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Query: UMLS:C0021359 (infertility)
 26,075 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diabetes which occurs spontaneously in the BB Wistar rat is associated with reduced fertility, predominantly in breeding males. In the first month of diabetes, there is a significant (p less than 0.05) reduction in serum testosterone associated with a transient decrease of serum LH and the accumulation of lipid in Leydig cells. Between one and three months of diabetes, there is an increase in both serum testosterone and LH and a further deposition of lipid droplets in Leydig cells. From three to six months of diabetes, there is a reduction of serum testosterone similar to age-matched controls, but high serum LH levels persist. Similar levels of LH and testosterone are noted after six months of diabetes, and all BB rats show marked changes in seminiferous tubules. These morphological changes in tubules consist of increased tubular wall thickness, severe germ-cell depletion, and Sertoli-cell vacuolization. Similar morphological changes of testes associated with generalized atrophy are noted in all control rats after 16 months of age. Decreased fertility in the BB rat appears to be associated with a primary disorder of Leydig cells, which precedes changes in seminiferous tubules consistent with accelerated aging. Preliminary data in impotent diabetic men suggest that the BB rat may be a valuable model for investigating human diabetic impotence and infertility.
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PMID:Gonadal dysfunction in the spontaneously diabetic BB rat. 686 64

The psychologic aspects of infertility in men and women are reviewed, neuroendocrinologic factors thought to affect reproduction physiologically are described, and awareness of the stresses that infertility places on a couple's relationship is encouraged. Studies have found infertile women to be more neurotic, dependent, and anxious than fertile women, experiencing conflict over their femininity and fear associated with reproduction. In contrast to these reports, a double blind study could not determine the difference in the psychologic makeup of women who were infertile because of demonstrated somatic causes and those women in whom no somatic cause could be found and who were considered infertile on an emotional etiologic basis. Other studies have similarly come to negative conclusions regarding the relationship between psychologic factors and infertility. The 1st set of studies failed to consider the stress that infertility itself places on the couple. Emotional factors may negatively affect fertility in the male. Up to 10% of infertile males have had improvement in their semen analysis after cessation of all treatment for a prolonged period of time. The concept that emotional stress might lead to oligospermia was further supported in a report describing testicular biopsies obtained from men awaiting sentencing after raping and impregnating women. A more obvious effect of the emotional stress infertility places on the male is the occurrence of impotence. It has been estimated that up to 10% of infertilty may be partially or completely explained on the basis of male sexual dysfunction. The gradual unraveling of the complexities of neuroendocrinology have permitted increased understanding of the role that stress might play in infertility. Catecholamines, prolactin, adrenal steroids, endorphins, and serotonin all affect ovulation and in turn are all affected by stress. Such stress might result from infertility or habitual abortion. Infertility is frequently perceived by the couple as an enormous emotional strain, and counseling may prove helpful as a part of the initial infertility evaluation, an adjunctive measure during treatment, or a final measure to help patients cope with acceptance of their infertility problem. Although statistical evidence is overwhelmingly against the relationship of adoption and subsequent conception, it does appear that a small percentage of patients do achieve pregnancy following adoption. Possibly this can be explained by a reduction in stress, and subsequently, alterations in the neuroendocrinologic characteristics of the infertile couple.
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PMID:Emotional aspects of infertility. 703 62

