Seminal plasma magnesium and premature ejaculation: a case-control study

OBJECTIVE: To determine the relationship between premature ejaculation (PE) and serum and seminal plasma magnesium levels, in a case-control study. PATIENTS AND METHODS: Thirty-eight patients referred to the authors' urology outpatient clinic were evaluated in two groups; cases comprised 19 men complaining of PE, defined using the Diagnostic and Statistical Manual of Mental Disorders IV criteria and an intravaginal ejaculatory latency time (IELT) of <1 min, and a control group of 19 married men with a normal IELT. All men had a history taken, a systemic physical examination and laboratory studies. After organic and psychogenic disorders were excluded, the 19 patients were included in the study. Seminal plasma and serum magnesium levels were determined using atomic absorption spectrophotometry. RESULTS: The mean (sd) plasma magnesium level was 94.7 (10.9) mg/L in the cases and 116.7 (11.6) mg/L in the controls. There was a significant relationship between seminal plasma magnesium, but not the plasma level, and PE (P < 0.001 and 0.597 respectively). CONCLUSION: PE is significantly related with a lower level of seminal plasma magnesium. The pathological physiology of this relationship requires more investigation.     

Relevance of seminal plasma nitric oxide levels and the efficacy of SSRI treatment on lifelong premature ejaculation

The aim of this study was to determine the relevance of seminal plasma nitric oxide (NO) levels and the efficacy of selective serotonin reuptake inhibitor (SSRI) treatment on premature ejaculation. A total of 16 men (aged 32.18 ± 3.32) with lifelong premature ejaculation [intravaginal ejaculation latency time (IELT) <1 min] and 11 healthy men (control group) were included in this study. The healthy men formed Group 1, and the patients were randomly categorised into two groups. Group 2 patients received 20 mg day^?1 of paroxetine, and Group 3 patients received 50 mg day^?1 of sertraline for 4 weeks. Baseline and post‐treatment findings were compared among the three groups. Mean baseline seminal NO levels in men with premature ejaculation were significantly higher than in the healthy control group (32.24 ± 5.61 μm  l^?1 versus 19.71 ± 3.50 μm  l^?1, respectively) (P < 0.001). There was no significant difference between the sertraline and paroxetine groups in terms of IIEF scores, IELT scores and NO levels. At the end of the first month, the mean IELT scores of the paroxetine and sertraline groups showed a significant improvement compared with the baseline values (P < 0.001). After treatment with paroxetine and sertraline, NO levels dec‐reased from baseline. Our study indicates that premature ejaculation is significantly related with a higher level of seminal NO. Baseline seminal plasma NO values obtained in patients with premature ejaculation were significantly higher than in the healthy control group. After treatment with SSRIs, decreased seminal NO may retard ejaculation. Further studies are needed to confirm this suggestion and the role of NO in the pathophysiology and treatment of premature ejaculation.     

前列腺分泌功能与早泄的相关性研究

目的:通过观察早泄(PE)患者前列腺分泌指标的含量,探讨前列腺分泌功能与PE的相关性,为临床治疗PE提供一种新的思路。方法:选取2018年10月—2019年8月来我院就诊的80例PE患者作为观察组,以及同时期就诊的77例无PE的正常生育男性作为对照组。手淫法留取精液,离心分离精浆,分别测定两组精浆柠檬酸、ACP和锌的含量。统计学分析两组患者的精浆生化检查结果。结果:观察组精浆柠檬酸、酸性磷酸酶(ACP)及锌的含量分别为(22.28±15.65)mmol/L、(157.27±85.35)U/mL、(1.41±1.16)mmol/L,与对照组(29.08±13.72)mmol/L、(200.84±57.44)U/mL、(2.90±1.60)mmol/L相比均显著降低(P<0.01)。且观察组精浆柠檬酸、ACP及锌含量异常者分别为38例(47.5%)、38例(47.5%)、46例(57.5%),与对照组的9例(11.7%)、5例(6.5%)、14例(18.2%)比较,差异有统计学意义(P<0.01)。结论:PE患者精浆柠檬酸、ACP、锌的含量明显低于无PE者,提示前列腺分泌功能指标异常可能与PE的发病具有一定的相关性。     

