Semen quality among Danish and Finnish men attempting to conceive. The Danish First Pregnancy Planner Study Team.

OBJECTIVE: To assess differences in semen quality between similar populations from Denmark and Finland. DESIGN: Comparison of semen quality between 221 Finnish men (of whom 115 had no proven fertility) and 411 Danish men with no proven fertility in two follow-up studies among normal couples trying to conceive. METHODS: In Finland male partners of couples without experienced infertility attempting to conceive were recruited through advertisements in local newspapers from 1984 to 1986. From 1992 to 1995 Danish men who lived with a partner and who had not attempted to achieve a pregnancy previously were recruited through their union when they discontinued birth control. All semen analyses were performed in accordance with the World Health Organization guidelines. RESULTS: Median sperm concentration, total sperm count and the percentage of morphologically normal spermatozoa were significantly higher among the Finnish men without proven fertility (104.0 million/ml, 304.0 million and 58% respectively) compared with the Danish men (53.0 million/ml, 140.8 million, and 41% respectively). Sperm concentration was 105.7% (95% confidence interval (CI) 58.1%-167.6%) and total sperm count was 127.4% (95% CI 71.4%-201.6%) higher among Finnish men without proven fertility than among Danish men after control for confounders. CONCLUSIONS: Some, but hardly all, of the observed difference in semen quality may be explained by differences in recruitment procedures, selection of the men and by methodological differences in semen analysis between the two countries. Also a birth cohort effect may explain some of the differences between countries as the Finnish men were recruited 11 years before the Danish men. Therefore, follow-up studies with identical recruitment and selection of men from the two countries are needed.

High and unchanged sperm counts of Finnish men.

Several recent reports have suggested that the sperm counts of normal men are declining in most countries. In this study the sperm counts of Finnish men, and their possible changes during the past 28 years, were investigated. The material consisted of semen samples from 238 normal healthy men of unknown fertility and 5481 men from infertile couples. The means (medians) of semen volume, sperm density and total sperm count in normal men were 3.3 (3.0) ml, 133.9 (94.0) x 10(6)/ml and 396.6 (309.0) x 10(6), respectively. These parameters and the relative frequency distribution of the sperm density were similar to those reported elsewhere in the 1940s. Multiple linear regression analysis revealed a significant decrease in semen volume, whereas sperm density and total sperm count of infertile men had not changed significantly during the past 28 years. In addition, no change in sperm counts was associated with the year of men's birth.

Acrosome reaction inducing activity in follicular fluid correlates with progesterone concentration but not with oocyte maturity or fertilizability.

Follicular fluid is a potent mediator of sperm acrosome reaction (AR) in vitro. The aim of this study was to investigate whether individual follicular fluids vary quantitatively in their ability to stimulate an AR, and whether such variability relates to fertilizability of the corresponding egg, its maturational level and/or progesterone content. Individual follicular fluids were obtained from 24 women undergoing in-vitro fertilization and assayed for their ability to induce an AR in normal human spermatozoa. After incubation in capacitation medium for 18 h, spermatozoa were challenged with the individual follicular fluids for 30 min. AR was detected by immunofluorescence, using fluorescein-labelled Pisum sativum lectin. We found that individual follicular fluids varied markedly in their ability to induce AR. Acrosome reaction correlated linearly with progesterone concentration (Spearman's r = 0.735, P = 0.01) at constant protein level, but no correlation was found between AR and protein concentration at constant progesterone level. Progesterone concentrations were not only higher (ANOVA, P = 0.002) in fluids from mature oocytes compared to those from less mature or post-mature eggs but also in fluids from fertilized compared to unfertilized eggs (ANOVA, P = 0.015, n = 13 patients with both fertilized and unfertilized eggs). In contrast, AR-inducing ability of individual follicular fluids did not differ for fertilized and unfertilized eggs. While AR-inducing ability appeared to increase with maturational stage of the egg, this trend was not statistically significant, probably due to small sample size. Our data suggest that progesterone rather than protein is the principal mediator of acrosome reaction induced by follicular fluid in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

Semen selenium content and sperm mitochondrial volume in human and some animal species.

