Leptin levels in infertile males

To determine the leptin levels in the serum of normal, subfertile and infertile men. Analytical study. Department of Animal Sciences Quaid-e-Azam University, Islamabad, National Institute of Health [NIH], Islamabad and Dr. Salma and Kafeel Medical Centre, Islamabad, from April to December 2009. Serum leptin levels hormonal concentrations [LH, FSH and testosterone] were determined by EIA in 154 males including 24 [15.58%] fertile, 19 [12.34%] polyzoospermic [PZs], 26 [16.88%] teratozoospermic [TZs], 27 [17.53%] astheno-teratozoospermic [ATZs], 18 [11.69%] oligozoospermic [OZs], 18 [11.69%] oligo-astheno-teratozoospermic [OATZs], 11 [7.14%] obstructive azoospermic [OBST-AZOOs] and 11 [7.14%] non-obstructive azoospermic [NON-OBST- AZOOs]. BMI was also determined, divided into groups of greater than 24. Hormonal concentrations were compared by ANOVA and correlation was performed by using Graph pad prism version 5. Significantly high levels of leptin concentrations were found in fertile [p < 0.001] as well as TZs, PZs, OZs, ATZs,[p < 0.001], OATZs [p < 0.01] and NON-OBST-AZOOs [p < 0.05] male subjects with BMI > 24 compared to fertile and infertile male patients with BMI < 24. Serum testosterone concentrations were significantly lower in PZs, OATZs, OZs, NON-OBST-AZOOs male patients with BMI < 24 compared to PZs [p < 0.05], OATZs, OZs [p < 0.01], OBST-AZOOs [p < 0.001] male patients with BMI > 24. Leptin showed a significant positive correlation with LH [p < 0.01] and FSH [p < 0.002] and a significant negative correlation with testosterone [p < 0.001]. Abnormal leptin level was significantly associated with fertility problems in males. Providing a link between leptin and reproduction factors contributing in control of testosterone and gonadotropins secretion in many aspects depending on fertility status in male subjects. BMI appears to have significant association with serum leptin levels

Ejaculatory duct obstruction in the infertile male: experience of 7 cases at Ramathibodi Hospital.

OBJECTIVE: To study the clinical presentations, management, outcomes as well as pregnancy rate of ejaculatory duct obstruction treated at the Division of Urology, Ramathibodi Hospital. MATERIAL AND METHOD: This retrospective study was done from 1980 to 1999 and information from the medical records of the patients of ejaculatory duct obstruction was obtained. Phone and mail were used for long-term follow-up. RESULTS: Seven male patients with ejaculatory duct obstruction were identified. The age ranged from 32-45 years old (mean 34.5). All of the patients had azoospermia without other symptoms related to ejaculatory duct obstruction such as painful ejaculation, perineal or testicular pain. Normal testicles and secondary sex characteristics were noted in all. Seventy-one per cent had normal hormonal profiles and twenty-nine per cent had a slight increase of FSH, LH but not more than one fold of normal range. Vasography was used as the diagnosis tool in all of the cases and 71 per cent of seminal vesicles were >1.5 cm in diameter and all the rest were 1 cm in diameter. Transurethral resection of ejaculatory duct (TURED) was done in 6 cases and transurethral incision of ejaculatory duct (TUIED) was done in 1 case. Semen analysis was done in the third month after operation and 4 of 7 (57%) showed improvement of semen analysis but another 3 cases (43%) still had azoospermia. Six months after operation 6 of 7 (86%) showed improvement of semen analysis. Up to one year, 6 of 7 (86%) have normal semen analysis and another one still had azoospermia. In the long-term follow-up, 4 of 7 (57%) were able to impregnate their wives. CONCLUSIONS: Ejaculatory duct obstruction is a treatable cause of male infertility. In an infertile male with oligospermia or azoospermia with low ejaculate volume, normal secondary sex characteristics, testes and normal hormonal profiles, ejaculatory duct obstruction is suggested. Transrectal ultrasonography (TRUS) and/or vasography can be done to confirm the dilatation of seminal vesicles and obstruction of the ejaculatory duct. Transurethral resection of the ejaculatory duct (TURED) has resulted in marked improvement in semen parameters, and pregnancies have been achieved.

Chemical pathology of infertile Pakistan men

Serum of azoospermic [n=59] and oligospermic [n=161] men was analysed for its chemical pathology to observe the relation between the infertile state and the blood chemistry profile. Our study indicates that infertility does not affect other physiological parameters, as demonstrated by the results of the chemical pathology of these patients

Inter-relationship of zinc levels in serum and semen in oligospermic infertile patients and fertile males.

