Showing papers on "Semen analysis published in 1992"

Results of 1,469 microsurgical vasectomy reversals by the Vasovasostomy Study Group.

Abstract: During a 9-year period 1469 men who underwent microsurgical vasectomy reversal procedures were studied at five institutions. Of 1247 men who had first-time procedures sperm were present in the semen in 865 of 1012 men (86%) who had postoperative semen analyses and pregnancy occurred in 421 of 810 couples (52%) for whom information regarding conception was available. Rates of patency (return of sperm to the semen) and pregnancy varied depending on the time interval between the vasectomy and its reversal. If the interval was shorter than 3 years the patency rate was 97% and the pregnancy rate was 76%; for intervals of 3 to 8 years the rates were 88% and 53%; for 9 to 14 years 79% and 44%; and for 15 years or more 71% and 30%. The patency and pregnancy rates were no better after 2-layer microsurgical vasovasostomy than after modified 1-layer microsurgical procedures and they were statistically the same for all patients regardless of the surgeon. When sperm was absent from the intraoperative vas fluid bilaterally and the patient underwent bilateral vasovasostomy rather than vasoepididymostomy patency occurred in 50 of 83 patients (60%) and pregnancy in 20 of 65 couples (31%). Neither presence nor absence of a sperm granuloma at the vasectomy site nor type of anesthesia affected results. Repeat microsurgical reversal procedures were less successful. A total of 222 repeat operations produced patency in 150 of 199 patients (75%) who had semen analyses and pregnancy was reported in 52 of 120 couples (43%). (authors modified)

Origin of reactive oxygen species in human semen: spermatozoa or leucocytes?

Abstract: Summary. Peroxidative damage induced by reactive oxygen species (ROS) has been proposed as one of the major causes of defective sperm function. In previous studies of the production of ROS in semen, the contribution of contaminating leucocytes was not assessed. We determined the levels of ROS in 60 semen samples from men attending our infertility clinic and demonstrated by performing extraction experiments with antibody-coated magnetic beads that, within this unselected population of patients, leucocytes were the major source of ROS in the low-density Percoll fraction. Of the sperm motion parameters examined using computerized semen analysis, beat-cross frequency was the only one significantly affected by the ROS in semen.

The removal of morphologically abnormal sperm forms by phagocytes: a positive role for seminal leukocytes?

Abstract: A preliminary investigation was undertaken further to determine the function of the leukocytic cells found in semen. We performed semen analysis and quantified leukocyte subsets using immunocytochemical staining techniques in ejaculates of 351 patients. Leukocyte profiles were examined in relation to sperm morphological data for evidence of a sperm removal/selection process. Three types of seminal phagocytic cell were found to contain spermatozoa: small polymorphonuclear leukocytes (approximately 10-12 microns), monocytes of similar size and much larger (30-40 microns) macrophages capable of engulfing multiple sperm heads. The total leukocyte count (P less than 0.01), the numbers of phagocytic cells i.e. polymorphonuclear leukocytes (P less than 0.05), monocyte/macrophages (P less than 0.01) and HLA-DR positive cells (P less than 0.01), were significantly higher in those samples with greater than 50% ideal sperm forms. Significantly fewer of these same cell types were observed in samples with greater than 50% head defects. There was no difference in the number of tail or midpiece defects between leukocytospermic (greater than 10(6)/ml) and non-leukocytospermic semen samples. Oligozoospermic samples contained significantly fewer leukocytes (P less than 0.005), although above a concentration of 5 x 10(6)/ml, the sperm number was not correlated with leukocyte number. These data, along with repeated observation of spermatozoa or sperm fragments within phagocytic cells, support the hypothesis that leukocytes have a role in the removal of abnormal spermatozoa from the ejaculate.

