The impact of a diagnosis of couple subfertility on male sexual function.

AIM: The aim was to study: a) the prevalence of sexual dysfunction in male partners of subfertile couples; b) the possible correlation between sexual dysfunction and seminal profile. SUBJECTS AND METHODS: Male partners (no.=171) of subfertile couples were studied, aged between 25 and 40 yr, attending the Andrology Unit of Sant'Andrea Hospital. All the subjects responded to a modified International Index of Erectile Function (IIEF) questionnaire, made up of 5 questions: 2 regarding erectile function, 1 concerning orgasmic function, 1 question on sexual desire, and 1 on satisfaction with intercourse. The questionnaire investigated both spontaneous sex for pleasure and sex intended to lead to pregnancy. The subjects underwent standard semen analysis, according to World Health Organization guidelines. RESULTS: The data showed a disorder in sexual intercourse for reproductive purposes in 37 subjects (23.7%). Of these, only 14 (8.9%) also had problems with sex for pleasure. On the other hand, there was no significant variation in the prevalence of sexual dysfunction related to seminal profile. CONCLUSIONS: A diagnosis of subfertility represents a stressful situation which can reduce the pleasure of sex, especially in intercourse intended for reproductive purposes; this disorder in sexual activity does not seem to be directly correlated with awareness of the severity of the semen alterations.

New software for the automatic and semiautomatic assessment of sperm morphology.

AIM: An attempt was made to improve the standardization of sperm morphology assessment. METHODS: A software for computerized automatic/semiautomatic sperm morphology assessment was developed and a comparative study between this computerized system and the subjective micrometric method was carried out. RESULTS: The software has shown to be very reliable and reproducible. The subjective micrometric method significantly underestimated the percentage of atypical forms compared with the objective method. CONCLUSION: Until the development of new fully-automatic techniques, this system is certainly an effective first step in the objective, reproducible standardization of sperm morphology assessment.

Prevalence of diabetes mellitus in male partners of infertile couples.

AIM: The aim of this study was to investigate the prevalence of diabetes mellitus (DM) in a population of male partners of infertile couples, to evaluate their seminal and biochemical parameters and to plan therapeutic strategies to achieve pregnancy. METHODS: Standard semen analysis was carried out in 510 male partners of infertile couples, aged 25 to 51 years. RESULTS: The prevalence of DM in the subjects studied was 1.18%, 4 cases with non insulin dependent diabetes mellitus (NIDDM) and 2 cases with insulin dependent diabetes mellitus (IDDM). Three subjects with NIDDM and 1 with IDDM had normal ejaculation. Semen analysis of these subjects showed qualitative alteration; the most important effects concerned the kinetic properties, especially progressive motility. Sperm morphology was also significantly compromised. On the other hand, sperm concentration did not show significant alterations. The therapeutic iter in these subjects is similar to that for other dyspermic male partners of infertile couples. The 2 remaining subjects (one with NIDDM and one with IDDM) had retrograde ejaculation (sperm recovery from post-orgasmic urine) and were included in intrauterine insemination or in vitro fertilization programs. In addition, in the subjects with DM, the biochemical seminal profile showed significantly higher levels of fructose compared with the nondiabetic subjects. CONCLUSION: DM has a negative impact both in terms of sperm quality and of the ejaculation mechanism. The low prevalence of DM among this study population of 510 male partners of infertile couples is due to the low prevalence of DM in this age range.

An attempt to improve standardization of sperm motility class assessment using the superimposed image analysis system (SIAS) software.

