Oligospermia due to partial maturation arrest responds to low dose estrogen-testosterone combination therapy resulting in live-birth: a case report

A man having severe oligospermia, due to partial maturation arrest at spermatid stage, was given low dose estrogen-testosterone combination therapy for three months. His sperm count increased enormously, following which his wife conceived and delivered a healthy baby at term.

The reversibility of sperm quality after discontinuing nandrolone decanoate in adult male rats

Aim： To investigate the reversibility of the effect of nandrolone decanoate （ND） on sperm parameters after discontinuing the drug. Methods： Three groups of rats received peanut oil （control）, low and high doses of ND for 14 weeks, respectively. Each group was divided into subgroups A and B, in which rats were killed 14 and 28 weeks after initiating the injection, respectively. Results： Sperm count and motile sperm fraction were decreased in the subgroups A and B that received low and high doses of ND in comparison with the controls A and B, respectively. The sperm count and motile sperm fraction increased in the subgroups B that received low and high doses of ND in comparison with their corresponding subgroups A. The number of normal morphology sperm was decreased significantly in subgroups A receiving low and high doses of ND in comparison with the control subgroup A. However, this parameter was not decreased in subgroups B receiving low and high doses in comparison with the control subgroup B. The normal sperm morphology did not show any significant differences in the subgroups B in comparison with their corresponding subgroups A. Conclusion： The 14-week injection of low and high doses of ND decreases sperm quality and quantity in rats. These parameters were improved after discontinuing ND, but not recovered completely even when they are left untreated for 14 weeks.

Has Sperm Count Declined in the General Male Danish Population during the Last Several Decades?A Study on the Relation of Sperm Count and Birth Year

It has been hypothesized that during the last several decades human sperm count has declined because of prenatal exposure to environmental chemicals. We examined the relation between semen quality and birth year among 8608 men born from 1922 to 1971 and who from 1968 to 1992 consulted 4 Danish medical centers because of barren marriage. Data were obtained from medical records and by a postal questionnaire to a subset of the population. The sperm concentration was significantly declining with increasing year of birth in 2 of the 4 centers, but this association disappeared when confounders were adjusted for. Within the subset of men born during 1955~1970 comprising 36% of the entire population we revealed a decrease of the average sperm concentration by 1.6 million /ml (95% CI:0.7~2.5) per one advancing year of birth.This finding was consistent across all the 4 centers and robust to adjustment for effects of calendar period, season and duration of sexual abstinence. Effects of age were accounted for by restriction of the sample to men between 20 and 45 years. The findings are compatible with environmental impact in the prenatal period after 1955 but are far from unequivocal evidence that the sperm count in the general male Danish population has changed during the past decades.

Semen analysis from an epidemiologic perspective

The fifth edition of the World Health Organization （WHO） manual for semen analysis includes for the first time reference values for human semen characteristics. This paper considers whether such values will help to resolve the intensely debated data indicating temporal and geographical shifts in sperm counts and hypotheses that anthropogenic activities that result in the release of chemicals into the environment are detrimental to male reproductive health. The reasons that these reference values will not fulfil these purposes are also explained. Although established reference values for semen characteristics are of limited value in analytical epidemiologic research, the WHO guidelines are of utmost importance for supporting the development of appropriate research protocols. Moreover, in spite of its limitations, semen analysis is still a useful research tool in epidemiological research, and no superior alternatives are on the horizon.

Lepidium meyenii (Maca) improved semen parameters in adult men

Aim:The present study was designed to determine the effect of a 4-month oral treatment with tablets of Lepidiwnmeyenii(Maca)on seminal analysis in nine adult normal men aged 24-44 years old.Methods:Nine men receivedtablets of Maca(1500 or 3000 mg/day)for 4 months.Seminal analysis was performed according to guidelines of theWorld Health Organization(WHO).Serum luteinizing hormone(LH),follicle stimulating hormone(FSH),prolactin(PRL),testosterone(T)and estradiol(E_(2))were measured before and after treatment.Results;Treatment withMaca resulted in increased seminal volume,sperm count per ejaculum,motile sperm count,and sperm motility.Serumhormone levels were not modified with Maca treatment.Increase of sperm count was not related to dose of Maca.Conclusion:Maca improved sperm production and sperm motility by mechanisms not related to LH,FSH,PRL,Tand E_(2).

