Immunohistochemical identification of GM-CSF in testis of rats with oligozoospermia with the intervention of Cuscuta chinensis flavonoids / Identificación inmunohistoquímica de GM-CSF en testículos de ratas con oligozoospermia con la intervención de flavonoides de Cuscuta chinensis

Oligozoospermia is a common infertility disease, and the incidence rate is increasing year by year. Cuscuta chinensis is a commonly used medicine for the treatment of oligozoospermia in Chinese medicine. Flavonoids are its main component. GM-CSF is a multifunctional cytokine that plays an important role in the inflammatory response. In this paper, we performed HE staining and immunohistochemical staining on the testis of rats with oligozoospermia. We intend to study the expression changes of GM-CSF in rats with oligospermia and the effect of flavonoids on the expression of GM-CSF in testis of rats with oligozoospermia.

La oligozoospermia es una enfermedad común de infertilidad, con una tasa de incidencia que aumenta año tras año. Cuscuta chinensis es un medicamento de uso común para el tratamiento de la oligozoospermia en la medicina china. Los flavonoides son su componente principal. GM-CSF es una citocina multifuncional que tiene un rol importante en la respuesta inflamatoria. En este trabajo, realizamos tinción con hematoxilina y eosina y tinción inmunohistoquímica en testículos de ratas con oligozoospermia. TNuestro objetivo fue estudiar los cambios de expresión de GM-CSF en ratas con oligozoospermia y el efecto de los flavonoides en la expresión de GM-CSF en testículos de ratas con oligozoospermia.

Impact of overactive bladder on retrograde ejaculation

ABSTRACT Purpose: To evaluate the impact of overactive bladder disorder on patients diagnosed with retrograde ejaculation. Materials and Methods: Retrospective analysis of prospective collected database made. Questionnaires conducted in urology polyclinics in five different centers. Main Outcome Measure(s): International Index of Erectile Function - 5 (IIEF - 5), Overactive Bladder 8 - Question Awareness Tool (OAB - V8), urodynamics, semen analysis. The participants of the study were n = 120 patients. There was retrograde ejaculation (RE) in only n = 47 patients (non / minimal symptomatic patients), n = 73 patients had RE and overactive (OAB) complaints (symptomatic patients) and received anticholinergic treatment (trospium), n = 37 control group patients who only had OAB and received an anticholinergic. Results: While no difference was observed in overactive bladder examination and urodynamic values between the non / minimal symptomatic group and the symptomatic group (p > 0.05), sperm was detected and identified as fructose positive in post - ejaculation urine in the symptomatic group. Thus, it was possible to demonstrate the differences between symptomatic patients and non - symptomatic patients. Consequently, following three - month daily treatment with trospium 30 mg 2 x 1 in the control group and the symptomatic group, it was observed that an evident increase was observed in the sperm count and ejaculate volume in the symptomatic group and that no change was observed in the control group (p < 0.05). Conclusion: This clinical study is the first of its kind in terms of revealing the coexistence of RE with OAB upon performing urodynamics and showing that treatment is possible in selected patients.

Reversible Infertility Associated with Testosterone Therapy for Symptomatic Hypogonadism in Infertile Couple

PURPOSE: Androgen replacement therapy has been shown to be safe and effective for most patients with testosterone deficiency. Male partners of infertile couples often report significantly poorer sexual activity and complain androgen deficiency symptoms. We report herein an adverse effect on fertility caused by misusage of androgen replacement therapy in infertile men with hypogonadal symptoms. MATERIALS AND METHODS: The study population consisted of 8 male patients referred from a local clinic for azoospermia or severe oligozoospermia between January 2008 and July 2011. After detailed evaluation at our andrology clinic, all patients were diagnosed with iatrogenic hypogonadism associated with external androgen replacement. We evaluated changes in semen parameters and serum hormone level, and fertility status. RESULTS: All patients had received multiple testosterone undecanoate (NebidoR) injections at local clinic due to androgen deficiency symptoms combined with lower serum testosterone level. The median duration of androgen replacement therapy prior to the development of azoospermia was 8 months (range: 4-12 months). After withdrawal of androgen therapy, sperm concentration and serum follicle-stimulating hormone level returned to normal range at a median 8.5 months (range: 7-10 months). CONCLUSION: Misusage of external androgen replacement therapy in infertile men with poor sexual function can cause temporary spermatogenic dysfunction, thus aggravating infertility.