AIM: An attempt was made to improve the standardization of sperm motility assessment. METHODS: A computerized system based on image superimposition producing final image with a motion effect was employed. Numerical definition of straight-line velocity (VSL), curvilinear velocity (VCL) and linearity (LIN) related to these motility classes were made, at different frame/rates (20 frames/s, 30 frames/s and 60 frames/s). RESULTS: At least 4 motility class categories were found to be necessary (instead of 3, WHO) for a valid assessment. According to the cut-offs suggested by the ROC curves, motility classes were defined as follows: Class 1 (straight progressive motility): VSL = or > 23 microm/s; LIN = or > 0.58 at 20 frames/s; LIN = or > 0.50 at 30 frames/s; LIN = or > 0.44 at 60 frames/s. Class 2 (straight slow motility): VSL > 10 microm/s and < 23 microm/s; LIN = or > 0.58 at 20 frames/s; LIN = or > 0.51 at 30 frames/s; LIN = or > 0.43 at 60 frames/s. Class 3 (progressive non straight motility): VSL > 10 microm/s; LIN < 0.58 at 20 frames/s; LIN < 0.51 at 30 frames/s; LIN<0.43 at 60 frames/s. Class 4 (non progressive motility): VSL <10 microm/s. A frame rate of 20 frames/s was found to be sufficient to distinguish sperm motility classes in standard semen analysis. CONCLUSIONS: The numerical definition of sperm motility classes may contribute towards standardization in the objective evaluation of sperm kinematics.

Survival of micro-organisms in cryostorage of human sperm.

The authors describe the clinical application of semen cryostorage, survival of micro-organism during cryostorage procedures and the risk of cross-contamination.

[Treatment of euthyroid goiter in the elderly]. / Terapia del gozzo eutiroideo degli anziani.

PURPOSE: A study was conducted to evaluate the effectiveness of the medical therapy with synthetic hormone levothyroxine (L-T4) in the elderly subjects with multinodular euthyroid goiter. PATIENTS AND METHODS: 187 elderly subjects (34 males and 153 females) ranging between 63 and 85 years of age with multinodular euthyroide goiter were examined. For each subject has been calculated the index of body mass (BMI) which has consented the identify two groups of subjects: the elderly patients with normal weight and the obese subjects. RESULTS: In the mostly of the patients (82%), both normal weight and obese, the L-T4 therapy has not determined significant changes either of the dimensions or the number of the nodules. In the obese subjects the L-T4 therapy has not caused decrease of weight at least to the 20% of the initial body weight. CONCLUSIONS: The results of the research have proved the limited effectiveness of the suppressive therapy with levothyroxine in the reduction of the volume and/or of the number of the nodules, without however denying the usefulness in the preventing the worsening of the nodular disease of thyroid. The study also has revealed that the therapy with levothyroxine is ineffective for the body weight reduction in the obese subjects.

[Prevalence of obesity in adolescence]. / Prevalenza dell' obesità nell'adolescenza.

PURPOSE: A clinical epidemiological research was conducted in Sardinia on a sample of hig school students to survey the preminence of obesity and overweight during adolescence. PATIENTS AND METHODS: 304 normal subjects were examined, 161 males and 143 females ranging between 16 and 18 years of age. For each subject the index of body mass was considered then compared to the standard values of population using Hamil schedules. RESULTS: The survey revealed a normal weight in mostly of the teen-agers. Obesity was observed however in 23.6% of males and in 5.6% of females on what was seen the percentage of overweight or excessively fat subjects is below the percentage of underweight teen-agers (21% of males and 43% of females). CONCLUSIONS: This difference could be considered the proof of a particular adolescential attitude that seen as a positive aim and is identified with social acceptance and sexual attraction especially among girls. This is confirmed by the fact that when questioned a great number of teen-agers admitted they were or they had been on a diet to lo lose weight.

Soviet women and the autonomous family.

"The USSR family is changing in form from that of a social collectivity, a bedrock conception to socialism, to that of an autonomous family. Autonomy discloses a lack of homogeneity, an independence of choices over life-styles and a flexibility toward an interpretation given to the meaning of a socialistic state. Women are exceedingly active in making greater use of their legal rights to divorce and abortion and demanding equal status with men both in the workplace and in the home. Women are initiating major social changes, are readily adapting to changing relations and patterns in a complex society and are serving to spearhead changes in the family unit. These factors have generated major changes in the normative, behavioral and structural dimensions of marriage and family life in the Soviet Union."