正常成年男性精浆同型半胱氨酸浓度及其与精液参数关联性研究

目的探讨正常成年男性精浆同型半胱氨酸(Hcy)的正常值参考范围;探讨精浆、血清Hcy浓度与精液参数的关联性以及精浆与血清Hcy浓度的关联性。方法从精子库捐精者中招募了31例健康志愿者,收集其精液及血清,检测其精液常规,采用酶联免疫吸附试验(ELISA)测定血清与精浆中的Hcy的浓度并计算精浆Hcy总含量;采用统计学软件SPSS 12.0分析精浆Hcy正常参考值范围,分析精浆、血清Hcy浓度,精浆Hcy总含量与精液参数的关联性以及精浆与血清Hcy的关联性。结果精浆Hcy浓度与精子活力呈负相关(r=-0.439,P=0.014),与其他精液参数无相关性;精浆与血清Hcy浓度之间也无相关性。结论健康青年男性精浆Hcy浓度的参考值范围:6.02~21.96μmol/L(95%CI);精浆Hcy浓度与精子活力呈负相关。     

精浆和血清生殖激素与精液质量的关系

目的为了评估精液质量不同的男性精浆和血清生殖激素的浓度与精子浓度及活动力的关系,探索精浆与血清生殖激素的关系。方法对301名男性进行精液检查,按照精液的质量参数将受试对象分成4组:精液正常组(n=176),弱精子症组(n=66),少精子症组(n=40)和非梗阻性无精子症组(n=19)。采用电化学发光免疫法测定各组受试对象血清卵泡刺激素(FSH)、黄体生成素(LH)、泌乳素(PRL)、孕酮(P)、睾酮(T)和雌二醇(E2)六项生殖激素和精浆PRL、T、P和E2四项生殖激素的浓度,比较组间差异并进行相关性分析。结果精液正常组和弱精子症组血清FSH和E2的浓度显著低于少精子症组和非梗阻性无精子症组(P0.05),精液正常组血清LH和P的浓度显著低于弱精子症、少精子症和非梗阻性无精子症的人群(P0.05);而精液正常、弱精子症和少精子症三组精浆PRL的浓度则高于非梗阻性无精子症组(P0.05)。除了非梗阻性无精子症组,受试者血清FSH的浓度与其精子浓度呈负相关(r分别为-0.350、-0.273和-0.448,P0.05)。精液正常组精浆PRL的浓度和精子的浓度之间呈正相关(r=0.269,P0.05);在少精子症组中,亦有相同趋势的相关性(r=0.432,P0.05)。结论精浆PRL及血清FSH的浓度能够反映精子浓度或活动力,在男性不育的病因分析中具有一定的指导价值。     

Melatonin hormone profile in infertile males

Melatonin is a hormone produced by the pineal gland. There is much controversy about its relationship to the male reproductive process. In this study, seminal plasma as well as the serum melatonin levels were studied in different infertile male groups and were correlated with their semen parameters and hormonal levels. One hundred twenty male cases subdivided into six equal groups were consecutively included; fertile normozoospermic men, oligoasthenozoospermia (OA), OA with leucocytospermia, OA with varicocele, non-obstructive azoospermia (NOA) with high serum follicle stimulating hormone (FSH) and NOA with normal FSH. Semen analysis, estimation of melatonin, FSH, testosterone (T) and prolactin (PRL) hormone was carried out. Mean level of serum melatonin was higher than its corresponding seminal concentrations in all investigated groups with a positive correlation between their levels (r = 0.532, p = 0.01). Serum and seminal plasma melatonin levels in all infertile groups were reduced significantly compared with their levels in the fertile group. The lowest concentrations were in OA with leucocytospermia group. Melatonin in both serum and semen demonstrated significant correlation with sperm motility (r = 607, 0.623 respectively, p = 0.01). Serum melatonin correlated positively with serum PRL (r = 0.611, p = 0.01). It may be concluded that melatonin may be involved in the modulation of reproductive neuroendocrine axis in male infertility. Also, low levels of melatonin in semen were observed in infertile groups having reduced sperm motility, leucocytospermia, varicocele and NOA.     

