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

Direct intraperitoneal insemination (DIPI) is one of the least invasive strategies of assisted reproduction. Unexplained infertility and male sub-fertility are the major indications for DIPI. It is otherwise well known that assisted procreation gives poor results in severe male infertility. This is a report of a pregnancy that occurred as a result of a direct intraperitoneal insemination of prepared spermatozoa characterized by a particularly severe astheno-teratozoospermia in a couple unsuccessfully treated with other, more invasive methods of assisted fertilization.
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PMID:Pregnancy after direct intraperitoneal insemination of spermatozoa from a man with severe infertility, after unsuccessful application of other methods of assisted fertilization. 232 66

Since relatively few spermatozoa are needed for oocyte fertilization during gamete intra-Fallopian transfer (GIFT) or in-vitro fertilization (IVF), these methods have been applied in couples with infertility due to male causes. Forty-six couples with male factor infertility were enrolled in this study and results were compared with those attained in 48 couples treated with the same techniques for other than male causes. Overall, GIFT resulted in 26% ongoing pregnancies. GIFT seems to be particularly successful when the sperm concentration is 20 x 10(6)/ml or more, but sperm motility and/or morphology are poor. Nine pregnancies occurred out of 26 GIFT cycles in 18 cases selected on this basis. The ongoing pregnancy rate after IVF was 16% per patient. The latter treatment should be attempted in male immune infertility and in cases with a low sperm concentration, with or without abnormal sperm motility and/or morphology. In these circumstances, five pregnancies were attained out of 28 cycles in 14 cases. For similar sperm concentrations, the conception rate per cycle attained with techniques of assisted reproduction was more than twice that attained with conventional treatment of male infertility.
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PMID:Possibilities and limitations of techniques of assisted reproduction for the treatment of male infertility. 239 85

Eighty-two men underwent spermatic vein ligation as treatment for infertility. The resultant mean rates of 22% for semen improvement and 28% for pregnancy justify the surgical approach in selected cases of male infertility.
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PMID:Spermatic vein ligation as treatment for male infertility. Justification by postoperative semen improvement and pregnancy rates. 240 37

Semen samples from 179 infertility patients were analyzed for type and number of white blood cells (WBC) by a combination of immunologic techniques. Forty-one (23%) had more than 10(6) WBC/mL semen (leukocytospermia). Semen parameters in patients with less than 10(6) WBC/mL were similar to those of 15 fertile donors. In contrast, the leukocytospermic group had significant reductions in total sperm number, percent sperm motility, sperm velocity, motility index, and total number of motile sperm. Patients with high concentrations of monocytes/macrophages (greater than 5 X 10(5)/mL; n = 27) had significantly reduced ejaculate volume; patients with high numbers of T lymphocytes (greater than 10(5)/mL; n = 19) had a significant reduction in sperm velocity; and patients with high levels of granulocyte elastase in semen (greater than 1,000 ng/mL; n = 26) had significant reductions in ejaculate volume, total sperm number, and total motile sperm number. There was no correlation between the presence of antisperm antibodies and leukocytospermia. Our data suggest that leukocytospermia may occur frequently in male infertility patients and show that elevated levels of WBC in semen are associated with poor semen quality. This provides further rationale for white blood cell testing in semen of male infertility patients, since antibiotic or anti-inflammatory therapy may be helpful in appropriately selected cases.
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PMID:Leukocytospermia is associated with poor semen quality. 240 66

Diamine oxidase (DAO: EC 1.4.3.6) activity was measured for seminal plasma of patients complaining of infertility to investigate whether measurement of DAO activity in seminal plasma is a significant laboratory examination or not for evaluation of male infertility. (1) DAO activity showed a slight decrease with increasing sperm density, but there was no significant correlation between DAO activity and sperm density. (2) DAO activity was higher in samples with sperm motility below 20%. There was a significant negative correlation between DAO activity and sperm motility. (3) DAO activity was higher in samples with motile sperm count below 10 x 10/ml. In conclusion, the simple spectrophotometric assays for DAO could form the base of a routine examination of male infertility.
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PMID:[Studies on diamine oxidase (DAO) activity in seminal plasma]. 250 50

Pulsatile administration of LHRH can drive the pituitary to secrete LH and FSH in a pattern that closely mimics the physiological pattern of the hypothalamic-pituitary-gonadal axis. As there is evidence that infertility in some men is due to dysfunction of this axis, 14 men with reported infertility of more than 2 years duration were treated by long-term pulsatile LHRH therapy. They were 24-42 years of age, with variable degrees of oligozoospermia, elevated FSH levels but normal LH and testosterone levels. The number of endogenous LH pulses/24 h was less than eight in all 14 subjects. The degree of testicular damage was assessed semi-thin sections prepared from biopsies of both testes. Scores for spermatogonia per seminiferous tubule (SPT) were calculated from the actual number of Ad-spermatogonia/tubule. Patients were grouped according to sperm density and SPT score (groups I-III). Pulsatile LHRH therapy was administered by means of a portable infusion pump; 4 micrograms LHRH were administered subcutaneously every 120 min for a period of 6 months. This treatment restored the normal pattern of LH secretion to 12 LH pulses/24 h in all patients. A statistically significant decrease of mean FSH levels to normal, and an increase of mean LH levels was observed in most of the 14 patients. Testosterone values did not change in any group. Marked improvement of the sperm count was observed in eight out of 14 patients (groups I and II) and three pregnancies were reported during the treatment periods. These results suggest that some states of male infertility are due to hormonal dysregulation and that these patients may benefit from pulsatile LHRH therapy.
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PMID:Pulsatile LHRH therapy in patients with oligozoospermia and disturbed LH pulsatility. 250 77

