Semen analysis. An office technique

The Effect of Supplementation with Some Essential Oils on the Mobility and the Vitality of Human Sperm

The objective of this work is to study the improvement effect of some essential oils of sage (Salvia officinalis), oregano (Origanum vulgare), and eucalyptus (eucalyptus globulus) on the physiological parameters characterizing the quality of human sperm (mobility and vitality). We find natural biomolecules to improve sperm quality to increase the chances of success of very low in vitro fertilization (IVF) that stagnate around 20%. Sperm samples were mixed with different concentrations of essential oils. The effect of these essential oils on the motility and vitality of spermatozoa has been analyzed. The mobility was determined using a Computer Assisted Sperm Analysis (CASA). In the other side, the evaluation of sperm vitality was performed by staining eosin 2% and the microscopic examination is carried out via optical microscope. A drop of sperm will be mixed with a drop of eosin solution 2%, spread between the slip and coverslip, then allowed to air dry, and examined under a microscope. A significant improvement in the mobility and vitality of human spermatozoa has been noted with oregano. Eucalyptus after 10 min of exposure also significantly improves the mobility and vitality of the spermatozoa. Sage does not improve mobility for these incubation times but significantly improves vitality.

A Simple Confocal Microscopy-based Method for Assessing Sperm Movement

In the field of reproductive medicine, assessment of sperm motility is a key factor for achieving successful artificial insemination, in vitro fertilization, or intracellular sperm injection. In this study, the motility of boar sperms was estimated using real-time imaging via confocal microscopy. To confirm this confocal imaging method, flagellar beats and whiplash-like movement angles were compared between fresh and low-temperature-preserved (17℃ for 24 h) porcine sperms. Low-temperature preservation reduced the number of flagellar beats from 11.0±2.3 beats/s (fresh sperm) to 5.7±1.8 beats/s and increased the flagellar bending angle from 19.8°±13.8° (fresh) to 30.6°±15.6°. These data suggest that sperm activity can be assessed using confocal microscopy. The observed motility patterns could be used to develop a sperm evaluation index and automated confocal microscopic sperm motility analysis techniques.

Melatonin and alpha lipoic acid attenuate lopinavir/ritonavir - induced testicular toxicity in albino rats

The use of lopinavir/ritonavir (LPV/r) could be associated with testicular toxicity as a limiting factor. The present study evaluated the effects of melatonin (MT) and alpha lipoic (ALA) acid on LPV/r–induced testicular toxicity in male albino rats. Eighty five male albino rats used for this study were randomized into 6 groups (A-F). Rats in groups A1 and A2 served as placebo and solvent control and were orally exposed to water and 1% ethanol, respectively. Rats in group B were exposed to oral doses of MT (10 mg kg-1/day), ALA (10 mg kg-1/day) and combined doses of MT and ALA, respectively. Rats in group C were exposed to oral doses of LPV/r (22.9/5.71 - 91.4/22.9 mg kg-1/ day), respectively. Rats in group D-F were exposed to oral doses of MT (10 mg kg-1/day), ALA (10 mg kg-1/day) and combined doses of MT and ALA prior to oral exposure to LPV/r (22.9/5.71 - 91.4/22.9 mg kg-1/day), respectively. At the end of 60 days of exposure to drugs, rats were sacrificed; blood was collected and serum extracted and evaluated for testosterone. Testes were collected and evaluated for sperm parameters. LPV/r-treated rats showed significant (P<0.05) and dose-dependent decreases in sperm count, sperm motility, sperm viability and serum testosterone levels with increases in abnormal sperm cells, debris, and primordial sperm cells when compared to placebo control. However, LPV/r-induced changes in sperm parameters and serum testosterone levels were attenuated in rats pretreated with MT and ALA. The best effects were observed in rats pretreated with combined doses of MT and ALA. Melatonin and alpha lipoic acid have potential to reduce testicular toxicity associated with lopinavir/ritonavir treatment.

