Antidepressant-associated changes in semen parameters

We describe 2 cases of patients referred for evaluation of male infertility who had antidepressant medication-associated changes in sperm motility and/or concentration. The physical examination and endocrinologic study findings were unremarkable in each case. Analysis of the initial semen specimens revealed oligospermia, impaired motility, and abnormal morphology in each patient while they were taking serotonin reuptake inhibitors. Repeat semen analyses performed 1 to 2 months after discontinuation of the antidepressants demonstrated marked improvements in sperm concentration and motility. Additional assessment of the potential impact of antidepressant medications on male fertility is warranted.     

Circannual variation in human semen parameters

The aim of the present study was to determine whether there were significant monthly variations in the semen parameters (i.e. volume, sperm count, total sperm count, motile and normal sperm count) of men living in a Mediterranean climate area. A total of 10 877 semen analysis results were included. Semen samples were obtained as a part of an initial screening of male partners from couples with infertility problems who were attending our laboratory from 1970 to 2000. Log transformation and cubic root transformation were used to test the sample distribution. Statistical significance was adjusted by year of examination, patient's age and sexual abstinence period by performing covariance analyses. Differences between months were assessed with the Bonferroni post-hoc test. There was an increase in March and a decrease in September in the adjusted mean sperm count (p < 0.0005), total sperm count (p < 0.0005), motile sperm count (p=0.01) and normal sperm count (p=0.002). There were no variations in semen volume in the study period. Monthly changes in semen quality are confirmed in this population.     

Variation of semen parameters in fertile men

The spermiograms of 63 fertile men (whose female partners were pregnant at the time of examination) were evaluated. A wide Gaussian distribution of the different semen parameters was found. Both parametric and nonparametric statistical tests were applied and gave almost identical results. In a subgroup of 34 men, a second semen sample was analysed, but a significant difference (p less than or equal to 0.05) between the two samples was found only regarding the proportion of abnormal forms. Between various semen parameters significant correlations were found. There was no association between follicle stimulating hormone (FSH) and sperm density with sperm counts greater than 20 mill/ml.     

Nonsperm cells in human semen and their relationship with semen parameters

The prevalence and clinical significance of leukocytes (WBC) and immature germ cells in semen is currently a matter of controversy. The aim of this work was to assess the prevalence of leukocytospermia in semen samples from Venezuelan men and its possible effects on sperm parameters. The concentration of WBC and round cells (RC) was evaluated in 118 semen samples from 19 fertile subjects (group 1), 62 infertile patients (group II), and 37 men with varicocele (group III). Semen WBC concentration was assessed by peroxidase assay. Twenty-six (22%) of the total samples had more than 10 WBC/mL semen. Twenty of the infertile men had leukocytospermia (32%) compared with 16% in the fertile group and 8% in the varicocele group. Semen RC concentration was lower than 5 x 10(6)/mL in all groups but, in groups II and III was significantly higher compared with group I. Infertile men had the highest WBC concentration. WBC concentration was negatively correlated with progressive motility, percentage of morphologically normal sperm, and hypoosmotic swelling test in infertile men but not in the varicocele group. In this group a negative correlation was obtained between immature germ cells and normal sperm morphology. The data show that leukcytospermia occurs frequently in infertile patients and is associated with poor semen quality parameters. In contrast, in men with varicocele, the increased number of immature germ cells might play a pivotal role in the pathogenesis of abnormal spermatozoa.     

Interpretation and misinterpretation of semen parameters

Semen analysis, which is traditionally used to evaluate male fertility, may be misleading if sample is lost or inadequately mixed. A short or excessive abstinence period may cause a low count or a high count with low motility. Damage from low temperature or delay in evaluation may decrease the reported motility. Computer-assisted semen analysis has eliminated some of the variability and has allowed the evaluation of other sperm motion variables such as sperm velocity, linearity, maximum and mean amplitude lateral head displacement, and beat-cross frequency. These measurements may also occasionally be misleading. Other tests may give a better indication of the function of sperm. The hamster egg penetration test has been used but is technically difficult, and perhaps that is why there is controversy as to the clinical value of the test in predicting subfertile sperm despite normal conventional semen analysis. Some recent data suggest that the hypo-osmotic swelling test, which determines the functional integrity of the sperm membrane, may be the appropriate prognosticator. There is a need for further studies to define the best method to determine whether a male factor is responsible for a couple's infertility.     