Tratamiento con ácido fólico y zinc en hombres subfértiles: servicio de fertilidad Maternidad "Concepción Palacios" / Treatment with folic acid and zinc in subfertil men: service of fertility Maternidad “Concepcion Palacios”

Estudiar el efecto del tratamiento con ácido fólico y zinc, en pacientes masculinos subfértiles, con diagnóstico de astenospermia, oligospermia y/o teratospermia. Estudio prospectivo y descriptivo. Se administró tratamiento con ácido fólico (55 mg) y zinc (550 mg) diarios, por un período de 90 días, a pacientes con alteración de la motilidad, concentración y/o morfología espermática. Servicio de Fertilidad. Maternidad “Concepción Palacios ”. Caracas. Después de 90 días de tratamiento, la motilidad total aumento de 44,37 por ciento a 55,22 por ciento, (P=,0002). Las formas espermáticas normales pasaron de 54,11 por ciento a 55,46 por ciento (P=,0001) y las formas anormales disminuyeron e 44,29 por ciento a 4,25 (P=,0001). El tratamiento con ácido fólico y zinc, mejora significativamente la motilidad total y la morfología espermática, en el hombre sub-fértil.

Effect of clomiphene citrate on sperm density in male partners of infertile couples.

Infertility is on the rise in today's world. A subnormal sperm count is frequently encountered in infertile couples. Clomiphene citrate, 1-[p-(beta-diethyl aminoethoxy) phenyl]-1,2-diphenyl chloroethylene, is an orally active nonsteroidal agent distantly related to diethylstilbestrol. It is thought to stimulate pituitary gonadotropin release by excluding estradiol from hypothalamic receptor sites. This interaction neutralizes the normal negative feedback control of estrogen and results in enhanced secretion of LH-RH, FSH-RH and gonadotropins. Testosterone is produced by the Leydig cells in response to LH secretion. The concentration of testosterone in the tubular environment is believed to maintain the gametogenic function of the testis. Clomiphene citrate in the dose of 25 mg daily for 25 days with five days rest was administered to 25 extreme oligozoospermic men (group I) and 40 moderate oligozoospermic men (group II) the cycle being continued for three months). Repeat semen analysis was done at the end of three months and all the routine seminal parameters were reevaluated. The data thus obtained was analyzed using Student's paired 't' test. The mean sperm count in Group I increased from 3.84 +/- 0.32 to 8.2 +/- 1.58 (P < 0.05) and in Group II from 13.05 +/- 0.48 to 24.55 +/- 1.73 (P < 0.001). The mean motile sperm count in Group I increased from 1.74 +/- 0.25 to 3.92 +/- 0.83 (P < 0.05) and in Group II from 8.27 +/- 0.40 to 10.05 +/- 0.56 (P < 0.01). Thus clomiphene citrate exerts its effect on spermatogenesis by raising the endogenous serum FSH, LH and testosterone levels to initiate and maintain gametogenesis (10). Researchers opined that this increase in endogenous gonadotrophins manifests itself in improving the sperm count, sperm motility and to certain extent morphology of the sperms, when there is no end-organ pathology.

Medical management of male infertility.

Management of male infertility is always a difficult task. In recent years booming of artificial reproductive technologies (ART) has put infertologists and andrologists in front of a million dollar question whether to treat the person or the gametes. A basic andrology laboratory at present has become part and parcel of an infertility clinic. Hence treatment of male infertility has become institutional and collective for clinicians and basic scientists. The basic approach towards management of male infertility includes confirmation of diagnosis and to find out the cause for which pathological, endocrinological and biochemical tests are essential. In this series specific defects causing seminopathy has been found in 18% cases where treatment is straightforward and towards the cause. The main bulk of idiopathic seminal defects (82%) really poses challenge to the infertologists so far management is concerned. In this study commonest seminal defect has been found to be oligoasthenozoospermia which amounts to 63% cases. For medical management purpose drugs commonly used are clomiphene, gonadotrophins, bromocriptine, L-thyroxine, vitamin E, B12, etc. When they fail the main approach remains to be intra-uterine insemination (IUI) and ART eg, in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI).

