The Male Factor in Human Infertility Diagnosis and Treatment

This book is a compilation of edited papers which were presented at the XIth World Congress of Fertility and Sterility held in June 1983 in Dublin, Ireland. Although it has long been known that male factors are responsible in at least 30% of infertile couples only recently have concerted efforts been made on the part of urologists, gynaecologists and basic scientists to identify these factors more precisely. The nature of spermatogenesis is complex but application of various scientific methods have at last opened up new and promising approaches to our understanding of this subject. Clinical results however have been depressing; the majority of treatments lack realistic evaluation and are initiated in hope rather than with a sound scientific basis. We anticipate that this volume will in some small way correct these deficiencies. The papers have been grouped into related topics. The first section deals with the evaluation of the spermatozoa and includes a critical assessment of the recently introduced zona-free hamster egg test of sperm function. Further sections include the biochemistry of gonadal function and the immunology of male reproduction; most papers are concerned with studies in the human. The clinical sections cover medical and surgical approaches to treatment and the final section deals with various aspects of AID practice.

Section 1: Evaluation of the spermatozoa.- 1 A computerized technique for the measurement of sperm cell velocity: correlation of the results with in vitro fertilization assays.- 2 Automatic analysis of sperm characteristics by means of a microcomputer system.- 3 In vitro cross penetration testing in infertile couples.- 4 A new standardized in vitro penetration test (bovine) measuring the capacity of fertilization. I.- 5 A new standardized in vitro penetration test (bovine) measuring the capacity of fertilization. II.- 6 Penetration of zona-free hamster eggs by human spermatoza. Comparison of two methods.- 7 Reduced penetration of zona-free hamster ova by cryopreserved human spermatozoa.- 8 Effect of caffeine on human sperm penetration into zona-free hamster ova.- 9 The variability and clinical value of a heterologous ovum penetration test.- 10 Laser-induced stimulation of sperm motility in vitro.- 11 Time-sequential observation on human sperm penetration into zona pellucida-free hamster oocytes by scanning electron microscopy.- 12 Analysis of various experimental conditions on the rate of human sperm penetration into zona-free hamster ova.- Section 2 The Biochemistry of Gonadal Function.- 13 Levels of vitamin B12 and folic acid in seminal plasma from subjects with normal semen analysis and patients with idiopathic oligoasthenozoospermia.- 14 Functional role of relaxin in human seminal fluid.- 15 Hyperprolactinaemia and abnormal seminal cytology.- 16 Serum FSH and spermatogenesis.- 17 Response to FSH of human Sertoli cells in culture.- 18 Anaerobic urinary and prostatic bacteria, and prostatic biochemical markers in urine after prostatic massage of infertile men.- 19 Effects of bombesin on the pituitary response to TRH and LHRH in humans.- Section 3 Immunology and Male Reproduction.- 20 Characteristics of a monoclonal anti-human sperm antibody.- 21 Topographical analysis of the surface of human spermatozoa by means of monoclonal antibodies.- 22 Human seminal plasma proteins: identification and preliminary characterization of a human sperm coating antigen (h-SCA) protein in physiological and pathological conditions.- 23 Antigenicity of sperm cells after freezing and thawing.- 24 A radioimmunoassay for antisperm antibodies using 125I-labelled protein A.- 25 Human cervical response to artificial insemination.- Section 4 Medical Treatment of the Infertile Male.- 26 Kallman’s syndrome — sustained spermatogenesis three years after cessation of treatment.- 27 Effects of testosterone undecanoate on semen quality and sexual behaviour.- 28 Tamoxifen in the treatment of reduced semen quality: preliminary results.- 29 Tamoxifen in the management of male subfertility — a retrospective analysis.- 30 Increased sperm count in 41 cases of idiopathic normogonadotropic oligozoospermia following treatment with tamoxifen.- 31 Treatment of oligozoospermia with Chinese herb medicine.- 32 Bacterial contamination of semen of infertile couples and the effect of antibiotic treatment of semen quality and fertility.- Section 5 Surgical Treatment of the Infertile Male.- 33 Effects on semen parameters and pregnancy rate after occlusion of the spermatic vein in subfertile men with idiopathic varicocele.- 34 Varicocelectomy for oligozoospermia.- 35 Emission failure due to retroperitoneal lymphadenectomy: first report of a pregnancy after insemination of spermatozoa obtained by midodrin-induced retrograde ejaculation.- 36 Restoration of antegrade ejaculation following radical retroperitoneal lymphadenectomy.- 37 Transurethral resection of verumontanum forejaculatory duct stenosis and oligozoospermia.- 38 Results of microsurgical testicular autotransplantation in nine patients with high-lying undescended testis.- Section 6 Artificial Insemination.- 39 Echosonographic control of follicular growth in heterologous therapeutic insemination (AID).- 40 A comparison of fresh and frozen semen in AID practice.- 41 AID in the problem patient.- 42 Repeat pregnancies with AID.- 43 The post-insemination test in predicting the outcome of artificial insemination with husband’s semen.- 44 The relationship between the survival of human spermatozoa in culture medium and pregnancy rate.- 45 Duration of vitality and migrating ability of +4 °C cryopreserved human spermatozoa.- 46 Male sterility caused by anejaculation — aetiology diagnosis and treatment.- 47 Psychological patterns of AID-demanding marital couples.- 48 The complexity of psychological issues involved in artificial insemination by donor.- 49 Secrecy in the provision of artificial insemination by donor (AID).- Addendum to Section 1.- 50 Relationships between results of post-coital test and parameters of semen analysis.- Addendum to Section 2.- 51 Seminal plasma isoenzyme LDH-X values in extreme oligozoospermia.