芹菜素对小鼠精液参数影响的研究

目的:探讨芹菜素对小鼠精液参数的影响。方法:成年健康SPF级昆明种雄性小鼠100只按体重随机分成5个剂量组(阴性对照组、溶剂对照组及芹菜素低、中和高剂量组),各剂量组又随机分成7 d和14 d处理组。每天定时依次灌胃,7 d处理组和14 d处理组分别连续灌胃7 d和14 d,在首次灌胃第35 d时处死小鼠,取材,应用计算机辅助精液分析技术(CASA)检测小鼠精子运动参数。结果:芹菜素7 d处理各剂量组精子运动参数及精子密度、a+b级精子百分率与阴性对照组比较差异无统计学意义;芹菜素14 d处理高剂量组平均路径速度(VAP)、直线速度(VSL)、前向性(STR)、摆动性(WOB)、b级精子所占比例及a+b级精子百分率低于阴性对照组,鞭打频率(BCF)高于阴性对照组,均有统计学意义(P<0.05)。结论:芹菜素对小鼠精子运动参数有一定的影响。     

Important semen parameters during postcoital testing

One hundred and sixty-two females who attended our infertility clinic were selected according to the quality of their cervical mucus. Only mucus of extremely high quality was used in the study to determine the influence of different semen parameters on the postcoital test results. All mucus samples were evaluated 8 h following coitus. The results of the postcoital tests were divided into group I (less than 7 spermatozoa per 400 X magnification) and group II (greater than 7 spermatozoa per 400 X magnification). The results of the statistical analysis indicated the order of importance of the different semen parameters during postcoital testing. By using the stepwise discriminant analyses, it was calculated that the sperm concentration and forward progression rate of the spermatozoa are discriminating factors between the two groups.     

禁欲时间对人类精液参数的影响

目的探讨禁欲时间对精液参数的影响。方法回顾性分析85名供精者精液常规分析记录的精液量、密度、活动率、前向运动精子比率（a＋b）％、精子总数和前向运动精子总数，结果按禁欲时间分为〉3d（组1）、〈5d（组2）和≥5d（组3）3个组。结果在精液量和精子总数方面：组1、组2和组3均值逐渐升高，而组3与组1、组2比较差异有显著性意义；密度方面：组1、组2和组3均值逐渐升高，但3组之间比较差异无显著性意义；在活动率与（a＋b）％方面：组1、组2和组3均值逐渐降低，组1与组2、组3比较差异有显著性意义；而在前向运动精子总数方面，组1、组2和组3均值也是逐渐升高，但仅组1与组3比较差异有显著性意义。结论禁欲时间对精液参数有一定的影响，禁欲时间越长，一次排出的精子活动率及（a＋b）％越低；而精液量、精子密度、精子总数、活动精子总数及前向运动精子总数等数值越高。要想获得最高的（a＋b）％，禁欲时间≤3d最好；要想获得较好的（a＋b）％与前向运动精子总数，禁欲时间以〉3d、〈5d最好。     

Determination of the time for improvement in semen parameters after varicocelectomy

This retrospective study aimed to determine the time for improvement in semen parameters after varicocelectomy. A total of 175 patients over 18 years of age, who underwent microscopic inguinal varicocelectomy in a tertiary centre between 2005 and 2016 and had post-operative follow-up data of at least 12 months, were included in the study. Serial semen analyses in the pre-operative period and at the post-operative third, sixth, ninth and 12th months were retrospectively documented. With respect to their pre-operative total motile sperm counts, the patients were classified into three subgroups as <5 million, 5–9 million and >9 million. In the overall cohort and the group with a total motile sperm count of >9 million, the semen parameters continued to improve up to the post-operative 12th month. No further significant improvement was observed after the post-operative third and sixth months for the patients with pre-operative total motile sperm counts of <5 million and 5–9 million respectively. For the candidates of varicocelectomy, the decision of treatment strategies, such as assisted reproductive technologies and waiting for spontaneous pregnancy can be based on the prediction of the time for improvement in semen parameters.     

Individual variation in semen parameters of healthy young volunteers

Individual variation in semen parameters was investigated in healthy young volunteers. Semen samples were collected approximately once a month over a one-year period for a total of 93 samples (5 to 10 samples per subject) from 12 volunteers in their twenties. Semen analysis was carried out according to the WHO Manual. The amount of variation in each semen variable was calculated for each subject by dividing the maximum value by the minimum value. The results showed that the semen volume varied by 1.9+/-0.8 fold (1.3 to 4.2 fold), the sperm concentration by 4.8+/-4.3 fold (1.5 to 17.2 fold), the percentage of sperm with forward progression by 2.8+/-1.4 fold (1.6 to 6.4 fold), the percentage of sperm with rapid linear progression by 3.4+/-2.6 fold (1.7 to 10.9 fold), the percentage of sperm with normal morphology by 1.9+/-0.4 fold (1.3 to 2.4 fold), and the percentage of live sperm by 1.5+/-0.4 fold (1.1 to 2.6 fold). A between-group comparison showed significant differences in all of the variables except the percentage of sperm with normal morphology. These results suggest multiple and considerable semen analyses are needed when evaluating semen parameters.     