Contemporary concepts in the evaluation and management of male infertility

Infertility in men is a common condition. At the core of the medical evaluation of the male partner in a couple who are unable to conceive is the history and physical examination. Special attention should be directed to the patient's developmental history and any use of testosterone products. The physical examination focuses on the genitals, and includes assessments of the size and consistency of the testicles, epididymis, vas deferens, and presence of varicoceles. Although many sophisticated tests are available, semen analysis is still the most important diagnostic tool used to assess fertility, and includes parameters such as sperm count, motility and viability. Treatment of male factor infertility can involve targeted agents, in the case of specific conditions such as hypogonadotropic hypogonadism, or it can be empirical-using medical therapy or assisted conception techniques-for patients in whom no underlying cause has been identified. Although an all-encompassing treatment for male factor infertility has not yet been developed, the field offers many promising avenues of research.

Effects of micronised purified flavonoid fraction on pain, spermiogram and scrotal color Doppler parameters in patients with painful varicocele

PURPOSE

Micronised purified flavonoid fraction (MPFF) is a phlebotropic drug improving venous tone, elasticity and lymphatic drainage, decreasing venous distensibility, venous emptying times, reflux time of venous blood and capillary hyperpermeability, and having antioxidant activities. Since varicocele is a venous pathology, we evaluated the effects of MPFF on pain, spermiogram and color Doppler parameters in patients with painful varicocele.

MATERIAL AND METHODS

Semen analyses and Doppler sonography were performed in 16 patients (aged 20-62 years, mean 31.2 +/- 10.9) before and after 1,000 mg/day MPFF treatment. Pain change was assessed with visual analogue scale scored between 0 and 10. Patient satisfaction with outcome and side effects were recorded.

RESULTS

Mean pain scores at 1, 3, and 6 months were 1.25 +/- 1.34, 0.25 +/- 0.68, and 0.12 +/- 0.34, respectively, all being significantly lower (p < 0.001 for each) than baseline (4.93 +/- 1.77). Mean score at 12 months (0.93 +/- 1.06) was still lower than baseline (p < 0.001) but higher than at 6 months (p = 0.019). Respectively, 14 (87.5%) and 2 (12.5%) patients reported complete and very significant resolution of pain at the 6th month. All patients were very satisfied with the outcome. While semen volume, total sperm count, sperm concentration and morphology did not change significantly, motility increased significantly (p = 0.009) due to decrease of grade 0 sperms (p = 0.006) and increase of grade 3 + 4 sperms (p < 0.001). Reflux time of left spermatic vein during the Valsalva maneuver decreased significantly (p = 0.003). No significant change occurred in reflux time of the right spermatic vein. No side effect was recorded.

CONCLUSIONS

Results of this preliminary study suggest the safety and efficacy of MPFF in the treatment of varicocele-associated pain. However, no recommendation for the use of MPFF in the treatment of pain associated with varicocele can be made before these preliminary results are confirmed by a randomized placebo-controlled trial.

Computer assisted semen analyzers in andrology research and veterinary practice

The evaluation of sperm cell motility and morphology is an essential parameter in the examination of sperm quality and in the establishment of correlations between sperm quality and fertility. Computer-assisted sperm analysis (CASA) allows an objective assessment of different cell characteristics: motion, velocity, and morphology. The development and problems related to this technology are raised in this review, paying particular attention to the biases and standardization requirements absolutely needed to obtain useful results. Although some interesting results, mainly in humans, have already been obtained, many questions remain, which have to be answered to allow for further development of this technology in veterinary medicine, clinical fertility settings, physiological, and toxicology research activities. The main problem is related to the standardization and optimization of the equipment and procedures. The different CASA instruments have all demonstrated high levels of precision and reliability using different sperm classification methodology. Their availability gives us a great tool to objectively compare sperm motility and morphology and to improve our knowledge and ability to manipulate spermatozoa.

Ultrasound and infertility: diagnostic and therapeutic uses

Ultrasound has become essential in the diagnosis and management of the infertile male. Scrotal ultrasonography provides a detailed examination of the testes and assesses the presence or absence of varicoceles and can identify other abnormalities of the scrotal contents and the spermatic cord. Transrectal ultrasonography can "visualize" the excurrent ejaculatory ductal system, including the ejaculatory ducts, seminal vesicles, and vas deferens. The expansion of these ultrasonographic techniques has provided the urologist with non- or minimally invasive techniques with which to evaluate the infertile male. These advancements consequently have led to innovative surgical and radiologic treatments.