Pure human follicle stimulating hormone has a role in the treatment of severe male infertility by assisted reproduction: Norfolk's total experience

Abstract: Fifty patients [79 in-vitro fertilization (IVF) cycles] with severe male factor infertility were included in an experimental clinical trial running from October 1987 to March 1991 to assess the potential of systemic follicle stimulating hormone (FSH) treatment to improve sperm fertilizing ability in IVF. Two groups were defined: a secondary group (24 patients, 33 IVF cycles) with a history of failed fertilization in previous IVF attempts and a primary group (26 patients, 46 IVF cycles) with poor sperm parameters which suggested that fertilization would not occur according to previously established criteria. Basic semen analysis and a battery of endocrine radioimmunoassays [serum FSH, luteinizing hormone (LH), oestradiol, prolactin and testosterone] were performed in these patients. Bioactive-FSH and LH were also determined in some patients. For this study, pure FSH was administered (150 IU i.m. three times per week) for at least 3 months, after which the semen analysis and endocrine tests were repeated. Although no significant changes were observed after FSH therapy, either in the endocrine profile or in the basic semen parameters, except for FSH radioimmunoassay levels, the fertilization rate of pre-ovulatory oocytes was significantly improved from 2 to 54.4% in the secondary group; the primary group showed a 52.3% fertilization rate. Eighteen clinical pregnancies were achieved, 11 in the primary group and seven in the secondary group, giving 30 and 26% term pregnancy rates per transfer respectively. These results, which are in complete agreement with our preliminary study, re-emphasized the benefits of systemic FSH administration as an adjunct to assisted reproduction in selected cases of severe male factor infertility.(ABSTRACT TRUNCATED AT 250 WORDS)

The Acridine Orange test: determining the relationship between sperm morphology and fertilization in vitro.

Abstract: The prediction of human fertilization is an important aspect of research protocols dealing with male fertility. Sperm DNA has been reported to be an indicator of human sperm fertility potential. The Acridine Orange test for evaluation of sperm DNA has been employed during the present study to determine its relationship with human sperm morphology and fertilization in vitro. Seventy-six patients from the in-vitro fertilization (IVF) and/or gamete intra-Fallopian transfer (GIFT) programme were randomly selected for the study. All patients had a routine semen analysis, sperm DNA evaluation and underwent standard IVF procedures at the time of the study. The results indicated a moderate positive correlation (r = 0.38, P = 0.0006) between results of the Acridine Orange test and normal sperm morphology. Patients with an Acridine Orange test value exceeding 24% had significantly higher oocyte fertilization rates than patients with lower values, for metaphase I (74 versus 51%, P = 0.0008) and for metaphase II oocytes (88 versus 60%, P = 0.0001). Sperm morphology, however, proved to be a more significant predictor of fertilization in vitro compared to the Acridine Orange test.

Semen quality of smoking and non-smoking men in infertile couples in a Swedish population

Abstract: A study of semen quality, using conventional semen analysis, was undertaken 186 male smokers were compared with 164 non-smoking men undergoing infertility investigation The cigarette smokers were subdivided into three groups according to the number of cigarettes they smoked: 19 cigarettes per day (n = 75) No statistically significant effect of cigarette smoking on sperm density, motility or morphologic features of sperm was detected Nor was any significant difference in sperm quality, except for semen volume and total sperm count, disclosed between men in the different smoking categories or between heavy smokers and non-smoking men Thus, the present study does not corroborate reports of detrimental effects of cigarette smoking alone on sperm concentration, motility or morphology on the bases of this population of Swedish men in infertile couples

Effect of bovine serum albumin on motility and fecundity of turkey spermatozoa before and after storage.

Abstract: Motility characteristics of turkey spermatozoa before and after storage for 24 h at 7 degrees C in diluent with and without bovine serum albumin (BSA; 1% final concentration) were measured by computer-assisted semen analysis. BSA significantly increased the percentage of motile spermatozoa and sperm velocity, linearity, lateral head displacement and beat frequency in each treatment, but BSA in fresh or stored semen in diluent did not augment hen fertility over 15 weeks of egg production. Fatty-acid-free BSA, globulin-free BSA and Fraction V BSA all significantly increased each sperm motility characteristic compared with semen in diluent alone. The lack of correlation between sperm motility and fecundity emphasizes the need to develop procedures for semen evaluation that accurately predict the fertilizing capacity of an aliquot of semen.

