach is limited, a minimum of 2 SA have been recommended and widely accepted in clinical practice. We evaluated the impact of 2nd SA on a treatment decision in the infertile men with varicocele and abnormal first SA. Retrospective study. The study included 160 infertile men with varicocele and abnormal first SA who had 2nd SA performed in the same Andrology lab about 3–8 weeks apart. SA was considered abnormal according to WHO criteria for sperm concentrtation, motility, morphology. Men with azoospermia, low semen volume, leukocytospermia, febrile illness within 3 months and habitual heat exposure were excluded from the study. SA of 112 patients were evaluated. Despite fluctuation in abslolute values of sperm concentration, motility, morphology between two SA, these parameters remained mainly unchanged - normal or abnormal-in the 2nd SA.The rare turns of a single parameter from normal to abnormal and vice versa were higher for motility and concentration and lower for morphology (Table 1). Overall, 2nd SA was abnormal in 111 out of 112 men (99.1%) with abnormal first SA. Table 1Changes in semen parameters in 2nd SAConcentrationMotilityMorphologyDecrease (absolute value)44 (39%)46 (41%)50 (45%)Increase (absolute value)68 (61%)66 (59%)62 (55%)Unchanged (normal or abnormal)95 (85%)94 (84%)109 (97%)Changed (to abnormal or to normal)17 (15%)18 (16%)3 (3%) Open table in a new tab In most patients with varicocele and abnormal first SA the 2nd SA is also abnormal and does not change decision for varicocelectomy. Therefore, single first abnormal SA is a sufficient to consider surgery if test performed in the Andrology lab under strict guidelines for semen collection, handling and analysis. Second SA is indicated in certain clinical situation e.g. azoospermia, low semen volume, leukocytospermia, recent febrile illness, habitual heat exposure. Clinical evaluation is recommended prior to frequently ordered “screening” SA. This approach may decrease cost and expedite treatment of infertile men with varicocele.

Comparison of semen parameters in samples collected by masturbation at a clinic and at home

To investigate differences in semen quality between samples collected by masturbation at a clinic and at home. Cross-sectional study. Fertility center. Three hundred seventy-nine men assessed for infertility. None. Semen was analyzed according to World Health Organization guidelines. Seminal markers of epididymal (neutral alpha-glucosidase), prostatic (prostate-specific antigen and zinc), and seminal vesicle (fructose) function were measured. Two patient groups were defined according to sample collection location: at a clinic (n = 273) or at home (n = 106). Compared with clinic-collected semen, home-collected samples had statistically significantly higher values for sperm concentration, total sperm count, rapid progressive motility, and total count of progressive motility. Semen volume, proportion of normal sperm morphology, neutral alpha-glucosidase, prostate-specific antigen, zinc, and fructose did not differ significantly between groups. An abnormal sperm concentration (<20 x 10(6)/mL) was seen in statistically significantly fewer of the samples obtained at home (19/106, 18%) than at the clinic (81/273, 30%), and the same applied to proportions of samples with abnormal (< 25%) rapid progressive motility (68/106 [64%] and 205/273 [75%], respectively). The present results demonstrate superior semen quality in samples collected by masturbation at home compared with at a clinic. This should be taken into consideration in infertility investigations.

Altered Semen Quality in Relation to Urinary Concentrations of Phthalate Monoester and Oxidative Metabolites

Phthalates are multifunctional chemicals used in a variety of consumer, medical, and personal care products. Previously, we reported dose-response associations of decreased semen quality with urinary concentrations of monobutyl phthalate (MBP) and monobenzyl (MBzP) phthalate, which are metabolites of dibutyl phthalate and butylbenzyl phthalate, respectively. The present study extends our work in a larger sample of men and includes measurements of di(2-ethylhexyl) phthalate (DEHP) oxidative metabolites. Between January 2000 and May 2004, we recruited 463 male partners of subfertile couples who presented for semen analysis to the Massachusetts General Hospital. Semen parameters were dichotomized based on World Health Organization reference values for sperm concentration (<20 million/mL) and motility (<50% motile) and the Tygerberg Kruger Strict criteria for morphology (<4% normal). The comparison group was men with all 3 semen parameters above the reference values. In a single spot urine sample from each man, phthalate metabolites were measured using solid-phase extraction coupled to high-performance liquid chromatography isotope-dilution tandem mass spectrometry. There were dose-response relationships of MBP with low sperm concentration (odds ratio per quartile adjusted for age, abstinence time, and smoking status = 1.00, 3.1, 2.5, 3.3; P for trend = 0.04) and motility (1.0, 1.5, 1.5, 1.8; P for trend = 0.04). There was suggestive evidence of an association between the highest MBzP quartile and low sperm concentration (1.00, 1.1, 1.1, 1.9; P for trend = 0.13). There were no relationships of monoethyl phthalate, monomethyl phthalate, and the DEHP metabolites with these semen parameters. The present study confirms previous results on the relationship of altered semen quality with exposure to MBP at general population levels. We did not find associations between semen parameters and 3 DEHP metabolites.