Evaluation of trend in semen analysis for 11 years in subjects attending a fertility clinic in India

Aim: The data on semen analysis of subjects attending the Fertility Clinic at NIHFW (National Institute of Health and Family Welfare) Munirka, New Delhi for the last 11 years were analyzed to verify the claims and speculations on declining sperm counts in men. Methods: Approximately 10 % of the records every year starting from 1990 to 2000 (numbering 1176 in total) were randomly selected for analysis. Subjects with azoospermia or severe oligozoospermia were excluded from analysis. Results: The average age of the men attending the infertility clinic was 31.2 years. The average semen volume and sperm count were found to be (2.6 ±0.1) mL and (60.6 ± 0.9) × 106/mL, respectively. No significant decline in sperm counts was observed in any year during the entire study period. Only 1.8 % of the total number of sperm counts in the random sampling were less then 20 × 106/mL. On the basis of WHO criteria on motility, the total percentage of non-progressive and non-motile sperm in the ejaculate was higher (63 %) as compared to the combined categories of slow and rapid linear progressive. Conclusion: The present study has confirmed similar findings from other different countries that declining sperm counts in humans is not a global phenomenon.

Effect of alcoholic extract of Lepidium meyenii (Maca) on testicular function in male rats

Aim: To evaluate the effect of the alcoholic extract of Lepidium meyenii (Maca) on the spermatogenesis in male rats. Methods: In Holtzman rats, Maca alcoholic extract (5%) was given by oral route at doses of 48 mg/day or 96 mg/day for 7 days, 14 days and 21 days. Testicular function was assessed by measurements of lengths of different stages of seminiferous epithelia and by epididymal sperm count. Results: Ethanolic extract of Maca increased the length of stages IX-XI of seminiferous epithelium at treatment day 7, day 14 and day 21. Progression of spermatogenesis was evident only after day 21 when lengths of stages XII-XIV of seminiferous epithelium were increased; at day 7 and day 14, no important change in spermatogenesis was observed. Epididymal sperm count was increased with 48 mg/day at all times. With 96 mg/day an increase in sperm count was observed at day 7, but it was reduced at day 14 and day 21 of treatment. Serum testosterone levels were not affected. Conclusion: The alcoholic extract of Maca activates onset ant progression of spermatogenesis at 48 mg/day or 96 mg/day in rats.

Urinary follicle stimulating hormone can be used as a biomarker to assess male reproductive function

Aim: To develop an algorithm for use in population-based studies to assess testicular function by measurements of totalurinary follicle stimulating hormone (FSH). Methods: Total concentrations of urinary FSH were measured in a groupof 44 men at the University of California, Davis (UCD) and were compared to FSH measurements in serum. On thebasis of these and other published data, a urinary FSH value of >2 ng/mg creatinine (Cr) was selected as the cutoffpoint to identify men with elevated serum FSH ( > 12 IU/L) or low sperm counts ( < 20 million/mL). Results: Thesensitivity and specificity of this algorithm for detecting elevated serum FSH in a group of 58 agricultural workers in thePeople's Republic of China were 100 % and 50 %, respectively. The sensitivity and specificity of this algorithm fordetecting low sperm counts in a population of 105 infertility patients at UCD were 58 % and 76 %, respectively.Conclusion: This test may have particular value in identifying populations with no evidence of testicular toxicity, andin which labor-intensive semen studies may not be feasible.

Impact of chronological ageing on semen parameters in southern Indian men visiting infertility centre:A retrospective study

Objective:To investigate the association between age and semen parameters among male partners of subfertile couples.Methods:This retrospective study analyzed the semen of 1523 infertile men aged 26 to 50 years.Data were extracted from GarbhaGudi IVF Centre database from January 2019 to September 2020.The basic semen parameters were interpreted according to the WHO manual 2021,6th edition.Semen parameters in different age groups were compared.Results:Total and progressive motile sperms were significantly higher in the age group of 26-30 years compared to other age groups(P<0.05).Normal sperm count was significantly higher in the age group of 26-30 years compared to the age groups of 41-45 years and>46 years(P=0.001).However,sperm head defects,neck and midpiece defects,tail defects,and cytoplasmic droplets showed statistically insignificant difference in all the age groups(P>0.05).Semen viscosity showed no statistical difference in all the age groups compared to the reference age group of 26 to 30 years.Conclusions:Higher age can lead to a significant decrease in normal sperms and motility in subfertile men.Hence,male partner age should be considered as one of the major determining factors for reproductive outcomes.