Selenium (Se) and glutathione peroxidase (GSH-Px) were determined from the seminal plasma samples and spermatozoa of human and four different animal species. The human sperm Se concentration was 1.8 +/- 0.8 micrograms/g dry weight, which was about half of that in the bull. Abnormal sperm morphology and motility correlated with low sperm Se content. The volume of sperm mitochondrial sheath in human, bull and stallion was measured using transmission electron microscopy. In these species the sperm Se content was highly correlated with the volume of mitochondria. Among the five species studied, the seminal plasma level of Se was lowest in human male and stallion, while the highest levels were encountered in the bull. No correlation was obtained between human semen quality and seminal plasma Se concentration. The seminal plasma GSH-Px activity was low in man and ram, absent in boar and stallion but very high in the bull. The amount of structural sperm Se as well as seminal plasma Se and GSH-Px activity appears to be highly variable in different species.

Human seminal plasma cadmium: comparison with fertility and smoking habits.

Cadmium, selenium and zinc were determined in seminal plasma and serum of 64 men by atomic absorption spectrometry (AAS). The mean (+/- SD) cadmium concentrations in seminal plasma and serum were 0.22 +/- 0.22 micrograms and 0.28 +/- 0.10 micrograms, respectively, but they did not correlate with each other. Smokers (n = 31) had significantly (p less than 0.01) higher serum cadmium concentrations than non-smokers (n = 31). Also seminal plasma cadmium in smokers was elevated, but a significant difference to non-smokers was only found if more than 20 cigarettes were consumed daily. No differences were found in semen quality and fertility between smokers and non-smokers. The seminal plasma cadmium had no correlation to selenium or zinc which, however, displayed a positive correlation (r = 0.852, p less than 0.001) to each other. It is concluded that smoking increases the exposure to cadmium. Although no obvious reproductive suppression was observed, heavy smoking may possibly enhance toxic effects in men under other detrimental exposures.

PIP: Cadmium, selenium, and zinc were determined in seminal plasma and serum of 64 men by atomic absorption spectrometry (AAS). The mean (+or- SD) cadmium concentrations in seminal plasma and serum were 0.22 +or- 0.22 mcg and 0.28 +or- 0.10 mcg, respectively, but they did not correlate with each other. Smokers (n=31) had significantly (p0.01) higher serum cadmium concentrations than nonsmokers (n=31). Also, seminal plasma cadmium in smokers was elevated, but a significant difference to nonsmokers was only found if 20 cigarettes were consumed daily. No differences were found in semen quality and fertility between smokers and nonsmokers. The seminal plasma cadmium had no correlation to selenium or zinc which, however, displayed a positive correlation (r=0.852, p 0.001) to each other. It is concluded that smoking increases the exposure to cadmium. Although no obvious reproductive suppression was observed, heavy smoking may possible enhance toxic effects in men under other detrimental exposures. (author's)

Selenium and glutathione peroxidase in seminal plasma of men and bulls.

High levels of selenium and glutathione peroxidase (GSH-Px) were found in bull seminal plasma but low concentrations in human seminal plasma. In man the seminal plasma selenium was associated with two macromolecules separable by gel filtration, but no GSH-Px was found in the same fractions. Selenium in bull seminal plasma was associated with two proteins, which could be separated by gel filtration and anion exchange chromatography. Both macromolecules coeluted with GSH-Px activity and had identical optima at pH 7.0. Their responses to thermal treatment, however, differed. Seminal vesicle secretory fluid in the bull contained both these proteins, while the larger molecule was also found in fractionations of ampulla, prostate and Cowper's glands. The larger enzyme form is evidently a tetramer of the smaller one. Both enzyme forms were extremely sensitive to heavy metals and some divalent metal ions. GSH caused an activation while other reducing agents were suppressive. Triton X-100 had no effect, while sodium deoxycholate was inhibitory. These properties are typical for a phospholipid hydroperoxide GSH-Px. It is concluded that this selenium-dependent enzyme may be important in the protection of bovine spermatozoa against damage caused by oxygen radicals, while in man such a mechanism is not functional.