Fertility Parameters and Urine Concentrations of Phthalate Metabolites in German Men Visiting an Outpatient Clinic for Fertility Workup

TM1-O-08 Introduction: Phthalates are thought to be hormonally active in humans and exert reproductive toxicity. The general population is exposed to phthalates through nutrition, consumer products, and medical devices. The present study explored whether internal phthalate exposure can be related to parameters of semen quality (ie, concentration, motility, and morphology) and hormone status. Methods: We recruited 335 men who were part of subfertile couples and were referred to the Outpatients Department Centre of Dermatology and Andrology of the University of Giessen, Germany, for fertility workup between April 2004 and October 2005. Semen analysis was performed according to guidelines of the World Health Organization (WHO) using the revised Duesseldorf classification of sperm morphology. If necessary, parameters were dichotomized based on 1999 WHO reference values for sperm concentration (<20 million/mL) and motility (<50% motile), as well as Tygerberg strict criteria for morphology (<4% normal). In single spot urine secondary metabolites of DEHP, 5OH-MEHP, and 5oxo-MEHP next to the monoester metabolite MEHP and depending on volume of urine sample, other phthalate metabolites were analyzed (eg, MnBP, MBzBP, MBzP). Results: Concentrations of phthalate metabolites of n = 296 men (median age, 34 years; median body mass index, 25.99 kg/m2) entered analysis. Median concentrations (μg/L) were as follows: MEHP (n = 287), 4.91; MnBP (n = 249), 32.76; MBzBP (n = 137), 5.14; and MBzP (n = 111), 5.03. Semen parameters of n = 253 men entered analysis. Semen concentration (<20 million/mL (n = 279): 33.0%) or sperm motility (WHO A+B <50% [n = 266]: 24.8%) were not found to be associated neither with the secondary metabolites nor with MEHP (adjusted logistic and linear regression). Adjustment was performed for: age, time of abstinence, and smoking status. Tendencies found in preliminary evaluations for sperm morphology (<4% normal [n = 259]: 62.2%) did not turn to significant values in this larger sample. Semen concentrations and motility as well as hormone levels (n = 276) (median for FSH, 5.0 mU/mL; LH, 3.5 mU/mL; and testosterone, 3.5 ng/mL) were not related to concentrations of any metabolites. Conclusions: Metabolites of DEHP and other phthalates analyzed in the scope of this study are considered to be very specific for determining internal phthalate exposure. According to this evaluation fertility parameters, ie, hormones and semen analyses do not show significant associations with concentrations of phthalate metabolites determined in spot urine sampled at the day of fertility workup, ie, no indication of acute effects. Further analyses, aimed at studying middle-term effects will address associations between the phthalate concentrations presented here and fertility parameters assessed in the same men during a second consultation several weeks later.

Induction of spermatogenesis in men with azoospermia or severe oligoteratoasthenospermia after antegrade internal spermatic vein sclerotherapy for the treatment of varicocele

To evaluate the treatment outcome of antegrade internal spermatic vein sclerotherapy in men with non-obstructive azoospermia or severe oligoteratoasthenospermia (OTA) as a result of varicocele. Between September 1995 and January 2004, 47 patients (mean age 33.8 +/- 6.3 years) underwent antegrade internal spermatic vein sclerotherapy for the treatment of varicocele with azoospermia (14 patients) or severe OTA (33 patients). Testicular core biopsy was also performed in complete azoospermic patients who provided informed consent. The outcome was assessed in terms of improvement in semen parameters and conception rate. Forty-two (89.4%) of 47 patients had bilateral varicocele. Serum follicle stimulating hormone (FSH) did not differ between patients with azoospermia and severe OTA. After the follow-up of 24.8 +/- 9.2 months, significant improvement was noted in mean sperm concentration, motility and morphology in 35 patients (74.5%). Comparison between groups during the follow-up revealed significantly higher values of sperm concentration, motility and normal morphology in the severe OTA group. Pregnancy was achieved in 14 cases (29.8%). Testicular histopathology of the azoospermic patients with postoperative induction of spermatogenesis revealed maturation arrest at spermatid stage, Sertoli-cell-only (SCO) with focal spermatogenesis or hypospermatogenesis. None of the patients with pure SCO pattern or maturation arrest at spermatocyte stage achieved spermatogenesis after the treatment. Preoperative serum FSH levels didn't relate to treatment outcome. Antegrade internal spermatic vein sclerotherapy is an easy and effective treatment for symptomatic varicocele. It can significantly reverse testicular dysfunction and improve spermatogenesis in men with severe OTA, as well as induce sperm production in men with azoospermia, improving pregnancy rates in subfertile couples.

Study of Apoptosis by DNA Fragmentation and Phosphatidylserine Externalization, and of Meiotic Segregation in Ejaculated Sperm of Chromosomal Translocation Carrier Patients

Study of Apoptosis by DNA Fragmentation and Phosphatidylserine Externalization, and of Meiotic Segregation in Ejaculated Sperm of Chromosomal Translocation Carrier Patients