Epidemiologic methods for investigating male fecundity

Fertility is a couple concept that has been measured since the beginning of demography, and male fecundity （his biological capacity to reproduce） is a component of the fertility rate. Unfortunately, we have no way of measuring the male component directly, although several indirect markers can be used. Population registers can be used to monitor the proportion of childless couples, couples who receive donor semen, trends in dizygotic twinning, and infertility diagnoses. Studies using time-to-pregnancy （TTP） may identify couple subfecundity, and TTP data will correlate with sperm quality and quantity as well as sexual activity and a number of other conditions. Having exposure data available for couples with a fecund female partner would make TTP studies of interest in identifying exposures that may affect male fecundity. Biological indicators such as sperm quality and quantity isolate the male component of fertility, and semen data therefore remain an important source of information for research. Unfortunately, often over half of those invited to provide a sperm sample will refuse, and the study is then subject to a selection that may introduce bias. Because the most important time windows for exposures that impair semen production could be early fetal life, puberty, and the time of ejaculation; longitudinal data over decades of time are required. The ongoing monitoring of semen quality and quantity should continue, and surveys monitoring fertility and waiting TTP should also be designed.

Differential Genotoxicity of the Crude Leaf Extract of a Medicinal Plant, Casearia tomentosa

The genotoxic potentiality of the crude leaf extract of Casearia tomentosa, a medicinal preparation, has been evaluated in Swiss albino mice. The extract significantly induced the division_disruptive chromosomal changes in bone marrow cells as well as in primary spermatocytes; the latter also exhibited marked increase in synaptic disruptions. A significant decrease in sperm count was noted. The incidence of structural damages in chromosomes, however, remained within the range of control level frequency. This herbal preparation, therefore, appears to be primarily spindle_poisoning in its action, but not clastogenic. The probable mechanism of this differential genotoxicity is discussed.

Comments on the release Laboratory Manual for the Human Semen of the 5th edition of the WHO Examination and Processing of

The authors of the World Health Organization Semen Analysis Manual are to be congratulated on producing a new edition; it is an essential tool to disseminate good practice in andrology. However, the tests described have poor prognostic power to predict a man＇s fertility and show little about the underlying causes of sub-fertility. This commentary urges a revival of research into the diagnosis of male fertility. It suggests that fertility should be regarded as a continuum and that the artificial binary division between fertile and infertile should be abandoned. Models to predict a sub-fertile couple＇s chance of conception in a year should be developed on the basis of prospective data. These models would allow for sophisticated decision making about management. The future lies in the identification of tests to detect underlying pathologies open to specific treatment. Leads such as oxidative stress, defects in the intracellular regulation and the developing field ofproteomics should be explored.

Effect of Wuziyanzong Pill on sperm quality and calcium ion content in oligoasthenospermia rats

OBJECTIVE： To study the effect of Wuziyanzong treatment on the sperm quality and content of cal- cium ions （Ca2＋） in oligoasthenospermia rats. METHODS： A model of oligoasthenospermia was induced in 50 Sprague Dawley rats by treatment with tripterygium glycosides at 30 mg/kg per day for 8 weeks. They were divided randomly into a model group, a positive group （Huangjingzanyu capsule, 3.01 g/kg）, and low, medium and high dose Wuziyanzong treatment groups （2.30, 4.60, 9.20 g/kg crude drug respectively） with 10 in each group. Another 10 rats were used as a control group. The rats in the control and model groups were administered distilled water, while the rats in the remaining groups were administered Wuziyan- zong for 30 d. The epididymides were removed, spermatozoa recovered and the sperm density and viability were measured. The spermatozoa were pu- rified and the contents of Ca2~ in the cytoplasm and mitochondria were detected by flow cytometry and atomic absorption spectrometry, respectively. RESULTS： After 8 weeks of treatment with tripteryg- ium glycosides, the sperm density, sperm activity and the Ca2~ content of spermatozoa in the model rats were all significantly decreased compared with the control group （all P〈O.05）. After 30 d treatment, the sperm density and activity improved and the Ca2＋ content of sperm were increased significantly in the medium and high dose Wuziyanzong treat- ment groups in comparison with the model group （all P〈O.05）. CONCLUSION： The Wuziyanzong treatment in： creased sperm density, improved sperm viability and enhanced the content of Ca2＋ in the sperm cy- toplasm and mitochondria in this rat model of oli- goasthenospermia.

