The potential roles of estrogens in regulating Leydig cell development and function: a review.

This chapter details a successful method for obtaining highly motile spermatozoa from human semen for in vitro fertilization Background studies, areas of uncertainty which require further investigation and the possibility of using IVF as a method of treatment for infertility due to poor semen quality are also mentioned

Assessment and Preparation of Semen for In Vitro Fertilization

Nonspermatozoal cells (NSC) in semen, including immature germ cells, leukocytes (WBC) and epithelial cells, are normally found in a concentration less than 15% of the sperm concentration. Cytological staining methods and immunoenzymatic assays for characterization of seminal WBC and methods for detection of various enzymes from WBC are evaluated. Criteria for abnormally high levels of WBC in semen, caused by exogenic factors (e.g., infection) and possibly by endogenic factors (e.g., abnormal sperm), are discussed. Leukocytospermia is associated with reduced in vitro fertilization rate, and experimentally-measured sperm functions (e.g., motility) are inhibited by high concentrations of certain WBC products (e.g., reactive oxygen species and interferon-gamma). At the present stage, the following procedures could be used to evaluate WBC in ejaculates from infertile patients: (1) count the number of NSC using a hemocytometer. (2) Determine the number of WBC in percentage of NSC in smears using the Papanicolaou staining technique, or an immuno-enzymatic assay using monoclonal antibodies to the different kinds of WBC. (3) If, abnormally high levels of WBC (according to the WHO criteria or based on a percentile determined from examination of normal, fertile men) is detected, a second ejaculate should be examined 3 months later. (4) Persistent leukocytospermia should indicate physical and microbiological examinations, after which antibiotic treatment may be indicated.

https://www.tandfonline.com/doi/pdf/10.3109/01485019608987883

Nonsperm Cells in Human Semen: With Special Reference to Seminal Leukocytes and their Possible Influence on Fertility

The inflammatory response is a beneficial process, but inflammatory injury of male accessory sex organs can reduce fertility by the following pathophysiological mechanisms: increased sperm agglutination (Derrick and Dahlberg 1976); reduced sperm motility and viability (Eliasson 1975); and obstruction of the ejaculatory ducts (Pomerol 1978) Disturbances in epididymal sperm maturation (Bedford 1975) affecting motility (Gaddum 1968) and the fertilizing ability of spermatozoa (Bedford et al 1973) may also be sequelae of inflammation Inflammation and infection are often mistakenly considered to be interchangeable terms Infections by microorganisms are just one among several causes of inflammation (Woolf 1977) Diagnostic and therapeutic criteria for the management of the inflammatory state of male accessory genital organs are the subjects of this chapter

Inflammation and Infection

The direct effect of 17β-estradiol on lh-stimulated testosterone production in hypophysectomized rats

The cytology and bacteriology of urethral urine specimens and expressed prostatic secretions were examined in 24 infertile men suspected of having chronic prostatitis. Lencocytes were found and commensal bacteria cultured from most subjects but these were unrelated to clinical features, seminal characteristics or the outcome of treatment. Infection with pathogenic bacteria was not found in any subject. Despite this, there was a significant increase in sperm motility after antibacterial treatment, principally with erythromycin or cotrimoxazole, and three pregnancies coincided with the improvement.



It is concluded that antibacterial therapy may improve fertility in patients with low sperm motility, but more investigation is necessary before the role of genital tract infection in male infertility can be placed in its proper perspective.

G. Murphy

Papers

Prostatitis and Male Infertility: A Pilot Study. Possible Increase in Sperm Motility with Antibacterial Chemotherapy