Geographical differences in semen characteristics: Comparing semen parameters of infertile men of the United States and Iraq

The declining trend of male fecundity is a major global health and social concern. Among numerous other confounding factors, variations in male fertility parameters in different regions have repeatedly been suggested to be influenced by geographic locations. The impact of overall lifestyle, behavioural patterns, ethnicity, work stress and associated factors upon health differ greatly between developed and developing countries. These factors, individually or in combination, affect male reproductive functions ensuing the discrepancies in semen qualities in connection with geographic variations. However, reports comparing semen characteristics between developed and developing countries are sparse. The present study finds its novelty in presenting a comparison in semen parameters of infertile men in the United States (n = 76) that fairly represents the population of a highly developed region and Iraq (n = 102), the representative of male populations of a developing region. Samples were collected and analysed according to WHO (WHO laboratory manual for the examination and processing of human semen, WHO; 2010) criteria by means of the Mann–Whitney test. The US population demonstrated lower sperm concentration, total count, and total and progressive sperm motility with a higher seminal total antioxidant capacity (TAC) as compared to the Iraqi population. This report encourages further investigations concerning the confounding factors leading to such alterations in semen qualities between these two geographic areas.     

Varicocelectomy: semen parameters and protamine deficiency

Different methods have been used to evaluate the beneficial effect of varicocelectomy; these include semen parameters and pregnancy rate. Because of high biological variability of semen parameters, sperm functional tests have been considered as an efficient end point in assessment of fertility. Therefore, the aim of this study was to evaluate the effect of varicocelectomy on semen parameters and sperm protamine deficiency in 192 patients. The results of the present study show that all the three semen parameters and percentage of sperms with normal protamine content have improved post-surgery. The cumulative pregnancy rate was 34.6%. Comparing the results of the semen parameters and protamine content between patients whose partner became pregnant to those who did not benefit from varicocelectomy before and 6 months after surgery, show that patients may benefit from varicocelectomy that had higher initial semen density and better sperm morphology prior to surgery. Detailed analyses of sperm morphology, along with aforementioned results reveal that the factors which account for pregnancy difference are: (i) improvement in early events of spermatogenesis, possibly during spermatocytogensis and reduction division; and (ii) late spermiogenesis events. Thus, it can be suggested that patients with low initial sperm count may benefit more from assisted reproductive techniques or varicocelectomy followed by assisted reproduction.     

冷冻前平衡处理对人精子冻融后相关参数的影响

目的:研究冻前平衡处理对冷冻精子复苏率的影响,优化一步熏蒸法,以寻找人类精子冷冻的最优方法。方法:使用50例自愿供精者的正常精液标本,同1例供精者的精液一式3份,分别采用不平衡直接冷冻法、室温平衡10 min后冷冻与4℃平衡10 min后冷冻的方法进行处理。复苏后用计算机辅助精液分析(CASA)系统分析3组标本冷冻前后精子运动参数的变化,并检测各组标本精子的畸形率和存活率。结果:4℃平衡组的前向运动精子复苏率[(61.88±16.94)%]显著高于未平衡组[(48.61±16.44)%]和室温平衡组[(49.41±13.77)%](P<0.05),而室温平衡组与未平衡组前向运动精子复苏率则无显著性差异。3组标本经冷冻复苏后其精子畸形率和存活率无显著性差异。结论:冻前4℃平衡10 min的冷冻前处理方法操作简单,实验条件易控,对提高精子复苏率有重要意义。     

Recommended biochemical parameters for routine semen analysis

Summary The measurement of biochemical markers in human seminal plasma is important in the evaluation of male infertility. We recommend the measurement of one representative substance for each organ involved in seminal fluid production as a routine diagnostic tool: The initial fructose level for seminal vesicular function, citrate or acid phosphatase for the prostate gland and free carnitine as an index of epididymal function. A biochemical analysis of seminal fluid enables us to detect disturbances of the male adnexal organs and may lead to more exact therapy.     

Effect of SARS-CoV-2 infection on semen parameters

IntroductionIn this study, we aimed to assess the effect of SARS-CoV-2 infection on semen parameters in one group of patients before and after infection.MethodsPatients were screened if they had a semen analysis performed between October 1, 2019, and December 1, 2020, in the assisted reproduction unit and later had positive polymerase chain reaction (PCR) test for SARS-CoV-2 infection. The patients’ semen parameters were recorded before and after SARS-CoV-2 infection, along with degrees of SARS-CoV-2 infection, dates of SARS-CoV-2 infection, durations between the treatment for SARS-CoV-2 infection and the second semen analysis, time of symptom onset, duration of their symptoms, ages, comorbidities, and any medications patients were taking.ResultsForty-one patients were included in the study. The mean age of the patients was 31.29±5.95 years. The mean duration from first semen analysis to the PCR test was 7.74±3.03 months. The mean duration between the PCR test and later semen analysis was 2.35±1.35 months. The median sperm concentration for the patients before and after SARS-CoV-2 infection were 24 mil/ml and 13 mil/ml, respectively (p<0.001). The normal morphology percentage before infection was 3.16±0.92, while it was 2.44±1.04 after infection (p=0.011). In 26 patients, the period from the time of infection to the second semen analysis was over 70 days, while this period was less than 70 days in the other 15 patients. In both patient groups, a significant decrease was detected in the sperm concentrations and total sperm count.ConclusionsIn the semen samples we assessed, we observed a significant decrease in the mean sperm concentration, total sperm count, and mean percentage of samples with normal morphology after SARS-CoV-2 infection.