FSH dosage effect on conventional sperm parameters:a meta-analysis of randomized controlled studies

Follicle-stimulating hormone(FSH)represents a therapeutic option in normogonadotropic patients with idiopathic oligozoospermia.The aim of this review was to evaluate the possible dose-and drug-dependent efficacy of FSH treatment on conventional sperm parameters.We performed a comprehensive systematic review via a meta-analysis of all available randomized controlled trials,in which FSH administration was compared with placebo or no treatment when administered to normogonadotropic patients with idiopathic oligozoospermia.Of the 971 articles that were retrieved,5 were fin ally included,in eluding a total of 372 patie nts and 294 controls.Overall,FSH treatment was effective in ameliorating the sperm concentration,total count,progressive motility,but not normal forms.On the basis of the weekly dosage,the studies were classified into those using low(175-262.5 IU per week),intermediate(350-525 IU per week),and high(700-1050 IU per week)doses.At low doses,FSH improved only sperm motility.At intermediate doses,FSH ameliorated sperm concentration and morphology.Total sperm count and progressive motility showed a trend toward the increase.At high doses,FSH increased sperm concentration,total sperm count,and progressive motility.Sperm morphology showed a trend toward the increase.Finally,both highly purified FSH(hpFSH)and recombinant human FSH(rhFSH)improved sperm concentration,total sperm count,progressive motility,but not morphology.No different efficacy was observed between these two preparations.This meta-analysis provides evidence in favor of high FSH doses.The FSH efficacy was not related to the preparation type(recombinant vs highly purified).Further studies are needed to evaluate the effectiveness of Iong-standing treatment regimes.

Sperm banking before gonadotoxic treatment:is it worth the effort?

We aimed to compare the sperm quality in different cancer types and benign diseases before gonadotoxic treatment,and assess the usage rate of cryopreserved sperm for assisted reproductive treatment(ART).This retrospective study was conducted at two university clinics between January 2008 and July 2018.A total of 545 patients suffering from cancer or benign diseases were included in the study.The pretreatment sperm analyses were based on the World Health Organization(WHO)guidelines.Patients with testicular malignancy(TM)showed a significantly lower sperm count(median[interquartile range]:18.7×10^(6)[5.3×10^(6)-43.0×10^(6)]ml^(-1);P=0.03)as well as total sperm count(42.4×10^(6)[13.3×10^(6)-108.5×10^(6)]per ejaculate;P=0.007)compared to other malignant and benign diseases.In addition,patients with nonseminomatous TM showed the lowest sperm count(14.3×10^(6)[6.0×10^(6)-29.9×10^(6)]ml^(-1),vs seminomas:16.5 x 106[4.6×10^(6)-20.3×10^(6)]ml^(-1);P=0.001).With reference to the WHO 2010 guidelines,approximately 48.0%of the patients with TM and 23.0%with hematological malignancies(HM)had oligozoospermia.During the observation period,only 29 patients(5.3%)used their frozen sperms for 48 ART cycles,resulting in 15 clinical pregnancies and 10 live births.The sperm quality varies with the type of underlying disease,with TM and HM patients showing the lowest sperm counts.Due to the observed low usage rate of cryopreserved sperm,further patient interviews and sperm analyses should be included in the routine oncologic protocols to avoid unnecessary storage expenses.However,sperm banking is worth the effort as it provides hope for men who cannot reproduce naturally after gonadotoxic treatment.

Evaluation on sperm parameters of ejaculates with hyperspermia

Objective To investigate sperm parameters of ejaculates with hyperspermia.Methods One hundred and thirty-three ejaculates with hyperspermia （semen volume 〉6 ml） were divided into three groups： group A, n=66, semen volume 6.0-6.9 ml; group B, n=63, semen volume 〉7.0 ml, group C, n=4, semen volume 〉6.0 ml, no sperm in the ejaculates. Sperm motility, count, and morphology were determined according to the World Health Organization Laboratory Manual （2010）.Results Of the 133 ejaculates studied, the largest volume was 10.8 ml. Most samples with hyperspermia had normal conventional sperm parameters. No differences were found on sperm motility and abnormal morphology rate between groups A and B （P〉 0. 05）. In addition, no differences were also found on incidences of low motility, low sperm count, high abnormal morphology, and white blood cell （WBC） positivity between groups A and B （P〉0. 05）. However, sperm count in group B was significantly lower than that in group A （P〈0.05）. Ejaculates in group C had no WBC positivity. Conclusion Hyperspermia could have multiple forms for sperm parameters including good or poor status. Increasing seminal volume could not influence sperm parameters except for sperm count.

