Distinct Expression of Cytokines and Mitogenic Inhibitory Factors in Semen of Fertile and Infertile Men

PROBLEM: To assess the effect of seminal plasma (SP) of fertile and infertile men on leukocyte mitogenic response, and the capability of sperm cells to produce IL-1. METHODS: This study included four groups: fertile men (donors, normal), infertile men with azoospermia (azoo), oligo-terato-asthenozoospermia (OTA), and OTA with genital infection (OTA-inf). Mouse spleen cell proliferation in response to lipopolysaccharide (LPS) or Concanavalin-A (Con-A) was examined in the presence of SP from the above four groups. Supernatants (sup) and lysates (lys) of sperm cells from fertile and oligoteratoasthenospermic (OTA) men were evaluated for IL-1 bioactivity by specific bioassay. RESULTS: Seminal plasma (SP) of the four groups were shown to inhibit the mitogenic response of mouse spleen cells to LPS and Con-A. SP of fertile men was significantly more inhibitory than SP from infertile men. Sperm cells from fertile and OTA infertile men constitutively produced IL-1. Sperm cells of both groups produced similar levels of IL-1 as examined in the supernatants and lysates. CONCLUSIONS: Seminal plasma of fertile men had more inhibitory mitogenic activity than that of OTA. Sperm cells constitutively produce IL-1. It is possible that the factors involved in this inhibition are not only anti-proliferative immune factors. Cytokines and inhibitory factors of mitogenesis in the seminal plasma may be involved in the physiology and pathophysiology of sperm functions and thus affect male fertility.     

The Fertilizing Capacity of Golden Hamster Epididymal Spermatozoa in Relation to Age, Number, Motility and Morphology

Experiments with spermatozoa of prepubertal hamsters aged 35-48 days were performed in order to determine if the appearance of spermatozoa with fertilizing capacity in the cauda epididymis during puberty is related to changes in their morphology, motility and number. Epididymal spermatozoa of prepubertal animals were evaluated for number, motility and morphology and were injected into one uterine horn of a female, following induction of ovulation. A comparable number of sperm from mature animals (which served as control) was injected into the contralateral horn. Prior to 40 days fertilizing capacity was nil. It increased thereafter and reached control levels of 74% at 48 day age. Concomitantly there was an increase in the number of sperm per cauda epididymidis from less than 1 million to 55 million. Following removal of spermatozoa from the cauda the motility increased from 24% motile cells at the age of 39 days to 66% at the age of 48 days when most cells exhibited progressive motility. The percentage of cells having normal morphology increased from 18% at the age of 39 days to 50% at the age of 48 days. Developmental processes resulting in improvement of cell motility, morphology and number are correlated with attainment of fertilizing capacity. These processes seem to be gradual and occur between time of completion of spermatogenesis and time when capacity for fertilization is achieved.     

Assessment of emergency medicine: a comparison of an experimental objective structured clinical examintion with a practical examination

An emergency medicine and trauma programme was implemented at Ben Gurion University Medical School in Israel. Clinical performance assessment of the first-year course in emergency medicine and trauma was done using a practical examination (PE). In the continuous process of critically reviewing the course objectives and assessment methods the objective structured clinical examination (OSCE) was chosen, for the first time in our medical school, as a tool for course development as well as evaluation of the existing PE. Seven experimental OSCE stations were designed which covered some of the course and practical examination topics. Twenty-six first-year medical students have taken both examinations concurrently. Twenty-three students answered an attitude questionnaire regarding both examinations. Results have indicated that the OSCE provided additional and crucial information on students' deficiencies in clinical performance which were not available from the PE. Those differences were probably due to realistic OSCE station content, highly simulated set-ups, and the objectivity of the examiner, all of which have contributed to a more challenging examination, as compared to the PE. The OSCE in emergency medicine and trauma seemed to have a relatively high level of acceptance by both staff and students. In our opinion it seems that the OSCE is a better tool for first-year level final assessment in emergency medicine and trauma. is a better tool for first-year level final assessment     

Comparison of Pituitary Response to Regular GnRH, Analogue (D–TRP6) and Placebo

Pituitary response to synthetic regular GnRH, to a potent analogue (D-TRp6) and to placebo were compared in ten azoospermic males. FSH and LH were measured prior to and at given intervals following administration of each substance. In addition, plasma levels of testosterone and prolactin were measured. There was no significant difference in the magnitude of FSH and LH release following injection of their the regular or the analogue form of GnRH. However, plasma gonadotrophins remained elevated for significantly longer time periods following the administration of the analogue GnRH. In those patients in whom LH levels remained elevated for at least 24 hours the observation of elevated testosterone levels permitted the inference of adequate biological activity of endogenously produced LH. Patients who did not respond to the regular GnRH were also non-responsive to D-TRp6 GnRH. A surprising finding ws elevated prolactin levels 4-6 hours following GnRH administration. Placebo had no influence on gonadotrophins, testosterone and prolactin.