D-tryptophan-6-LH-RH-at los doses in the treatment of male subfertility.

The aim of this trial was to evaluate the effect of D-TRP-6-LH-RH in patients with idiopathic normogonadotropic oligoasthenozoospermia (I.N.O.). The LH and FSH response to LH-RH before and during treatment was also studied. Seven patients (age 27 to 32 years) with long standing infertility were incorporated. All of them were considered to have I.N.O. on the basis of at least three spermatograms and absence of evidence of other diseases. All patients were treated wtih D-TRP-6-LH-RH (2 microgram i.m. every two days) during 90 days. Control spermatograms were performed at monthly intervals during and after treatment. The responses of LH and FSH to 50 microgram i.v. LH-RH were studied before and after 90 days of treatment. Five of the patients achieved a normalization of the concentration of spermatozoa per ml and of the percentage of forwardly progressive spermatozoa. None of the patients showed inhibition of the response to LH and FSH to LH-RH during treatment. These results differ from others in which larger doses of D-TRP-6-LH-RH determined an inhibition of the pituitary response to LH-RH and an impairment of the spermogram.

The effect of a treatment with doxycycline on semen of asthenozoospermic patients with T-mycoplasma genital infection.

The pathogenic role of T-Mycoplasma seminal infection in male sterility is a matter of controversy. The aim of this study was to observe the effect of a specific treatment in asthenozoospermic patients in which the only finding was the presence of T-Mycoplasma in semen. Twenty five patients (age 24 to 49 years) were incorporated. Average time of known infertility was 4.0 +/- 0.5 years. Asthenozoospermia was diagnosed by at least three previous spermatograms. All other studies were negative with the only exception of the tests to study the presence of T-Mycoplasma in semen. Each patient was treated with doxycycline (200 mg/day) during 20 days. Control spermatograms were performed at 30 and 90 days from the initiation of treatment. After treatment the tests to detect the presence of T-Mycoplasma in semen were negative in all patients. A significant increase of the percentages of forwardly progressive spermatozoa and of live and motile spermatozoa was observed together with a significant decrease of the percentage of non motile spermatozoa. Qualitatively eleven patients (44%) achieved a normalization of the spermogram; five patients (20%) obtained significant improvements while nine patients (36%) did not experience any significant change. Although the real significance of T-Mycoplasma in the determination of male sterility is still a matter of controversy, its presence in semen in asthenozoospermic patients should be considered and, consequently, treated.

Effect of D-leucine-6-luteinizing hormone-releasing hormone ethylamide in patients with hypogonadotropic hypogonadism with anosmia.

Four men with hypogonadotropic hypogonadism and anosmia were tested with acute intravenous injections of luteinizing hormone-releasing hormone (LH-RH) and D-leucine-6-LH-RH-ethylamide (D-L eu-6-LH-RH-EA) with a 1-week interval. Each patient was then treated with this drug for 60 days and tested again after this period with an intravenous injection of D-L eu-6-LH-RH-EA. The administration of LH-RH resulted in a significant increase in the LH level in only one patient and in follicle-stimulating hormone (FSH) and testosterone increases in none. The analog D-Leu-6-LH-RH-EA resulted in significant increases in LH levels in two patients, in FSH levels in three, and in testosterone levels in one. Results obtained after treatment were closely similar to those observed before treatment. Clinical improvement in terms of increased libido, erection, pubic hair growth, and testicular size was observed. D-Leu-6-LH-RH-EA could be useful in the treatment of patients with hypogonadotropic hypogonadism, a possibility deserving further studies.