Anti-spermatogenic Effects of Ethanol Extract of Mucuna Urens

Objective To investigate the age-long claim by the locales that the food thickener, M. urens seed, has antispermatogenic, hence, antifertility effects in man. Methods Eight-week old male Albino rats were used as the mammalian model for this study. They were assigned to four groups of 6 rats each and treatment with the ethanol extract was for a period of 14 d. The treatment regimes were 70 mg/kg, 140 mg/kg, 210 mg/kg and 0 mg/kg BW in groups A, B, C and D, respectively. Extracts were prepared by Soxhlet extraction using 80% ethanol as the extracting solvent. The stock solution was prepared by dissolving 1 g of the paste extract in 10 ml corn oil （vehicle） to make up 100 mg/ml concentration. At the end of the treatment, sperm from the distal caudal epididymis was collected and analyzed for sperm count, sperm motility and sperm morphology. Results Significant reduction was observed in sperm count and sperm motility （P〈0.05）. The mean sperm count for group A was 6.27±0.02×10^6, for group B was 6.16±0.02×10^6 and group C had 6.0±0.0×10^6 sperm cells The control （group D） had a mean sperm count of 6.50±0.09×10^6 which was higher than that of any treated group. Results of the sperm motility test gave the following mean rates for motile sperm cells after treatment： group A, 57.6±% 2.1; group B, 50.0±4.0; group C, 45.0±4.0. The control had the highest mean motility rate of 72.3±2.1. The observed sperm abnormalities included unusual head with large acrosome, looped tailpiece, mid piece with distal droplet, pin head, pyriform head and long hook.Conclusion The anti-spermatogenic effects of the extract on the sperm in the Albino rat may lead to reduction of fertility.

Is There A Close Relation between Sperm Count and Ejaculation Volume?

Objective To evaluate the relation between sperm count and ejaculatory volume. Methods Semen samples from 1 364 men were collected and ejaculate volume and sperm count were performed. Results A low correlation （11.6%） was found but statistically significant （P 〈O.O00 1） and a trend was observed to decrease in the linear regression analysis. In addition, the ejaculate volume was lower in the group with higher sperm count. Conclusion Sperm cells are diluted in the ejaculate volume, for this reason the ejaculates with more volume present less sperm count.

Study Finds Lower Sperm Count in Country Than City

本文标题里的 Sperm count,是“精子数”的意思。男性精液中的精子数量历来是医学界重视的一个问题。曾经有消息说,上个世纪的100年中,男性的 sperm count约减少了20％,而本文报道的最新研究表明,美国的若干乡村地区男性的 sperm count比城市男性要少！ 于是,就有了以下种种猜测: l/a man’s sperm count is affected by where he lives and the kind of things he is exposed to. 2/agricultural chemicals may be to blame 3/in some animal species that are crowded,the dominant males become more fertile(能繁殖的).

Semen parameters in men recovered from COVID-19

The novel coronavirus disease(COVID-19)pandemic is emerging as a global health threat and shows a higher risk for men than women.Thus far,the studies on andrological consequences of COVID-19 are limited.To ascertain the consequences of COVID-19 on sperm parameters after recovery,we recruited 41 reproductive-aged male patients who had recovered from COVID-19,and analyzed their semen parameters and serum sex hormones at a median time of 56 days after hospital discharge.For longitudinal analysis,a second sampling was obtained from 22 of the 41 patients after a median time interval of 29 days from first sampling.Compared with controls who had not suffered from COVID-19,the total sperm count,sperm concentration,and percentages of motile and progressively motile spermatozoa in the patients were significantly lower at first sampling,while sperm vitality and morphology were not affected.The total sperm count,sperm concentration,and number of motile spermatozoa per ejaculate were significantly increased and the percentage of morphologically abnormal sperm was reduced at the second sampling compared with those at first in the 22 patients examined.Though there were higher prolactin and lower progesterone levels in patients at first sampling than those in controls,no significant alterations were detected for any sex hormones examined over time following COVID-19 recovery in the 22 patients.Although it should be interpreted carefully,these findings indicate an adverse but potentially reversible consequence of COVID-19 on sperm quality.