Infertility is a problem affecting 10-12% of couples. Zinc is necessary for growth, sexual maturation and reproduction. Semen analysis is helpful in ascertaining the evidence of spermatogenesis, sperm transport, sperm quantity and quality and also provides clue to the functioning of the accessory glands i.e. seminal vesicles and prostate. The present study was conducted in 50 oligospermic infertile males and control group consisting of 25 normospermic known fertile males. Semen and Serum samples were obtained from each case in study as well as control group. Semen and serum were processed by wet ash method. The seminal and serum zinc levels of each case in study and control group were estimated. Statistically, serum zinc and semen zinc levels were significantly lower in infertile patients than fertile males. A significant correlation was observed between serum and semen zinc levels in study group.

Effect of Y virilin on male infertility.

A prospective placebo controlled double blind study was conducted in patients attending male infertility clinics of our hospital to evaluate effects of a herbal formulation for male infertility--'Y-virilin'. In phase 1 forty patients with oligospermia with or without asthenospermia were randomly allocated to 2 treatment groups--Treatment Group A i.e. formulation under test and treatment Group B (Placebo). Therapy with these agents was given twice a day for 6 months. In phase 2, 12 patients with azospermia were administered either 'Y virilin' or the placebo (n = 6/Gp). In all patients along with semen analysis (sperm count, percentage of motile sperms and grade of motility) was done monthly for 6 months. Serum FSH levels were estimated before and at the end of therapy. A significant increase in sperm count was observed from 2-3 months in oligospermics receiving Y virilin as compared to basal values (p < 0.05). In Group B the follow-up sperm counts were either comparable to basal values or were lesser. However, the percentage and grade of motility did not differ in two groups at the end of respective treatment. No change was found in mean FSH value. During the therapy period incidence of conception was 20% in treatment Group A and 5% in Group B. Of the azospermic receiving 'Y-virilin' 50% showed a count of 10-20 millions/cmm while none from the placebo group. This study highlights the therapeutic potential of the tested formulation in the patients with infertility.

Plasma LH and FSH levels in azoospermia and in normal male and female human subjects.

Immunoassay of human plasma LH and FSH level was carried out in the Institute of Nuclear Medicine, Bangladesh. Apparently normal male and female volunteers and subjects having primary sterility were studied. Plasma LH and FSH levels of normal males ranged from 1.9 to 20.48 (mean 7.3) and 1.17 to 6.75 (mean 3.30) m IU/ml respectively. Corresponding values for females were 0.99 to 38.92 (mean 17.94). Level of LH and FSH in azoospermic males were found higher than normal ones with the mean value of 17.0 and 5.67 m IU/ml respectively. The study gives an impression about the plasma LH and FSH levels in azoospermia and normal population in Bangladesh.

Serum and semen levels of immunoreactive prolactin, LH and FSH in normospermic, oligospermic and azoospermic men with obstructive infertility prior to and after vasoepididymostomy.

Attempts were made to validate RIA for prolactin (PRL), LH and FSH in semen from normospermic, oligospermic and azoospermic subjects. The RIA used to measure PRL and LH in semen fulfilled the criteria of reliability, whereas low levels of FSH in semen precluded the validation of FSH assay in semen. Semen levels of PRL and LH were significantly (P < 0.05) higher than serum levels in all groups of subjects investigated. Semen levels of FSH in azoospermic men after vasoepididymostomy (VEA), were significantly (P < 0.05) higher compared to azoospermic men prior to surgery. Serum levels of PRL were significantly higher (P < 0.05) in normospermic men compared to oligospermic and azoospermic men prior to and after surgery. Semen levels of PRL in normospermic men were comparable with oligospermic and azoospermic subjects prior to and after surgery. Serum levels of LH in oligospermic and azoospermic men who did not undergo surgery and in men reporting oligospermia after VEA were comparable to normospermic subjects but in men showing azoospermia post surgically, serum LH levels were significantly (P < 0.005) elevated. Semen levels of LH in men reporting azoospermia before surgery and in subjects showing oligospermia or azoospermia post surgically were significantly lower (P < 0.05) compared to men with normal sperm count. Serum levels of FSH were significantly elevated (P < 0.05) compared to semen levels in oligospermic men prior to surgery but this increase was not seen in post VEA subjects. These results were discussed.