Serum concentrations of pituitary and testicular hormones in infertile Nigerian males

Serum concentrations of luteinising hormone, follicle stimulating hormone, prolactin, and testosterone were measured by radioimmunoassay in 384 male partners of infertile Nigerian couples in order to assess the prevalence of abnormalities of these hormones in this population of African males. Eighty-eight (23%) of the patients had hyperprolactinemia, which was associated with subnormal testosterone concentration in 38 patients. Thirteen percent had features suggesting either primary gonadal failure or germinal tubular dysfunction, while 1% had hypogonadotropic hypogonadism. The results show that a substantial proportion of our infertile males have abnormalities of the hormones measured. It is suggested that the estimation of these hormones should be an integral part of the evaluation of infertile African males, since the information so provided will be of value in the management and treatment of a large number of these patients.     

Diagnosis and treatment of immunologically infertile males with antisperm antibodies

The presence of antisperm antibodies (ASA) can reduce fecundity in both males and females. The present review describes a strategy, established by investigations of the diverse inhibitory effects of ASA on fertility, for the appropriate diagnosis and treatment of infertile males with ASA. For infertile males with ASA, diagnosis using the direct-immunobead test (DIBT), the postcoital test (PCT) and the hemizona assay (HZA) should be carried out as the basis for decision-making. If the patient with ASA has an abnormal hemizona index, it seems reasonable to advise selecting intracytoplasmic sperm injection-embryo transfer (ICSI-ET) as a primary treatment. However, it has been shown that some immunologically infertile males with normal fertilizing ability established pregnancy by timed intercourse (TI) or intrauterine insemination (IUI). In such patients with ASA having normal hemizona index, TI or IUI can be selected based on the PCT result. Therefore, the treatment strategy for males with ASA is similar to that for infertile males with oligozoospermia or asthenozoospermia. In conclusion, it should be emphasized that a diversity of ASA exists and their effects on fertility in infertile males. Although there is an argument that routine testing for ASA in males is not always necessary, one should be aware that in some cases of failed IUI or IVF, ICSI is selected afterward because of the diagnosis of ASA.     

Characterisation of a sperm coating auto-antigen reacting with antisperm antibodies of infertile males using monoclonal antibodies

Objective In a previous study a number of sperm-specific antigens were identified which reacted with antisperm antibodies from both infertile and vasovasostomised males. To investigate the localisation and distribution of these antigens and their role in male fertility, monoclonal antibodies were raised against them; immunoblotting techniques were used to select only those antibodies which competed with human antisperm antibodies for these human auto-antigens.
Design One antibody, NW21, reacted with an 18 kDa auto-antigen present on epididymal sperm but absent from testicular sperm. Immunohistochemical studies showed that the antigen is produced in small basal cells between the columnar epithelium of the corpus epididymis, passes up into the tubule and then coats sperm passing along the epididymis. Sperm stored in the cauda epididymis and ductus deferens stain strongly for this sperm coating glycoprotein.
Conclusions The localisation of this antigen supports the suggestion that auto-immune infertility may represent a response to epididymal rather than testicular sperm. Monoclonal antibodies raised to unique and immunologically accessible sperm coating proteins, produced in the epididymis rather than in the testis, would seem to present an excellent theoretical solution to male contraception.     

Clomiphene treatment in oligospermic infertile males

This study of the effects of long-term clomiphene administration on semen analyses of oligospermic infertile males once again points to the potential therapeutic efficacy of clomiphene in certain subjects. Although the group of 16 subjects was small, all were men with long-standing infertility that had been refractory to previous treatments such as exogenous injections of human chorionic gonadotropin and varicocelectomy; 10 of the 16 men (62.5%) showed improvement in sperm counts within 2 to 5 months of starting clomiphene. Sperm motility improved moderately when counts improved; no effects on sperm morphology were noted. Of the 10 men classified as semen responders to clomiphene, 5 (50%) were successful in impregnating their wives within 2 to 8 months of starting treatment. These results approach the therapeutic efficacy seen with clomiphene in appropriately selected females with ovulatory disturbances. We have been unable to predict or characterize the patient who might be expected to show a semen response to clomiphene by history, physical examination response to previous treatment, or changes in blood testosterone levels while taking clomiphene.     

Sperm-agglutinating antibodies in infertile women

This paper explored the experience with sperm-agglutininating antibodies in 168 infertile couples. 2 of the 46 subjects with organic causes for infertility had positive sperm agglutination tests, and neither became pregnant in the 6-18 month followup period. Of the remaining 122 subjects with no organic cause for infertility, 24 (20%) had positive tests (including 13 women with primary infertility and 11 with secondary infertility). 9 of the 24 women (38%) with positive tests became pregnant following condom therapy. There was no correlation between the sperm antibody test and postcoital test, nor between sperm agglutinins and ABO incompatibility. These results suggest that a small number of women have specific reactions against sperm or seminal fluid that inhibit fertility. It is concluded that screening of serum for sperm agglutinins should be continued to provide an estimate of immunologic reactions against semen in cases of infertility.     