Sperm chromatin stability and zinc binding properties in semen from men in barren unions

Sperm chromatin stability and zinc binding properties were studied in semen samples from 115 men living in barren unions. Of these men, 26% had a high proportion of swelling sperm, i.e. less than 80% sperm with stable chromatin after exposure to the detergent sodium dodecyl sulphate. From 2-67% of seminal zinc was bound to high molecular weight ligands of vesicular origin (HMW). This shows that, among infertile men, liquefied seminal plasma has huge variations in zinc chelating properties. The relationship between prostatic palpatory status, the proportion of abnormal sperm, the percentage zinc bound to HMW (HMW-Zn), the time between ejaculation and analysis and chromatin stability were studied. Samples with low chromatin stability were found more frequently in men with low HMW-Zn levels in semen. The proportion of stable sperm decreased in samples with prolonged exposure to seminal plasma. Neither the proportion of stable sperm heads nor the percentage zinc bound to HMW could be used to predict the future chances of the infertile men fathering children when studied 15-180 min after ejaculation. To differentiate between initial zinc-dependent stability and superstability developed in seminal plasma, other more sensitive methods must be developed.     

Serum leptin levels in patients with premature ejaculation before and after citalopram treatment

OBJECTIVE: To evaluate serum leptin levels (an adipocyte hormone involved in the suppression of appetite) in patients with premature ejaculation before and after treatment with citalopram, a selective serotonin reuptake inhibitor, with the hypothesis that leptin levels might become normal during this treatment. PATIENTS AND METHODS: The inhibitory effect of serotonin on libido, ejaculation and orgasm is well documented. Although there is no direct evidence of an association involving brain pathways which are related to sexual behaviour, there is an interaction between leptinergic and serotonergic systems. In a previous study serum leptin levels were high in patients with premature ejaculation. The present study comprised 30 patients with premature ejaculation according to the Diagnostic and Statistical Manual of Mental Disorders Third Revised Version. Fifteen patients (group I) were randomly assigned to 8 weeks of citalopram treatment and the remainder (15, group II) received no therapy. The patients were asked to determine the average intravaginal ejaculation latency time, and their fasting serum leptin levels were measured at baseline and after 8 weeks. RESULTS: There was no significant difference in the mean intravaginal ejaculation latency time between the groups at baseline; it increased after 8 weeks of treatment with citalopram in group I, to a mean (sd) of 209 (72.1) s, but not in group II. No difference was detected in leptin levels between the groups at baseline, but at 8 weeks they were lower in group I. CONCLUSION: As hypothesized, leptin levels decreased in patients with premature ejaculation after treatment with citalopram, and this decrease seemed to be linked to the therapeutic effect. Further experimental studies are needed.     

不育男性抗苗勒管激素与生殖激素及精液质量参数关系的研究

目的探讨男性不育患者精浆和血清抗苗勒管激素(AMH)与血清生殖激素及精液参数之间关系。方法选取2018年9~12月于我院生殖中心就诊的男性不育患者107例,按照《世界卫生组织人类精液检查与处理实验室手册(第五版)》操作规范检测精液体积、精子浓度、前向运动精子(PR)百分比、精子顶体酶、精子DNA完整性、正常形态精子率,根据精液参数分为4组:少精子症组(n=15)、弱精子症组(n=26)、少弱精子组(n=31)、正常精子组(n=35),比较各组患者精浆和血清AMH及血清FSH、LH、催乳素(PRL)、T、E 2之间的差异,并对精浆和血清AMH与生殖激素及精液参数的相关性进行统计分析。结果弱精子症组血清AMH水平高于其他3组,但各组间差异无统计学意义(P>0.05);正常精子组精浆AMH水平[中位数(四分位距)]为1.28(7.71)ng/ml,显著高于少精子症组[0.11(1.26)ng/ml]和少弱精子组[0.16(2.15)ng/ml](P<0.05)。相关性分析显示,血清AMH与生殖激素及精液参数不存在相关(P>0.05);精浆AMH与血清FSH、LH呈负相关(P<0.05),与血清T呈正相关(P<0.05);精浆AMH与精子总数、精子浓度、PR%呈正相关(P<0.05),与其他精液参数不相关(P>0.05)。结论不育男性精浆AMH与血清生殖激素及精子浓度、活力具有一定的相关性,一定程度上反映睾丸生精功能,对男性不育的诊断和治疗有一定的参考作用。     