The aim of this study was to examine the hypothesis that decreased LHRH pulse frequency may be responsible for the preferential rise in FSH in infertile men. The LH pulse pattern was determined as an index of hypothalamic LHRH secretion in 21 infertile patients with idiopathic azoospermia or oligoasthenozoospermia and 14 fertile age-matched controls by frequent blood sampling at 10-min intervals for 24 h. The infertile patients were further divided into three groups according to their relative concentrations of FSH and LH: (1) normal FSH and LH, (2) raised FSH but normal LH, and (3) raised FSH and LH. LH pulses were detected by a computerized algorithm (Munro) validated against a threshold method. Concentrations of FSH, testosterone, sex hormone-binding globulin and oestradiol were measured in pooled plasma. Luteinizing hormone pulse frequencies in normal men were not significantly different from the infertile group as a whole. Similarly, mean LH pulse frequencies in infertile subgroups 1, 2 and 3 were not significantly lower than normal. Pulse interval, however, was increased in subgroup 1 compared with normal. Mean 24 h LH in group 2 was significantly higher than normal, but still within the normal range. The total testosterone, but not the free testosterone index was significantly decreased in the infertile group compared with normal. There was no correlation between mean FSH and LH pulse frequency or interval. In conclusion, our results show that in patients with seminiferous tubular dysfunction, the typical pattern of raised plasma FSH, increased LH pulse amplitude, raised FSH: LH ratio and normal or marginally low testosterone was not associated with any significant deviations in LHRH pulse frequency from the range observed in normal fertile men. This is not compatible with the hypothesis that decreased LHRH pulse frequency is associated with or the cause of the preferential rise in FSH in men with idiopathic infertility. Thus unlike anovulatory infertility in females, functional defects of hypothalamic LHRH secretion remain an uncommon finding in male infertility. Attempts to treat idiopathic oligozoospermia by altering LHRH pulse frequency is therefore unlikely to yield any clinical benefit.
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PMID:LHRH pulse frequency in normal and infertile men. 250 19

It has been demonstrated that the semen of infertile patients contains at high percentage of abnormal forms and no clear answer has been so far provided to the questions of which malformations are compatible with male fertility, which malformations are responsible for the infertility and which is the percentage of defective cells that gives rise to infertility. In this study the eiaculates of 56 patients of suspected male infertility were used as material. The semen samples were fixed for 2 hr at room temperature in 4% glutaraldehyde in 0.05 M cacodilate buffer + 0.018% CaCl2 + 6.6% sucrose, post-fixed in 1.5% OsO4 in same buffer + 6.6% sucrose, dehydrated and embedded in Spurr. The samples were sectioned with Reichert OMu3 ultratome. The sections, contrasted with uranyl acetate and lead citrate, were examined in a Feol M T8 E.M. The varieties of sperm malformations are described and classificated into morphological categories based upon the type of alteration and the cellular portion in which the malformation appeared. From this research we have got the following conclusions: 1) an absolute correlation between microscopical, ultrastructural defects and functionality of spermatozoa does not exists; 2) the submicroscopic analysis contributes to a more accurate definition of the eiaculate; 3) the high variability of the ultrastructural defects needs that the submicroscopical analysis of the human semen must be supplemented by a quantitative evaluation.
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PMID:[Ultrastructural analysis of human ejaculate from infertile subjects]. 252 66

A male patient suffering from ulcerative colitis, presented with primary infertility due to sulphasalazine therapy. Sulphasalazine was discontinued and the patient was treated with a 5-aminosalicylic acid preparation (Salofalk) in the form of an enema. After 3 months, the semen quality was dramatically improved and a successful pregnancy ensued. The sulphapyridine moiety of sulphasalazine seems to be responsible for male infertility and depressed semen quality. The metabolite 5-aminosalicylic acid is proposed as a suitable alternative to sulphasalazine in cases of male infertility.
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PMID:Sulphasalazine-induced reversible male infertility. 256 74

Sperm chromatin heterogeneity has been evaluated in infertile males affected by different testicular diseases: 37 subjects had undergone orchidopexy in childhood (ex-cryptorchid), 50 were affected by idiopathic varicocele, 18 had a history of bilateral post-parotitis orchitis and 23 were "idiopathic infertiles". All subjects, except post-parotitis orchitic patients, exhibited significantly higher sperm chromatin heterogeneity than controls, with the highest incidence in ex-cryptorchid and in idiopathic infertiles. Ex-cryptorchid subjects also presented a significant positive linear correlation (p less than 0.001) between degree of sperm chromatin abnormality and percentage of morphological sperm alterations. Four monolateral ex-cryptorchid subjects showed a higher percentage of chromatin heterogeneity even when the cryptorchid testis had been removed during orchidopexy. In patients affected by varicocele, we also observed a significant correlation between chronological age and percentage of chromatin alterations. The results are discussed in relation to the pathogenesis of the disease concerned. Since sperm chromatin heterogeneity appears to be strongly involved in the development of infertility, we would suggest that it should be evaluated in routine diagnostic procedures of male infertility.
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PMID:Sperm nuclear chromatin heterogeneity in infertile subjects. 257 13


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