Effect of swim-up, Percoll and Sephadex sperm separation methods on the hypo-osmotic swelling test

Abstract: The separation of spermatozoa from the seminal plasma is required to prepare the spermatozoa for intrauterine insemination, in-vitro fertilization and sex selection. This study evaluated the effects of sperm preparation techniques on the functional integrity of the sperm membrane, as measured by the hypo-osmotic swelling test (HOS). Thirty-four semen specimens obtained from the male partner of infertile couples were evaluated. A semen analysis and HOS test were performed on each specimen. The remainder of the specimen was divided into three equal aliquots, the first prepared using Percoll, the second using a swim-up method and the third using a Sephadex column. After the preparation, a semen analysis and HOS test was performed on each aliquot. The mean and standard deviation for the HOS test was 72.9 +/- 8.5% initially, 71.2 +/- 13.1 after Percoll, 75.2 +/- 15.1 after swim-up and 62.4 +/- 14.5 after Sephadex. Analysis of variance showed that the mean HOS score was the same after Percoll and swim-up as it was initially but significantly lower after preparation with Sephadex. There was also a higher proportion of abnormal semen specimens (HOS less than 50%) after preparation with Sephadex than after the other preparation methods. We recommend the use of the HOS test as part of a screening panel for sperm separation.

Residual sperm function in oligozoospermia induced by testosterone enanthate administered as a potential steroid male contraceptive

Abstract: To investigate the fertility of men who remain oligozoospermic despite sex steroid suppression the in-vitro fertilizing capacity of residual spermatozoa was assessed in 30 men receiving intramuscular testosterone enanthate (TE). Spermatozoa were prepared by either Percoll or repetitive centrifugation/washing. Although the mean (+or- SEM) pretreatment zona-free hamster oocyte penetration (HOP) rates were similar (59.4 +or- 10.1 and 63.8 +or- 10.8%) following the induction of oligozoospermia the Percoll-prepared spermatozoa exhibited a penetration rate (26.9 +or- 10.2%) which was markedly greater than that obtained for sperm prepared by repetitive washing (0 +or- 0%). In addition the partners of two men exhibiting a HOP test with Percoll-prepared spermatozoa conceived despite a sperm concentration of 3 x 10 ml and a negative HOP test with spermatozoa prepared by repetitive washing. These results suggest that Percoll preparation optimizes the assessment of in-vitro sperm function and that the fertility of men with TE-induced severe oligozoospermia is suppressed but not abolished. (authors)

Subnormal sperm parameters in conventional semen analysis are associated with discrepancies between fertilization and pregnancy rates in in‐vitro fertilization and embryo transfer

Abstract: Summary Three hundred and twenty-eight consecutive treatment cycles in 168 couples were analysed retrospectively in order to examine the influence of conventional semen analysis results on the outcome of in-vitro fertilization and embryo transfer with respect to the occurrence of both fertilizations and pregnancies. All treatments were performed under maximally standardized and controlled conditions. Each of the three main determinants of the spermiogram, namely the concentration, motility and morphology of sperm in seminal plasma, was of significant importance for fertilization and subsequent pregnancy. Best correlations were achieved by counting the number of progressively (a + b) motile sperm and the number of normally formed sperm in seminal plasma. The pregnancy rate was reduced significantly in cases in which the sperm concentration was < 10 × 106ml-1 (P< 0.01), or in which there was <40% progressively motile sperm (P<0.001), or <30% normally formed sperm (P< 0.001). If more than one parameter in the spermiogram was abnormal, the fertilization rate depended mainly on the most disturbed sperm parameter. The implantation rate as well as the pregnancy rate was reduced significantly in patients with low progressive sperm motility and normal morphology rates. The difference could only be attributed partially to the lower number of embryos replaced. In conclusion, subnormal sperm quality seems to interfere with developmental stages beyond the process of fertilization.

Migration sedimentation technique as a predictive test for the fertilizing capacity of spermatozoa in an in-vitro fertilization programme.

Abstract: The migration-sedimentation technique (MST) has been proposed as a means of separating high quality motile spermatozoa. The present study was conducted in order to evaluate whether sperm performance following separation by MST predicts their fertilizing capacity in an in-vitro fertilization (IVF) programme. Ninety semen specimens were analysed for use in an IVF-embryo transfer (ET) programme. Each specimens was divided into two parts: one was processed in the IVF programme and was used after sperm swim-up separation for insemination of human ova. The other aliquot (0.2 ml) was separated by MST, and the sperm then characterized by their concentration, motility, degree of motility and morphology. Sperm characteristics after separation by MST were then correlated with the results of the IVF-fertilization rates. In 79 of 90 IVF-ET cycles, at least one oocyte was fertilized. All post-MST sperm characteristics were significantly higher in cycles with fertilizations compared to IVF cycles without fertilization. A larger percentage of the total motile spermatozoa were recovered after MST in semen specimens with fertilization, compared to semen specimens without fertilization (39.9 +/- 3.6 and 20.6 +/- 6.6%, respectively; P 25% (P < 0.005), or when more than 1.5 x 10(6) motile spermatozoa were recovered after MST (P < 0.0001). As sperm characteristics after MST correlated significantly with their fertilizing capacity, the MST test could be used in evaluation of the fertilizing capacity of spermatozoa.