Frequency distribution of sperm counts in fertile and infertile males

In this study the frequency distribution of sperm counts and total sperm counts from more than 4000 allegedly fertile males were compared with those of husbands in 1000 infertile couples. Significant differences were observed only at the lower end of the scale (sperm counts below 10 million/ml and total sperm counts below 25 million/ejaculate). Frequency distributions of sperm counts above 10 million/ml or total sperm counts above 25 million/ejaculate revealed little difference between the fertile and infertile groups. These data suggest that, unless other parameters are found to be abnormal, sperm counts and total sperm counts above 10 million/ml and 25 million/ejaculate, respectively, probably are not major factors in a couple's infertility.     

Sperm-agglutinating antibodies in 236 infertile couples

19 wives of 236 couples had positive sperm agglutination tests. (SPAT) 6 of the 19 belonged to the 70 couples (9.4%) with no no known cause for infertility; 11 belonged to the group of 154 couples (7.1%) with a known cause; and 2 to the 12 couples inadequately investigated (15.7%). 6 of these 19 women (31.6%) became pregnant without condon therapy; of these 6, 3 had no known cause for infertility and 3 had a known cause. 11 husbands had positive sperm aggluatination tests. 4 of these 11 were among the 70 couples (5.6%) with no known cause for infertility, while the other 7 were among the 154 couples (4.5%) with a known cause. 5 of their wives (45.5%) became pregnant without any treatment. Outcomes of 8 of 11 pregnancies were normal deliveries and no abortioons, which showed that positive SPAT had no apparent effect on the pregnancies. There was no relationship between postitive SPAT and history of venereal disease, allergy, autoimmune disease, abortioon, postcoital tests, or ABO imcompatability.     

Thyroid hormones in the human pregnancy

Radio-immunologic T3, T4, FT3, FT4, rT3, TBG and 17 beta-estradiol were measured in women in the 2nd and 3rd trimester of pregnancy, during labor, and during the first 14 days of the puerperium. A group of women suffering with gestosis EPH were also investigated. Our data suggest that in women suffering with gestosis EPH and during labor in normal pregnancy there is a T3-selective defect (low T3 syndrome) in which the conversion route of T4 into T3 is inhibited while the conversion route of T4 into rT3 remains fully operative, resulting in low plasma levels of T3 and FT3 and normal levels of T4, normal or high levels of FT4 and high levels of reverse T3.     

Analysis of sperm chromosomes in infertile males with teratozoospermia

OBJECTIVES: The aim of the study was to examine sperm chromosomes from infertile males with teratozoospermia. DESIGN: Basic research study MATERIALS AND METHODS: Spermatozoa were obtained from infertile males with teratozoospermia. Intracytoplasmic sperm injection was used to inject human spermatozoa into mouse oocytes in order to examine sperm chromosomes. RESULTS: Chromosomes of spermatozoa obtained from 6 infertile teratozoospermic and 1 fertile normozoospermic males were investigated. The mean frequency of structural chromosome aberrations in amorphous, motile spermatozoa was similar to that of morphologically normal sperm (9 vs. 7.7%). The structural aberrations found in amorphous, immotile spermatozoa reached 93% and revealed severity was significant. CONCLUSIONS: Teratozoospermia per se did not increase the frequency of structural chromosome aberrations in sperm. Severe chromosomal damage was revealed when immotile spermatozoa were injected into oocytes by ICSI.     

Thyroid hormones and fetal brain development

Thyroid hormones are intricately involved in the developing fetal brain. The fetal central nervous system is sensitive to the maternal thyroid status. Critical amounts of maternal T3 and T4 must be transported across the placenta to the fetus to ensure the correct development of the brain throughout ontogeny. Severe mental retardation of the child can occur due to compromised iodine intake or thyroid disease. This has been reported in areas of the world with iodine insufficiency, New Guinea, and also in mother with thyroid complications such as hypothyroxinaemia and hyperthyroidism. The molecular control of thyroid hormones by deiodinases for the activation of thyroid hormones is critical to ensure the correct amount of active thyroid hormones are temporally supplied to the fetus. These hormones provide timing signals for the induction of programmes for differentiation and maturation at specific stages of development. Understanding these molecular mechanisms further will have profound implications in the clinical management of individuals affected by abnormal maternal of fetal thyroid status.     

Peculiarities of semen coagulation and liquefaction in males from infertile couples

The results of electrosemengraphy showed frequent absence of postejaculatory semen coagulation (62% of patients examined) and 3 variants of ejaculate liquefaction in males from infertile couples. Semen liquefaction was mostly of a cascade nature (one- and two-cascade types), but viscid ejaculates often liquefied slowly and monotonously (monotonous type of liquefaction).     

Chromosome abnormalities in one thousand infertile males with nonobstructive sperm disorders

One hundred thirty-five in 1,000 (13.5%) Tunisian male infertile patients with nonobstructive spermatogenesis disorders were found to have chromosomal abnormalities.