Male infertility following spinal cord injury

Ejaculatory dysfunction and poor semen quality are responsible for male infertility following spinal cord injury (SCI). Techniques which have been used to obtain semen include intrathecal neostigmine, subcutaneous physostigmine, direct aspiration of sperm from the vas deferens, vibratory stimulation and electroejaculation. Vibratory stimulation and electroejaculation are most widely used in the United States and have a 50-90% success rate at obtaining semen. Poor semen quality following SCI has been attributed to stasis of semen, testicular hyperthermia, urinary tract infections, sperm contact with urine, possible changes in the hypothalamic-pituitary axis, chronic use of various medications and possible sperm antibodies. The outlook for having a child following SCI continues to improve with advancements in obtaining and processing sperm and assisted reproductive technologies.

Seminal parameters of ejaculates collected successively with sixty minute interval in infertile men: effect of combination of prazosin and terbutaline on these parameters

Out of 37 infertile men, 33 who were able to give two ejaculates by masturbation successively with a sixty minute interval, were studied. There was no significant change in sperm density in the second ejaculation whereas seminal volume decreased (P less than 0.01) and sperm motility increased (P less than 0.05) significantly. After a seven-day treatment with combination of prazosin (alpha 1-blocker) and terbutaline (beta 2-stimulator), the same successive ejaculates were obtained from only 27 of these patients. In this case sperm density and motility changed insignificantly, whereas seminal volume again decreased (P less than 0.01) significantly. The changes in seminal parameters were not significant between the pre- and post-treatment second ones. In a short-term study there are not any alterations to observe. The favourable results with a long-term treatment, published by Japanese authors, require a confirmation by further studies.

The influence of relaxin on motility of human sperm in vitro

Sperm of healthy men were incubated in an IVF medium with relaxin at concentrations of 3, 30, 300 and 3000 ng ml-1. Immediately after addition of relaxin and 60 and 120 min later motility, progressive motility, mean path velocity, mean progressive velocity, mean linearity and mean lateral head displacement were measured with the Hamilton-Thorn motility analyser. Neither immediately after relaxin addition, nor after 60 or 120 min, was an improvement of sperm motility observed at any concentration.

The effect of spermine, spermidine and kallikrein on the triple adenosine triphosphatase enzyme activity of spermatozoa in males with oligoasthenozoospermia

Unknown factors in the seminal plasma of normal semen that affect the motility of spermatozoa have a positive effect on adenosine triphosphatase (ATPase) enzyme activity. In an attempt to produce such an effect, spermine, spermidine and kallikrein were added to the incubation media in which spermatozoal ATPase enzyme activity was determined. These seminal substances increased the triple ATPase enzyme activity of spermatozoa from oligoasthenozoospermic men. We propose that the ATPase enzyme activity of spermatozoa may indicate sperm motility as a biochemical test.

Therapeutic implications of left, right, and bilateral varicocelectomy

It now appears that the incidence of bilateral varicoceles in infertile men with varicocele may be around 50 per cent to 60 per cent. Infertile men should be examined carefully for varicoceles on both sides, and bilateral varicocelectomy should be performed when indicated. Furthermore, we have demonstrated that selected infertile patients who have failed to improve after left varicocelectomy may yet improve after correction of the right varicocele.

Right varicocelectomy in selected infertile patients who have failed to improve after previous left varicocelectomy

In the past 8 years we found 41 infertile men with poor semen quality in whom an overlooked right varicocele might have been the reason for failure to improve after previous left varicocelectomy. None had ever fathered a child. After we performed sequential right varicocelectomy in these 41 patients, semen quality improved in 23 (56%). Twenty-seven pregnancies have been achieved to date by the wives of 18 (43%) of the patients whose semen improved. No pregnancies were caused by those whose semen failed to improve. Infertile men should be carefully examined for varicoceles on both sides, and bilateral varicocelectomy should be performed when indicated. Selected infertile patients who have failed to improve after left varicocelectomy and are found subsequently to have a right varicocele may yet improve following correction of the right varicocele.