Germ cell alkaline phosphatase in human seminal plasma following vasectomy.

Abstract: Urologists at the University Hospital in Liverpool England asked 5 patients for 2 semen samples after 4 days of sexual abstinence and before they underwent a vasectomy and a semen sample for every 14-28 days after the vasectomy. They wanted to monitor the clearance rate of germ cell alkaline phosphatase (GCAP) in human semen plasma following vasectomy. After 3 months the urologists also examined semen samples for spermatozoa and did not find them in the semen of any of the patients. Even though wide differences in GCAP levels existed in the preoperative seminal plasma samples the GCAP level in each patient remained basically the same. There was no association between preoperative GCAP levels and preoperative sperm counts. The H17-E2 immunoassay revealed that 1 patient did not have detectable GCAP. This may be a result of nonreactivity of this immunoassay with certain phenotypes of GCAP. In the other 4 patients preoperative GCAP levels fell from 0.5-3 mcg/1 to <0.2 mcg/1 by the 1st postoperative sample at 14 days. Indeed GCAP levels remained undetectable for as long as 122 days. These results supported those of other studies suggesting that obstruction of the efferent duct of the testes may keep GCAP from entering the seminal plasma. The urologists suggested that measurement of GCAP in seminal plasma of postvasectomy patients could be used as a diagnostic check for infertility after vasectomy. It does take 3 months for azoospermia to occur however.

8 Evaluation of testicular function

Abstract: The evaluation of testicular function is based primarily on a detailed medical history, a careful physical examination, basal measurements of FSH, LH and testosterone and a routine semen analysis. In a patient with androgen deficiency, the diagnosis can often be made with these basic tests. The clinician will then decide on other investigations to localize the organic lesion and to plan further treatment for the patient. Sperm function tests are often performed in patients presenting with infertility. These newer tests may help to delineate the abnormality of the spermatozoa at each stage during the achievement of fertilizing capacity such as adequate forward motility, penetration of cervical mucus, acrosome reaction, development of hyperactivated motility, binding to the zona pellucida, and fusion with the oocyte. Currently, many of these sperm function tests depend on cumbersome bioassays with many limiting factors contributing to their availability, accuracy and precision. The development of biochemical tests as markers of sperm function may allow more precise definition of sperm functional abnormalities. With the continued improvement of computer-aided sperm analysis, objective motion parameter measurements are possible and morphological assessment are being developed. These newer objective methods of semen analysis have to be shown to be valuable in the clinical assessment of patients with testicular dysfunction.

Diagnosing male factors of infertility.

Abstract: The male factor is responsible for failure to conceive in approximately 50% of infertile couples. We considered the most appropriate plan for the evaluation of the male in this review. A comprehensive evaluation includes determination of the couple's history of infertility, their sexual habits, the husband's developmental, medical, and surgical histories, family history, exposure to gonadotoxins, and a thorough review of systems. Laboratory tests include endocrine evaluation, semen analysis, quantitation of leukocytes in semen, and antisperm antibodies. Tests of sperm function can include evaluation of cervical mucus interaction, ova penetration, and the hemizona assay. Additional tests may include transrectal ultrasonography, venography, and testis biopsy.

Reappraisal of the hypo-osmotic swelling test to improve assessment of seminal fertility status.

Abstract: The hypo-osmotic swelling (HOS) test has been proposed as a useful assay for evaluation of the functional competence of the human sperm membranes. To assess this further, the HOS-test was evaluated in 187 semen samples collected from fertile men and from male patients consulting for infertility. These samples were classified as normal, oligo-, astheno- or oligoasthenozoospermic on the basis of their standard semen variables. The percentage of total sperm tail swelling and of sperm exhibiting different tail swelling patterns was recorded. In the fertile men and in the group of patients with normal semen variables, significantly more (P less than 0.001) HOS-reactive sperm were observed after hypo-osmotic treatment in comparison with those groups exhibiting abnormal semen parameters. Swelling of the sperm in a hypo-osmotic medium was highly correlated with both progressive motility (r = 0.62, P less than 0.001) and sperm viability (r = 0.65, P less than 0.001). A weak positive correlation was also observed between sperm swelling and sperm morphological features (r = 0.31, P less than 0.005) and between sperm swelling and sperm concentration (r = 0.31, P less than 0.005). No significant correlation was observed between sperm swelling and in-vitro sperm fertilizing capacity as assessed by the zona-free hamster oocyte penetration assay. However the majority of the semen samples (87.3%) showing a normal penetration rate (greater than or equal to 10%) also exhibited a 60% (or higher) reaction in the HOS-test.(ABSTRACT TRUNCATED AT 250 WORDS)