SERUM AND SEMEN PROSTATE SPECIFIC ANTIGEN CONCENTRATIONS ARE DIFFERENT IN YOUNG SPINAL CORD INJURED MEN COMPARED TO NORMAL CONTROLS

PURPOSE: Recent investigations have indicated that factors within the seminal plasma may contribute to the condition of low sperm motility in men with spinal cord injury. To determine whether the prostate gland functions normally in these men we chose prostate specific antigen (PSA) as a marker of prostatic function, and compared serum and semen concentrations in spinal cord injured and healthy noninjured men. MATERIALS AND METHODS: The study included 21 spinal cord injured men (mean age 33.3+/-1.2 years) and 22 noninjured normal men (mean age 30.3+/-1.5 years). Blood was obtained from subjects following at least 24 hours of abstinence from ejaculation and serum PSA was determined by modified enzyme immunoassay. Antegrade ejaculates from all subjects were frozen to -80 C, exactly 15 minutes after collection. Seminal plasma PSA was determined using Hybritech Tandem MP assay. RESULTS: Mean serum PSA concentration was 1.20+/-0.19 ng./ml. in spinal cord injured and 0.69+/-0.07 ng./ml. in noninjured men (p<0.02). Mean seminal plasma PSA concentration was 0.59+/-0.11 mg./ml. in spinal cord injured and 1.29+/-0.15 mg./ml. in noninjured men (p<0.001). CONCLUSIONS: Our findings of elevated serum and decreased seminal plasma PSA concentrations indicate that prostatic secretory dysfunction is present in men with spinal cord injury.     

Evidence for the prostatic origin of immunoreactive inhibin-like material in human seminal plasma

Inhibin is defined as a gonadal peptide exerting an inhibitory effect on the secretion of follicle-stimulating hormone (FSH) by the pituitary. Using a radioimmunoassay (RIA) procedure developed for a homogeneous inhibin-like peptide with a molecular weight of 14 000 daltons isolated from human seminal plasma, immunoreactive inhibin-like matrial (ILM) was quantitated in serum, urine and semen of men in order to investigate its origin. Vasectomy did not result in a significant reduction in seminal plasma ILM. Determination of ILM immunoreactivity in ejaculates form normal men and semen samples characterized by prostate-rich and prostate-deficient secretions, indicated high levels of ILM in the prostatic secretions. Immunoreactive ILM levels estimated in different fractions of split ejaculates from normal men paralleled those of zinc and acid phosphatase activity and were significantly higher in fractions representing prostatic secretions compared to those representing the secretions of seminal vesicles. Estimation of ILM in semen, serum and urine from bilaterally gonadectomized men showed that immunoreactive ILM levels remained high after gonadectomy. It is concluded that the bulk of the immunoreactive ILM present in the semen, blood and urine of men is not secreted by the testes. The principal site of origin of this material, at least in semen, appears to be the prostate.     

Semen characteristics and diabetes mellitus: significance of insulin in male infertility

A study was made of semen quality and serum hormonal profiles (FSH, LH, prolactin, testosterone) of patients with type I diabetes mellitus. Semen parameters and levels of prolactin and testosterone were significantly altered in the diabetic state. The concentration of insulin in serum and seminal plasma and the serum levels of FSH, LH, and testosterone were measured in 80 men classified in the following groups: fertile subjects, infertile normoglycemic subjects, subjects with carbohydrate intolerance, and excretory and secretory azoospermic subjects. In all groups, seminal insulin concentrations were higher than those obtained in serum. The hormone appears to freely cross the blood-testis barrier, there to be concentrated in the semen. The levels of insulin in serum and seminal plasma did not correlate with semen parameters and are not suitable markers of seminal quality. For unknown reasons, the concentrations of insulin in seminal plasma were lower in the subjects suffering from carbohydrate intolerance.     