The effect of relaxin on the motility of sperm in freshly thawed human semen

In an attempt to improve the motility of thawed spermatozoa after 1 week of its being frozen, we treated ten normal semen samples with 16.7 nmol relaxin and 6 mmol caffeine. Motility and grade of forward progression were examined after thawing. Caffeine significantly improved motility of spermatozoa. Relaxin, when added to semen at the time of thawing, improved motility and grade of forward progression significantly. This effect was not seen if relaxin was added before freezing. These results suggest that the biologic activity of relaxin is adversely affected by freezing and thawing in seminal plasma. These observations may have clinical importance for the improvement of motility of frozen spermatozoan samples at the time of artificial insemination and for the possible improvement of pregnancy rates.

The effect of zinc, arginine, fructose and seminal supernatant of normal semen on the triple adenosine triphosphatase activities of the spermatozoa from males with oligoasthenozoospermia

When the spermatozoa of oligoasthenozoospermic patients were suspended with the supernatant of normal semen, an increase in triple ATPase enzyme activities besides enhancement of spermatozoa motilities were observed. This suggests that factor or factors present in the supernatant of normal semen that effects spermatozoa motility also have a positive effect on triple ATPase enzyme activities. In an attempt to produce such an effect, zinc, arginine and fructose were added to the incubation media where the spermatozoal ATPase enzyme activities were determined. Zinc increased Ca2+-Mg2+ ATPase enzyme activity without affecting Na+/K+-Mg2+ and Mg2+ ATPase activities. Triple ATPase enzyme activities remained unchanged after arginine and fructose additions. As a result zinc is thought to be one of the factors that affect spermatozoa motility in seminal plasma.

The effect of an anti-insulin antiserum on human sperm motility

Inhibition of sperm motility by anti-relaxin antiserum has been previously reported. This effect may be secondary to a nonspecific effect of immunoglobulins binding to sperm or to a specific inhibition of relaxin activity at the sperm surface. The current investigation demonstrates that an anti-insulin antiserum does not inhibit sperm motility in the same system in which an anti-relaxin antiserum results in inhibition. This supports the hypothesis that the anti-relaxin antiserum effect is specific.

Bromocriptine in the management of infertile men after surgery of prolactin secreting adenomas

This study evaluated bromocriptine treatment in nine patients with prolactin secreting adenomas who continued to have elevated circulating levels of prolactin after surgery, and who were interested in improving their sperm counts. These patients were brought into the study 3.2 +/- 1.8 years (mean +/- SD) after surgery. All of them presented with high circulating levels of prolactin, and eight of the patients had oligozoospermia (range 0-10 X 10(6) spermatozoa/ml). LH and testosterone levels were low in seven patients, and eight patients had low FSH values. All patients were treated for 90 days with 7.5 mg/day of bromocriptine. After treatment, prolactin levels decreased significantly in all patients, while sperm counts increased significantly in five of them. Testosterone levels increased in four subjects. Bromocriptine therefore seems useful in the management of this type of patient because of the observed decline in prolactin levels and the increase in sperm counts. Possible mechanisms involved in this action are discussed.

Stimulation of the zona-free hamster ova penetration efficiency by human spermatozoa after 17 beta-estradiol treatment

17 beta-Estradiol (E2) stimulated the zona-free hamster ova penetration by human spermatozoa from both fertile and subfertile men after 5 hours of incubation in vitro. For spermatozoa samples from fertile men, the mean penetration rates increased significantly (P less than 0.05), from 35.6% +/- 3.5% (control) to 60.1% +/- 5.8% (E2 = 50 ng/ ml) and 50.5% +/- 2.6% (E2 = 100 ng/ml), respectively. E2 also increased the mean penetration rates of spermatozoa samples from subfertile men significantly (P less than 0.05), from 10.2% +/- 1.8% (control) to 30.5% +/- 7.2% (E2 = 50 ng/ml) and 33.1% +/- 6.6% (E2 = 100 ng/ml), respectively. These findings indicate that E2 can affect the fertilizing ability of human spermatozoa in vitro.

A simple stain for differentiating semen constituents

Extensive use of Sedi-stain in an outpatient infertility office has demonstrated that this commercially available urinary sediment preparation is a valuable and practical stain in semen analysis. The stain is inexpensive, has a long shelf life, is easy to apply, and produces immediate and reproducible results. The accuracy of Sedi-stain has compared favorably to other staining compounds used. It should prove to be an asset to the office investigation of male infertility.

The effect of temperature on sperm motility. II. Is bacterial growth a factor?