Cigarette smoking and semen quality in men of reproductive age.

The effect of cigarette smoking on conventional semen parameters was studied in voluntary men of reproductive age (n = 190). Special attention was focused on sperm motility and its quantitative and qualitative change in vitro during the observation period. The sperm output war normal in both smokers (n = 54) and non-smokers (n = 110), but semen volume was smaller (p less than 0.03) in heavy smokers (greater than 16 cigarettes/day) than non-smokers. In sperm morphology there was no difference between study groups. The only clear difference between men with different smoking habits was in the percentual change in the sperm motility during 24 hours. At the time of first examination, the sperm motility was better (p less than 0.02) in heavy smokers than those who smoked less than 16 cigarettes per day and the motility decreased more rapidly (p less than 0.007) in heavy smokers than non-smokers. The objectively measured initial mean velocities of the whole sperm population and of the progressive spermatozoa were slightly higher in subgroup of smokers than in non-smokers. The rapid decrease in the survival spermatozoa in smokers may be uneconomical and harmful in respect of fertility.

PIP: The effect of cigarette smoking on conventional semen parameters was studied in voluntary men of reproductive age (n=190). Special attention was focused on sperm motility and its quantitative and qualitative change in vitro during the observation period. The sperm output was normal in both smokers (n=54) and nonsmokers (n=110), but semen volume was smaller (p 0.03) in heavy smokers ( 16 cigarettes/day) than nonsmokers. In sperm morphology there was no difference between study groups. The only clear difference between men with different smoking habits was in the % of change in sperm motility during 24 hours. At the time of 1st examination, sperm motility was better (p 0.02) in heavy smokers than those who smoked less than 16 cigarettes/day and the motility decreased more rapidly (p 0.007) in heavy smokers than nonsmokers. The objectively measured initial mean velocities of the entire sperm population and of the progressive spermatozoa were slightly higher in the subgroup of smokers than in that of nonsmokers. The rapid decrease in the survival spermatozoa in smokers may not be economical and may infact be harmful with regard to fertility.

Determination of selenium in human spermatozoa and prostasomes using base digestion and electrothermal atomic absorption spectrophotometry.

A method for the determination of selenium in human spermatozoa and prostasomes is described. The samples were digested with 25% (w/v) tetramethylammonium hydroxide (TMAH) in methanol and analyzed by atomic absorption spectrometry with electrothermal atomization and Zeeman background correction (ET-AAS). Nickel was used as a matrix modifier. Calibration was performed using the matrix-based calibration curve. The TMAH-digestion method agreed well with a conventional digestion procedure using concentrated nitric acid. The TMAH-digestion does not require heating or strong acids and it was suitable for small biological samples. The average recovery of added selenium in spermatozoan digests was 95.1 +/- 5.2% (n = 5). The coefficient of variation was 9.1% (n = 21). The accuracy of the method tested with the NBS standard 1577 (bovine liver, certified at 1.1 +/- 0.1 micrograms Se/g) resulted in a value of 0.98 +/- 0.10 micrograms Se/g (n = 16). The method was further tested in an interlaboratory comparison study.

Lead, magnesium, selenium and zinc in human seminal fluid: comparison with semen parameters and fertility.