Semen analysis and fertility prognosis in andrological patients.

Abstract: Summary Semen analyses of 529 men who consulted our department due to infertility problems, were related to the time period prior to conception, with factors adversely affecting the fertility of the female partner taken into consideration. The statistical method used was Cox's proportional-hazard model of regression. Untransformed, logarithmically transformed and dichotomized semen analysis variables were included in the calculations. The relationship between the following parameters and the probability of conception was examined: sperm count, sperm motility, progressive sperm motility, morphology and sperm motility remaining 24 h after ejaculation. All variables co-varied with the probability of conception; however, the exact type of relationship could not be determined by regression analyses. Cox's model assumes an exponential relationship. Our data suggest that this assumption is not suitable for fertility investigations. Using conventionally defined limiting values for normal and pathological semen quality, statistical analysis yielded significant differences in fertility between both categories for all of the variables considered; in the stepwise regression analysis, however, it could be shown that progressive motility and morphology alone were sufficient to discriminate between normal and pathological semen quality. The results are interpreted as indicating that, as a result of semen analysis, it is possible to predict the individual probability of conception if the exact shape of the relationship can be determined, which, up to now, has not been accomplished.

Evaluation of Hamilton-Thorn automated semen analysis system.

Abstract: Sperm concentration and percentage motility values generated by the HT M-2030 system (CASA) were compared with those obtained by subjective semen analysis (SSA). Three calibrations arbitrarily designated as A, M, and D for gates and discriminators and three calibrations arbitrarily designated LI, MI, and HI for default pixel count (DPC) and default intensity (DI) were evaluated. The best correlation between CASA and SSA was observed utilizing M calibration (n = 114) with which sperm concentration was +0.3 x 10(6)/mL (r = .96) and motility was -6.3% (r = .89) compared to the values obtained by SSA. It was found that 35.9% of sperm concentration values and 34.2% of sperm motility values were within 10% of the values obtained by SSA. When sperm concentration was between 50 and 100 x 10(6)/mL the difference in motility was reduced (-3.2%) while the difference in sperm concentration was reversed (-2.6 x 10(6)/mL). LI calibration (DPC = 4, DI = 86) gave acceptable results with M calibration for sperm concentration (+2.1 x 10(6)/mL) and motility (-6.9%) compared to the values obtained by SSA. In the presence of sperm clumping, the difference between CASA and SSA was reversed for sperm concentration (+0.56 x 10(6)/mL for normal samples vs. -2.2 x 10(6)/mL for samples with clumping) and was reduced for sperm motility (-7.14% vs. -4.55%, respectively). HT M-2030 under proper calibration can be used as a rapid, objective, and reliable alternative to conventional semen analysis in routine and for research purposes.

45,X/46,XY gonadal dysgenesis in an infertile adult male

Abstract: A 33-year-old male was referred for infertility. Examination revealed bilateral scrotal gonads of soft consistency and small size. Semen analysis showed azoospermia. Elevated serum follicle-stimulatin

Pilot surveys for proficiency testing of semen analysis. Comparison of dry-ice vs liquid nitrogen shipments.

Abstract: Two pilot surveys involving routine semen analysis were provided to eight and nine selected laboratories. The laboratories were selected for expertise and geographic diversity. Manual and computer-assisted semen analysis were performed by the participating laboratories on pooled cryopreserved human semen samples following shipment either on dry-ice pellets or in liquid nitrogen (dry shippers). Coefficient of variation values obtained were 13% to 39% for concentration, 19% to 127% for motility, and 42% to 90% for viability. Motility was impaired for sperm shipped on dry ice. However, variances and performance criteria can be established for all analyses. A semen analysis survey is feasible but expensive owing to the shipping costs of cryopreserved semen.