The reproductive system is considered to be particularly vulnerable to the effects of drugs. Hypothalamic neurotransmitters are sensitive to drugs that alter their synthesis, release, or action; disruption of these pathways changes the levels or patterns of secretion of the pituitary gonadotropins. Drugs also exert direct action on the gonadal functions of androgen production and spermatogenesis. Drugs that decrease testosterone levels produce a multitude of effects on male reproduction. Neuropharmacologic agents that either inhibit central nervous system (CNS) activities (e.g., analgesics, anesthetics, sedatives, tranquilizers) or stimulate CNS activities (e.g., antidepressants, stimulants, hallucinogens) modify the hypothalamic-pituitary control of the gonadotropins and prolactin. The changes in luteinizing hormone, follicle-stimulating hormone, and prolactin result in changes in libido, impotence, inability to ejaculate, testicular swelling, and gynecomastia. Narcotic drugs exert their primary effect on the hypothalamic-pituitary axis and their secondary effects on the gonads and sex accessory organs. Narcotics decrease gonadotropin secretion and stimulate prolactin secretion, both of which are inhibitory to male sexual function. With marijuana, the primary drug effect is at the level of the hypothalamus, with subsequent effects on gonadotropins and testosterone. Additional studies are needed on the association of marijuana with disruption of reproduction to resolve conflicing findings. The drugs most likely to affect suxual function are those that act on the sympathetic and parasympathetic systems. Antihypertensive drugs are likely to interfere with autonomic transmission, resulting in impotence or failure of ejaculation. However, it is difficult to determine whether this increased incidence of impotence is entirely a drug side effect of a complication of blood pressure changes. Chemotherapeutic agents, especially anticancer drugs, can cause prolonged but reversible infertility. Other drugs, including marijuana derivatives, phencyclidine, and alcohol, are believed to inhibit testosterone synthesis.
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PMID:Drug effects on male sexual function. 712 28

The prevalence of hypogonadism, sexual dysfunction and abnormalities of semen quality was determined in 28 consecutive males with coeliac disease. These observations were related to jejunal morphology and nutritional status, and were compared with findings in 19 men with Crohn's disease of similar age and nutritional status. Two of the 28 coeliacs (7%) had clinical evidence of hypogonadism but impotence and decreased sexual activity occurred more commonly, the latter apparently improving after gluten withdrawal. Of the married coeliacs, 19% had infertile marriages, a value greater than expected in the general population. Hypogonadism and sexual dysfunction were not detected in our patients with Crohn's disease. Seminal analysis in coeliacs revealed marked abnormalities of sperm morphology and motility, but only the former appeared to improve after gluten withdrawal. Similar abnormalities, however, were also detected in patients with Crohn's disease, although, unlike the coeliacs, 46% also had reduced concentrations of spermatozoa. Semen quality in coeliac disease could not be clearly related to general or specific (serum vitamin B(12) and red cell folate) nutritional deficiencies or to fertility, although sperm motility was markedly reduced in two of the three coeliacs with infertile marriages. The presence of antisperm antibodies did not appear to be an important aetiological factor in male infertility in coeliac disease. The pathogenesis of infertility and sexual dysfunction in coeliac disease remains unclear, suggesting that factors such as endocrine dysfunction or other specific nutritional deficiency may be involved.
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PMID:Male gonadal function in coeliac disease: 1. Sexual dysfunction, infertility, and semen quality. 720 Sep 31

Forty-seven men (median age, 31.5 years) were studied prospectively to assess the effect of Hodgkin's disease and subsequent chemotherapy on gonadal function. Before therapy, 16 (43%) of 37 men were functionally subfertile, as assessed by impotence (four of 37) and "inadequate" sperm counts (12 of 37). Histological abnormalities were noted in eight of nine pretreatment testicular biopsy specimens. Additionally, changes were noted in blood hormone levels and libido. After completion of only two cycles of chemotherapy, 14 of 14 men became persistently azoospermic, with blood follicle-stimulating hormone levels four to five times normal. Posttreatment testicular biopsy specimens confirmed germ cell aplasia. During therapy 17 (81%) of 21 men had mild or no libido; irritability in 16 (84%) of 19 and violence in four (18%) of 22 caused additional family distress. While it is clear that cytotoxic therapy induces infertility, these data further indicate that a proportion of men have gonadal dysfunction prior to treatment.
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PMID:Male gonadal dysfunction in Hodgkin's disease. A prospective study. 720 31