The concentrations of lead, magnesium, selenium and zinc in seminal fluid from men with variable semen quality (sperm morphology, density and motility) and fertility were determined by atomic absorption spectrometer without or with Zeeman background correction. The mean (+/- SD) concentration of selenium in the samples (n = 142) was 28.8 +/- 9.5 micrograms/l, which was about a third of the corresponding serum value (77.8 +/- 13.3 micrograms/l, n = 140). The serum selenium level was significantly (P less than 0.001) higher in infertile than in fertile men, but the seminal fluid did not show such a difference. No correlation was obtained between selenium values in seminal plasma and sperm density or motility. The levels of lead in seminal fluid were very low with no correlation to the levels of magnesium, selenium and zinc or the semen qualities. The seminal fluid lead concentration was significantly (P less than 0.001) higher in infertile (3.6 +/- 3.2 micrograms/l, n = 79) than in fertile men (1.7 +/- 1.0 micrograms/l, n = 39). Magnesium (103.5 +/- 49.2 mg/l, n = 90) and zinc (141.1 +/- 71.7 mg/l, n = 157) concentrations in seminal fluid were comparable with previous reports. Both minerals showed a positive correlation to the seminal fluid selenium, while only zinc displayed a borderline correlation with sperm density. The present findings indicate that the determination of seminal fluid selenium may not offer any advantages over zinc and magnesium measurement in the fertility assessment and its role in human semen remains obscure. The low lead concentrations in the present material is a clear indication of low industrial exposure.

Selenium in reproductive organs, seminal fluid and serum of men and bulls.

The concentrations of selenium in the reproductive organs, seminal fluid and serum of human males and bulls were analysed using an atomic absorption spectrometer with Zeeman background correction. The mean (+/- SD) concentration of selenium in human seminal fluid (33.4 +/- 14.1 micrograms/l, n = 70) was less than half the level detected in serum (78.2 +/- 9.9 micrograms/l, n = 32). In bulls, the mean selenium concentration in seminal fluid (457.4 +/- 108.7 micrograms/l, n = 113) was about nine times higher than in human males, while the level in serum (49.1 +/- 5.1 micrograms/l, n = 94) was significantly (P less than 0.001) lower than in human serum. The selenium concentration (500 +/- 244 micrograms/l) in the bovine seminal vesicle secretions were comparable to those in the seminal fluid and this gland appears to be mainly responsible for the high selenium levels in the seminal fluid. The mean selenium concentration in reproductive tissues of both species was highest in the testes. The distribution of selenium in the bovine epididymis was biphasic. The testicular and epididymal selenium are associated mainly with macromolecules of the spermatogenic cells and spermatozoa. It was concluded that studies in farm and laboratory animals do not necessarily form a reliable basis for conclusions with regard to human male reproduction, since selenium may have a different role and importance in the reproduction of various species.

Ultrasound in the timing of artificial insemination with frozen donor semen.

Ultrasonography was performed to time ovulation in 30 patients participating in program for artificial insemination with donor semen (AID). During this study (10 months) 61 scans were carried out where one or more follicles were visible. The mean number of treatment cycles per patient was 2.8. Insemination with frozen donor semen was performed if a clear and mature follicle was detectable. The mean follicular diameter in successful inseminations was 20.1 +/- 0.8 mm, ranging from 16 to 23 mm. Twelve patients became pregnant, 9 (75%) of them after three treatment cycles. The mean time to conception was 2.75 cycles and the most successful day of the menstrual cycle was day 13. Ovulation was induced in 8 (56.7%) patients who conceived. Ultrasound is a noninvasive, quick and reliable method in the detection and timing of ovulation in most AID patients.

Left-sided hydrothorax in connection with severe pre-eclampsia. Case reports.

Four cases of left-sided pleural hydrothorax in connection with severe pre-eclampsia are reported. In addition an increased formation of ascitic fluid was observed in the patients. A long-lasting bed rest in the left lateral recumbent position preceded the discovery of the roentgenologically verified pleural changes. Hypoproteinemia caused by the excretion of large amounts of protein in the urine seems to be a partial etiological factor aggravated by the renal retention of sodium and water. Pleural transudate disappeared spontaneously within two weeks from the delivery. In such cases, immediate diagnostic procedures, e.g. the exclusion of tuberculosis, are unnecessary. The authors think that the phenomenon is common in similar cases but usually remains undiagnosed.