effect of oral administration of Pentoxifylline on sperm motility of asthenozoospermic ejaculates from men with or without testicular varicoceles

Pentoxifylline [PX] is a methyxanthin derivative that influences the sperm motion characteristics. In general, PX has been reportedly effective in preserving sperm motility in vitro, also when administered orally to the asthenozoospermic patients. The main objective of this prospective clinical trial study was to rule out the effect of oral administration of PX on sperm progressive motility of asthenozoospermic ejaculates obtained from men with or without mild testicular varicoceles. In addition, the role of patient's age on sperm motility following PX administration was investigated. A total of 68 infertile men with asthenozoospermia were allocated to this study. Following physical examination, 20 cases were found with mild varicocele of testis. A dosage of 400 mg PX/ twice daily for duration of 3 months was administered to each patient. Two semen samples [one before and one after the PX therapy] were evaluated under blind condition. Semen parameters of sperm concentration, total and fast progressive motility [%] and morphology [%] were analyzed for each sample. Also, the sperm motion characteristics of asthenozoospermic patients with testicular varicocele were compared with cases lacking varicocele. The subjects were divided into two age groups of <30 and >/= 30 years old. PX was significantly effective on the fast progressive motility of sperm [p<0.01]. Also, total progressive motility was enhanced from 26.82 +/- 16.8 to 29.60 +/- 22.2 with PX therapy. However, PX did not have any negative effect on other semen parameters. Oral therapy of PX was also effective in improving the fast progressive motility of sperm of samples from cases with or without mild testicular varicocele [p<0.01]. Fast progressive motility was also significantly enhanced in ejaculates of men from both age groups. Our results demonstrate that low dose of oral therapy of PX is significantly useful in enhancing fast progressive motility of sperms from infertile men with asthenozoospermia. Also, testicular varicocele did not interfere with enhancing effect of PX on sperm motility

Prednisolone for post torsional azoospermia

A 24 year old medical student showed azoospermia on semenalysis performed after testicular fixation done within 12 hours of torsion. Patient's anxiety demanded treatment. Prednisolone rapidly improved the count to 30 million per ml at four weeks and though Prednisolone was discontinued, the count continued to rise and was 56 million per ml 6 months later

Cinética de la respuesta esteroidogénica a la estimulación testicular con gonadotrofina coriónica: aplicación clínica en hombres con infertilidad asintomática / Kinetics the steroidogenic response to the testicular stimulation whit gonadotrophin chorionic: clinical application in asymptomatic infertile man

En el presente trabajo, hemos desarrollado una prueba de estimulación testicular simplificada y de aplicación clínica. Además, se correlacionó la respuesta esteroidogénica a la hCG, con las alteraciones espermatogénicas en hombres con infertilidad asintomática. Los niveles circulantes de testosterona (T), estradiol (E2), 17OH-Progesterona (17OHP) fueron determinados en condiciones basales (3 muestras de sangre tomadas en intervalos de 15 min) y a las 2, 4, 24 y 48 h después de la inyección i.m. de 5.000 UI de hCG, en 420 pacientes oligoastenospérmicos normoprolactinémicos con niveles normales de LH y FSH. Las respuestas de T y 17OHP a la hCG, en el grupo control, mostraron un patrón bifásico con un pico agudo a las 4 h y un pico más sostenido y retrasado luego de las 24 h. Los pacientes infértiles mostraron 2 tipos de respuesta de la T a la hCG: grupo 1) (n = 290), con una respuesta disminuida entre las 2 y 4 h, pero en el rango de los valores de los hombres normales entre las 24 y las 48 h, y un grupo 2 (n = 130) con una respuesta de T similar al grupo control. Las respuestas de E2 en los pacientes del grupo 1 y 2 fueron similares a las del grupo control. La hCG indujo un crecimiento significativo en la relación 170HP/T en los pacientes del grupo 1. En 22 pacientes: 16 del grupo 1 y 6 del grupo 2, se administró aminoglutetimida-hidrocortisana (AGT-HC), un inhibidor de la aromatasa, durante 90 días. Díez pacientes del grupo 1 normalizaron el espermograma (5 de los cuales lograron embarazos, en 5 se obtuvo un incremento significativo de los espermatozoides grado 3 y en 1 no se observaron cambios. Por otro lado, sólo 1 paciente del grupo 2 presentó una leve mejoría en la calidad del semen. La AGT disminuyó la concentración de E2 y aumentó las gonadotrofinas y la relación T/E2. En los pacientes del grupo 1 se incrementó la respuesta aguda de T a la hCG, durante el tratamiento. Nuestros resultados sugieren que 1), el E2 podría estar involucrado, tanto en la etiología de algunos casos de oligoazoospermia, como en la falta de respuesta aguda de T a la hCG, induciendo, posiblemente, un bloqueo parcial de la 17,20 desmolasa; 2) la mejoría de la calidad del semen inducida por el AGT-HC podría estar relacionada a un incremento en la relación T:E2, a una disminución intratesticular de E2, a un incremento de gonadotrofinas o a la suma de cambios hormonales; 3) solamente los pacientes con una respuesta aguda disminuidas de T a la hCG serían posibles para el tratamiento