PSA和PAP在不同状态精液中的变化

目的　探讨不同状态精液中PSA和PAP的变化水平及二者间的关系。方法　按WHO精液分析标准 ,112份精液样品分为精液正常组 ,少、弱精子症组 ,无精子症组 ,白细胞精子症组 ,液化不良精子症和高粘度精液组。分别测定精浆中PSA水平和PAP活性 ,并分别以每毫升 ,每克精浆蛋白和 1次射精表示PSA的量及PAP活性。结果　三种表示方法的PSA含量在各异常精液组均较正常组呈下降趋势 ,但只有以每克精浆蛋白表示PSA量时 ,除无精子症组外 ,其它各异常组才显著低于正常组 ;三种方法表示的PAP活性 ,在少、弱精子症组均显著低于正常组 ;以 1次射精表示PSA和PAP时 ,无精子症组均低于正常组 ;以同一种表示方法的结果进行PSA和PAP间相关分析时显示以每克精浆蛋白表示法相关性最好 (r =0 .689,P <0 .0 0 1,n =112 )。结论　以mg/ g精浆蛋白表示PSA含量能更准确反映精浆中PSA的实际状态     

慢性前列腺炎患者精浆果糖、微量元素与血清生殖激素水平的关系

本文对30例正常人及48例慢性前列腺炎(CP)患者进行了糖浆果糖、微量元素及血清FSH,LH及睾酮测定并进行了相关分析。结果表明CP者精浆锌、镁及钙含量较正常人明显减低,果糖含量差异不显著。CP者血清FSH、LH及睾酮水平均与正常人无明显差异。精浆果糖含量在CP者与LH显著正相关。正常人精浆锌、镁及钙分别与睾酮负相关,CP者不存在此关系。精浆铜、锰、铁及硒与血清生殖激素无关。     

Increased levels of interleukin-8 in human seminal plasma

Summary.  The role of cell-mediated immunity in the aetiopathogenesis of male infertility is far from being defined. The cytochemokine interleukin-8 (IL-8) has a key role in T-cell mediated immune responses. The aim of this study was to confirm the presence of IL-8 in human seminal plasma, to show differences between IL-8 concentrations in fertile and infertile subjects, and to show the potential relationship between IL-8 amounts in semen and spermiogram parameters. IL-8 levels were determined in the seminal plasma of 77 men divided as follows: (a) into seven groups according to the aetiological diagnosis of fertility and (b) into two groups on the basis of a normal or abnormal spermiogram. The mean value of IL-8 in the seminal plasma was 31.5 times higher than the upper limit in normal serum. There is a borderline statistical significant difference among the means of the various groups ( P <0.051). The Tukey's HSD test for multiple comparisons indicated no two groups as being significantly different, whereas the less conservative test LSD showed significant differences between the group with infection and groups with normal controls, Klinefelter's syndrome, mumps orchitis, cryptorchidism, or varicocele. There was no significant difference in IL-8 levels between men with normal and those with abnormal spermiograms. Furthermore, there was no correlation between IL-8 levels and the variables of the spermiogram. Even though the conclusions of this study have to be tempered by the sample size, IL-8 concentration in seminal plasma may be considered as a potential marker for the diagnosis of male accessory gland infection.     

Metenkephalin in Seminal Plasma of Infertile Men

Background: Enkephalin is one of the opioids, which is expressed widely in reproductive organs. However, the function of enkephalin in male reproduction is not completely understood. The effect of metenkephalin on sperm motility remains especially controversial. In this study we examined the level of metenkephalin in seminal plasma from men with normal sperm production and patients with asthenospermia, oligospermia, and azoospermia to investigate the role of metenkephalin in seminal plasma on sperm function. We also investigated the effect of metenkephalin on sperm motility in vitro.
Methods: Sixty nine infertile patients (31 oligospermic, 21 asthenospermic, and 17 azoospermic) were included in this study. The level of metenkephalin in seminal plasma of these men was measured and the effect of the peptide on the motility of human sperm was examined in vitro. Seventeen men with normal seminograms were a control group.
Results: The level of metenkephalin in the seminal plasma of semen from asthenospermic men was significantly lower than that from the controls ( P < 0.05). No significant correlations between the level of metenkephalin and the mean pathing or progressive velocity of sperm, or serum hormone levels were observed. In the in vitro study, which used semen from the controls, treatment of sperm with metenkephalin (50–200 pg/mL) maintained sperm motility for 4 hours. On the other hand, motility of sperm incubated without metenkephalin began to decrease at 3 hours. Metenkephalin levels of 50 pg/mL in seminal plasma is considered to be necessary for maintaining sperm motility.
Conclusion: These results suggest that metenkephalin in seminal plasma is an important clue in the investigation of decreased sperm motility.     