Hyperprolactinemia associated with male infertility or impotence was found in ten patients. Mean prolactin level was 83 +/- 49 ng/ml (range 46-26- ng/ml). The etiological bases of the hyperprolactinemia were a microadenoma in one patient, liver disease in two, and idiopathic in seven patients. Bromocriptine treatment, 2.5-7.5 mg daily for 8-16 weeks lowered prolactin to normal levels in all patients. Three oligoasthenospermic subjects showed a marked increase in sperm motility; their wives conceived within 5-8 weeks of treatment after longstanding infertility. Two of these women gave birth to normal babies and one aborted in the first trimester of pregnancy. The mechanism by which hyperprolactinemia interferes with sperm production and the effect of bromocriptine on this mechanism is discussed.
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PMID:Effect of bromocriptine treatment on male infertility associated with hyperprolactinemia. 724 77

Surgical repair of a membranous urethral stricture is difficult because of the location and potential risks of incontinence, impotence and infertility. The treatment of 2 such strictures by the Badenoch pull-through urethroplasty is presented. The technique is described and its apparent advantages over other methods of repair are discussed.
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PMID:Urethral strictures secondary to pelvic injury in children. 735 28

Diminished libido, impotence and infertility have been detected in 5 of 6 men with adreno-leukodystrophy, a universally fatal disease. The importance of the clinical recognition of these patients and their separation from others with relatively innocuous causes of testicular dysfunction are discussed.
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PMID:A fatal cause of sexual inadequacy in men: adreno-leukodystrophy. 745 75

There is now substantial evidence that coeliac sprue is associated with infertility both in men and women. In women it can also lead to delayed menarche, amenorrhoea, early menopause, recurrent abortions, and a reduced pregnancy rate. In men it can cause hypogonadism, immature secondary sex characteristics and reduce semen quality. The real mechanism by which coeliac sprue produces these changes is unclear, but factors such as malnutrition, iron, folate and zinc deficiencies have all been implicated. In addition in men gonadal dysfunction is believed to be due to reduced conversion of testosterone to dihydrotestosterone caused by low levels of 5 alpha-reductase in coeliac sprue. This leads to derangement of the hypothalamic-pituitary axis. Hyperprolactinaemia is seen in 25% of coeliac patients, which causes impotence and loss of libido. Gluten withdrawal and correction of deficient dietary elements can lead to a return of fertility both in men and women.
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PMID:Infertility, obstetric and gynaecological problems in coeliac sprue. 798 65

The nucleotide sequence of the cDNA encoding a sperm protein (rSMP-B) was determined in a previous study. Two peptide segments corresponding to the extracellular domain of the deduced sperm polypeptide were synthesized as multiple antigen peptide (MAP) and designated as rSMP-229 and rSMP-230. Polyclonal antibodies were raised against the two MAPs. Sera obtained from rabbits immunized with rSMP-230 interacted with human and rabbit sperm membrane proteins with estimated molecular sizes of 72 and 20.1 kD, respectively. Adult female and male rats were immunized with the MAPs and their fertilities determined. Immunization of female rats with rSMP-229 and rSMP-230 induced infertility in 25% and 83% of the treated animals, respectively. All male rats immunized with rSMP-229 remained fertile; whereas animals immunized with rSMP-230 did not mate with normal cycling female rats. Three impotent male rats were found to regain their mating potency 45 days after the last booster injection. These findings demonstrated that immunization with rSMP-230 induced a reversible impotency in male rats. Serum testosterone and LH levels were reduced in rSMP-230-immunized male rats and were elevated in rSMP-229-immunized animals. Histopathological examination of sections of testes from male rats immunized with rSMP-230 showed impairment of spermatogenesis and sloughing of germ cells into the lumen of the seminiferous tubules. The testes of male rats immunized with rSMP-229 showed normal morphology and active spermatogenesis with scattered foci of nodular hyperplasia of Leydig cells in the interstitial areas. In conclusion, immunization with synthetic peptide segments corresponding to different domains of a deduced sperm protein induced infertility in a significant number of female rats and transient impotency in male rats.
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PMID:Immunization with synthetic peptide segments of a sperm protein impair fertility in rats. 804 7


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