Infertilidade masculina: diagnóstico, classificaçäo e tratamento das oligozoospermias de causa endócrina / Male infertility: diagnosis, classification and treatment of oligospermias of endocrine cause

O autor com base nas provas dinâmicas de funçäo hormonal faz uma classificaçäo das oligozoospermias de causa endócrina e, baseado na mesma, um resumo das possibilidades de tratamento hormonal dessas oligozoospermias

Effect of zinc administration on seminal zinc and fertility of oligospermic males.

Fourteen infertile males (age 24-45 years; married over 2 years) with idiopathic oligospermia (sperm count less than 40 millions/ml) were investigated for the effect of oral zinc sulphate (220 mg) for 4 months on their serum and seminal zinc levels, and seminal parameters. With zinc administration serum zinc levels remained essentially unaffected, however, seminal zinc levels increased significantly. There was significant improvement in sperm count, number of progressively motile and normal spermatozoa, and acid phosphates activity. Wives of 3 patients conceived. Observations suggest that zinc has potential to be used in male infertility. However, further studies are warranted.

Açäo da pentoxifilina sobre o número e motilidade dos espermatózoides, em pacientes com oligoastenozoospermia normogonadotrópica idiopática / Effect of pentoxifylline on sperm number and motility, in patients with idiopathic normogonadotropic oligoasthinozoospermia

Vinte e seis pacientes com oligoastenozoospermia normogonadotrópica idiopática foram tratados com 1.200mg/dia de pentoxifilina, sendo que 17 completaram seis meses de tratamento e os demais interromperam aos três meses. Espermogramas realizados antes do tratamento e após três meses do início do mesmo comprovaram aumento do número de espermatozóides, significativamente mais acentuado nos pacientes com contagens mais elevadas antes do tratamento. Näo ocorreram variaçöes significativas da motilidade. Os resultados justificam estudos mais amplos

Tratamiento prolongado de la oligozoospermia idiopática con dosis pequeñas de clomifeno / Long-term treatment of idiopathic oligospermia with low-dose of clomiphene

Se realizó la evaluación de los efectos de la terapéutica con dosis bajas de clomifeno por tiempo prolongado, sobre el semen de 26 hombres infértiles que presentaban oligozoospermia idiopática. Se realizaron espermogramas con intervalos de 3 meses durante el tratamiento. El volumen seminal y la velocidad de progresión de los espermatozoides no variaron. La evaluación cualitativa individual del conteo espermático mostró un incremento marcado sólo en 2 pacientes, moderado en 4 y mínimo en 3. El incremento en la morfología y la motilidad de los espermatozoides fue marcado en 4 y 2 pacientes, moderado en 2 y 2 y mínimo en 2 y 4 pacientes, respectivamente. En conclusión, en muchos de nuestros pacientes el tratamiento con clomifeno en dosis bajas no indujo a incrementos significativos en la calidad del semen. Por tanto, esta terapéutica puede ser beneficiosa sólo en un limitado número de pacientes