A test for the practical evaluation of male fertility by acridine orange (AO) fluorescence.

The biologic significance of white blood cells in semen.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/mrd.1080370314

Molecular biology of human male infertility: Links with aging, mitochondrial genetics, and oxidative stress?

The aim of the study was to conduct a structured review of the literature published on the use of normal sperm morphology, as an indicator of male fertility potential in the in-vitro fertilization (IVF) situation, and to establish the universal predictive value of this semen parameter. Published literature in which normal sperm morphology was used to predict fertilization and pregnancy, during the period 1978-1996, was reviewed. A total of 216 articles were identified by the sourcing methodology, but only 49 provided data that could be tabulated and analysed. Of these, only 18 provided sufficient data for statistical analysis. Fifteen studies used the strict criteria to evaluate sperm morphology, two used World Health Organization (WHO) guidelines and one used both the strict criteria and the WHO guidelines. All the studies (n = 10) using the 5 and 14% normal sperm morphology thresholds (strict criteria) produced positive predictive values for IVF success. In the prediction of pregnancy, 82% (9/11) and 75% (6/8) of the studies produced positive predictive values when using the 5% and 14% thresholds respectively. Aggregating the data produced around the 5% normal sperm morphology threshold (strict criteria), the overall fertilization rates were 59.3% (1979/3337; per oocyte) for the 4% group, and the overall pregnancy rates were 15.2% (60/395; per cycle) and 26.0% (355/1368; per cycle) respectively. The no-transfer rates across the 5% threshold were 24.0% (86/359; per cycle) in the 4% group. The inclusion of an accurately evaluated normal sperm morphology count as an integral part of the standard semen analysis makes this analysis still the most cost-effective means of evaluating the male factor.

/pdf/predictive-value-of-normal-sperm-morphology-a-structured-zlv1gg578p.pdf

Predictive value of normal sperm morphology: a structured literature review

There are several mechanisms acting in synergism that can impair sperm characteristics of patients with accessory gland infection In some cases, conventional sperm variables are disturbed with oligo and/or asthenozoospermia In other patients, these sperm variables may appear normal, but the functional capacity of spermatozoa may be impaired In particular, changes in the composition of the sperm membrane may result in reduced acrosome reactivity and capacity to fuse with the oolemma, and oxidative damage of the sperm DNA may induce mutagenesis Changes in the biochemical make-up of seminal plasma can also reduce the in-vivo fertilizing capacity of spermatozoa, and infection-related disruption of the blood-testis barrier can induce the generation of anti-sperm antibodies and immunological infertility Many of these functional abnormalities will not become evident upon 'basic semen analysis', which explains why some authors are unable to link infection of the accessory sex glands to subfertility Also, functional and anatomical damage acquired as a result of infection is often permanent and not reversible by (antibiotic) treatment Clearly, there are many more aspects of male accessory gland infection that require investigation Available data should stimulate clinicians to place more emphasis on the prevention of infection-related infertility than on its treatment, as the latter is often unsuccessful

Mechanisms and effects of male genital tract infection on sperm quality and fertilizing potential: the andrologist's viewpoint

Adenosine triphosphate in human semen: a quantitative estimate of fertilizing potential *

Infection of the male accessory sex glands may result in impaired secretory function and alteration of the composition of seminal plasma. Using receiver operating characteristic curves and accuracy tests, the power of several biochemical and physical markers was evaluated for their ability to discriminate between semen of infected and noninfected infertile men. The total output of citric acid had the strongest discriminating power, followed by acid phosphatase and gamma-glutamyltranspeptidase. Measurement of the concentration of fructose was found to be nondiscriminatory.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/j.1939-4640.1989.tb00060.x

Study of the accuracy of physical and biochemical markers in semen to detect infectious dysfunction of the accessory sex glands.

Based on the results of in vitro fertilization (IVF) in 56 couples, the power was assessed of traditional sperm characteristics of native semen to discriminate between in vitro fertile and in vitro infertile semen. The number per ejaculate of spermatozoa with regular oval heads was the best discriminant, followed by the concentration of progressively motile spermatozoa. This contrasts with the in vivo fertilizing capacity, which depends mostly on the proportion and concentration of spermatozoa with rapid linear progression. The lower limit of sperm characteristics was assessed as the fifth percentile of in vitro fertile semen and was compared with the lower limit of semen of fertile men and of subfertile men who achieved spontaneous or treatment-related conception in vivo. It appeared that the semen quality needed for in vitro fertilization is inferior to that of fertile men but not remarkably different from that of subfertile men who achieved spontaneous conception during 1-year follow-up after consultation. If conventional methods for semen preparation are used, there seems to be no major advantage in favor of IVF for the treatment of male infertility due to sperm deficiency. An increased success rate may, however, be attained, thanks to improved techniques of semen collection, semen preparation, and oocyte insemination.

Lutgard Vermeulen

Papers

Adenosine triphosphate in human semen: a quantitative estimate of fertilizing potential *

Study of the accuracy of physical and biochemical markers in semen to detect infectious dysfunction of the accessory sex glands.

Accuracy of sperm characteristics in predicting the in vitro fertilizing capacity of semen