Melatonin administration alters semen quality in healthy men

The role of melatonin in the regulation of reproduction in humans is unknown. We conducted a 6-month, double-blind, crossover study of a daily treatment dose of 3 mg melatonin or placebo given orally at 1700 hours in 8 healthy men. Semen quality (concentration, motility, and morphology), serum and seminal plasma 17-beta-estradiol (E(2)), testosterone, melatonin, and serum gonadotropin levels were determined every 3 months throughout the study. In 6 men, there was no change in semen quality or in serum and seminal plasma hormone levels during the study period. In 2 men, during the melatonin treatment period, sperm concentration decreased to 3 x 10(6)/mL and 12 x 10(6)/mL, and motility declined to 32% and 30%. These coincided with a decline in seminal plasma and serum E(2) levels and with an increase in testosterone:E(2) ratios. Six months after the cessation of melatonin, sperm concentration and motility were normal in 1 man but remained abnormal in the other one with a still elevated testosterone:E(2) ratio. Serum gonadotropin levels were unchanged during the study in all 8 men. Our preliminary observations suggest that long-term melatonin administration is associated with decreased semen quality in a number of healthy men, probably through the inhibition of aromatase at the testicular level.     

Decreased prostate-specific membrane antigen levels in the seminal plasma of oligoasthenoteratozoospermic men

Prostate-specific membrane antigen (PSMA) is a transmembrane glycoprotein with glutamate carboxypeptidase activity. However, its precise function in the prostate, prostasomes and seminal plasma with regard to male fertility remains unknown. This study was conducted to investigate the seminal plasma PSMA levels in fertile men and patients with oligoasthenoteratozoospermia (OAT) and to analyse its association with sperm parameters. Twenty fertile men and twenty patients admitted at the urology clinic of our institution with the diagnosis of OAT were included in the study. Following semen analysis, seminal plasma was isolated from semen ejaculates. PSMA concentrations in the seminal plasma were determined by ELISA. The correlations between seminal PSMA concentrations and semen parameters were statistically analysed. Seminal plasma PSMA concentration was significantly lower in OAT patients compared to fertile controls (p < .01). In fertile men, PSMA concentration was significantly correlated with the sperm concentration (r = −.481, p < .05), whereas in the patient group no statistically significant correlation was found between the sperm parameters and seminal PSMA level. This is the first study in the literature to investigate PSMA levels in the seminal plasma from infertile men. Decreased levels of seminal plasma PSMA might suggest a role for compromised prostasome function in the pathogenesis of OAT syndrome.     

Seminal plasma androgen/oestrogen balance in infertile men

The hypothesis that the balance between oestrogen and androgen in seminal plasma is important for normal fertility was investigated. We determined the concentrations of oestradiol and testosterone in blood and seminal plasma from 62 infertile men and 32 normozoospermic men. Infertile men were classified according to semen analysis (concentration, motility and morphology): asthenozoospermia, oligozoospermia and oligoteratoasthenozoospermia. Serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were determined in all participants. For all subjects, mean testosterone levels were lower and mean oestradiol were higher in seminal plasma than in blood. Seminal plasma testosterone levels were lower in the infertile groups vs. control men ( p < 0.0002). Oligpzoospermic and oligoteratoasthenozoospermic men had significantly higher seminal plasma oestradiol levels compared with controls ( p < 0.03). The three infertile groups had significantly lower seminal plasma testosterone/oestradiol ratio than control men ( p < 0.001). Sperm analysis data (concentration, motility and morphology) significantly correlated with seminal plasma testosterone/oestradiol ratio. The findings of elevated seminal plasma oestradiol, decreased testosterone and testosterone/oestradiol ratio in infertile men, and the significant correlation between hormone levels and sperm analysis data suggest that the local balance between androgen and oestrogen is important for spermatogenesis.