The previous demonstration that sperm kept at body temperature (37 degrees C) had a marked deterioration in motility accompanied by an overgrowth of bacteria in the semen and a concomitant decrease in pH led to this study to test the hypothesis that the decrease in motility was caused by the bacteria or by bacterial alteration of seminal pH. Semen specimens from fertile prevasectomy patients with and without added antibiotics were maintained at 20 degrees C and 37 degrees C and evaluated at 3, 12, and 18 hours after collection. There was still a significant deterioration in spermatozoal motility in the samples kept at 37 degrees C even when bacterial growth and change in pH were prevented by buffered antibiotics. Although the decrease in spermatozoal motility at body temperature may in part be attributed to bacterial growth or the products of bacterial metabolism, clearly another factor is present related to time and temperature and independent of the presence of bacteria.

The effect of temperature on sperm motility and viability

Semen specimens from fertile prevasectomy patients maintained at 4 degrees, 20 degrees, and 37 degrees C were evaluated at 3, 6, 12, and 18 hours after collection. Sperm viability, assessed by eosin-nigrosin stain, and motility decreased with time at 20 degrees and 37 degrees C, but at a significantly higher rate at 37 degrees C (where the motility was halved by 12 hours). The slope of the decrease in viability closely paralleled that of the motility except at 4 degrees C, where motility was nearly absent at 6 hours but viability was retained through 18 hours. Bacterial counts rose markedly and the pH fell at 37 degrees C, which may explain the decrease in motility and viability. It is clear from this study that semen should be kept at room temperature (20 degrees C) and not at 37 degrees C if there is to be any delay in its analysis, or a falsely lowered motility will result.

The effect of temperature on the motility and viability of sperm

In specimens of semen kept at 37 degrees C sperm lose their motility and viability. If kept at 4 degrees C they retain their viability but lose their motility from so-called thermal shock. The best temperature to keep semen in order to preserve sperm motility is 20 degrees C. Loss of motility at 37 degrees C is not entirely prevented by prevention of bacterial contamination with antibiotics.

Male infertility practice and Orthodox Jewish law

The evaluation and management of infertility problems in Orthodox Jewish couples can be made difficult because of restrictions which may be imposed by religious rules. The origins of the religious laws governing semen collection, diagnostic and therapeutic genital surgery, menstruation, and homologous and donor insemination are reviewed. Contemporary rabbinic authorities are quoted; their opinions may serve as guidelines for the patient and urologist dealing with infertility problems.

Infertility practice and Orthodox Jewish law

The evaluation and management of infertility problems in Orthodox Jewish couples can be made difficult because of restrictions which may be imposed by religious rules. The origins of the religious laws governing problems such as semen collection, diagnostic and therapeutic genital surgery, menstruation, and homologous and donor insemination are reviewed. Contemporary Rabbinic authorities are quoted; their opinions may serve as guidelines for the patient and physician dealing with infertility problems.

Stimulation of ejaculated human spermatozoa by caffeine

Caffeine (1, 3, 7-trimethyl-2, 6-dioxypurine), a cyclic nucleotide phosphodiesterase inhibitor, increased the motility of ejaculated human spermatozoa. Both the percent motility and the grade of forward progression were significantly increased (P smaller than 0.001) and maintained in the presence of 6 mM of caffeine for up to five hours at 37 C. Increases in percent motility greater than two-fold occurred among the groups having low initial motility. Increases in samples with a high initial percent motility (greater than 60%) were not as dramatic, but they were still significant. In addition, the grade of motility or forward progression was increased in all groups up to one full unit. The longevity of the spermatozoa, judged by activity, was also increased for up to five hours.

A coital technique for promotion of fertility

In selected cases of subfertile men, the first portion of the split ejaculate is superior to the specimen considered as a whole with regard to sperm density, motility, and cytology, and also in those cases in which there is increased seminal viscosity in the whole ejaculate. Use of the coital technique in which the husband withdraws his penis from the vagina after deposition of the better first portion of the ejaculate during the fertile time of the wife's cycle has resulted in rapidly achieving pregnancy in many instances in which the marriages had been barren for years. A total of 33 cases of pregnancy ascribed to this coital technique in the past four years, with detailed analyses of whole and split ejaculates, is presented.