OBJECTIVE: The goal of this study was to compare the semen parameters of two successive samples obtained within an interval of less than 60 minutes from patients planning to undergo intrauterine insemination (IUI) whose first samples exhibited low semen quality. METHODS: Thirty-two consecutive patients were enrolled in the study. On the day of IUI, the semen analysis of the samples initially presented by all patients met at least two of the following criteria: sperm concentration <5×10(6)/mL, total sperm count <10×10(6), progressive sperm motility (a+b) in the native sample <30%, and total motile sperm count (TMSC) <4×10(6). A successive semen sample was obtained no more than 60 minutes after the first sample. RESULTS: Compared to the first sample, the second exhibited significantly (p<0.05) improved sperm concentration, TMSC, progressive motility, and vitality. Regarding TMSC, the most critical parameter on the day of IUI, 23 patients (71.8%) improved it, while nine (28.2%) displayed poorer outcomes. CONCLUSION: In defined cases, requesting a second successive ejaculate on the day of insemination may result in a high percentage of cases in an improvement of the quality of the sample.
Humans ; Insemination* ; Semen Analysis ; Semen* ; Sperm Count ; Sperm Motility ; Spermatozoa

PURPOSE: The purpose of this study was to compare the surgical outcomes of two different surgical methods for varicocelectomy, and to assess the effects of varicocelectomy on semen parameters in subinfertile men. MATERIALS AND METHODS: This study included 63 patients with clinically palpable varicocele and abnormal semen parameters who underwent varicocelectomy. Thirty-three patients underwent laparoscopic varicocelectomy, and 30 received microsurgical inguinal varicocelectomy. Semen analyses were performed 5.3 months later, and compared with the pre-operative data. RESULTS: The mean age of patients was 32.1+/-1.3 years old. Comparison of the semen parameters between pre and post-varicocelectomy revealed significant improvement in the sperm count (p<0.05). In laparoscopic and microsurgical inguinal varicocelectomy, the sperm counts were increased from 16.2+/-4.3 to 30.6+/-7.5 and from 15.4+/-3.8 to 37.5+/-7.7, respectively. Sperm motility also tended to improve. CONCLUSIONS: Varicocelectomy enhanced semen parameters after both laparoscopic and microsurgical methods. In subfertile men, early varicocelectomy is recommended.
Humans ; Male ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Varicocele

PURPOSE: This study was performed to evaluate and compare threshold sperm parameters and sperm DNA fragmentation index (DFI), and further analyzed whether sperm DFI could be predicted from sperm parameters in men with varicocele. MATERIALS AND METHODS: A total of 157 semen samples underwent both semen analysis and sperm DNA fragmentation (SDF) testing in men with varicocele. Sperm parameters were assessed using the World Health Organization guidelines. SDF testing was performed using the Halosperm kit. Sperm parameters and sperm DFI results were compared. RESULTS: The overall sperm parameter results and sperm DFI showed normal values; however, the morphology value was at the lower limit of normal. High sperm DFI was associated with significantly lower motility and viability (p < 0.001, respectively). Sperm motility and morphology were significantly higher in the higher sperm count group compared to the lower sperm count group (p < 0.05), while sperm DFI was higher in the lower sperm count group (p < 0.05). Sperm count and viability and sperm DFI were significantly associated with the quality of sperm motility (p < 0.001). Sperm motility and sperm DFI were significantly different (p < 0.001) between normal and abnormal sperm viability groups. Between normal and abnormal sperm morphology groups, sperm count, motility, and sperm DFI showed significant differences (p < 0.001). CONCLUSIONS: In this study, a correlation between SDF and sperm parameters was confirmed in men with varicocele. SDF may be contributing factors to sperm motility, viability, and morphology. Abnormal sperm count, motility, and viability showed high sperm DFI. Therefore, lower sperm parameters were indicative of increasing SDF in men with varicocele.
DNA Fragmentation* ; DNA* ; Humans* ; Infertility ; Male ; Reference Values ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatogenesis ; Spermatozoa* ; Varicocele* ; World Health Organization

PURPOSE: Hypogonadotropic hypogonadism (HH) is an uncommon cause of virilization and male infertility. We evaluated the effect of the combination therapy with human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) in patients with HH. MATERIALS AND METHODS: Between May 2000 and April 2007, we evaluated 15patients with HH. Testicular volume, serum luteinizing hormone (LH), follicle stimulating hormone (FSH), total testosterone, and semen analysis were consecutively monitored at 6, 12, 24, 36 and 48 months after hCG/hMG combination therapy. Statistical analysis was performed by Paired Student's t-test. RESULTS: Testicular volume showed a time-dependent increase in all patients who received hCG/hMG combination therapy (p<0.01). At 12 months, 12 patients showed and were significant improvement in FSH (1.6+/-0.97mIU/ml, p<0.033) and in serum total testosterone (71+/-2.73ng/ml, p=0.003), respectively. During hCG/hMG combination therapy, semen volume, sperm number, sperm motility, and sperm morphology were improved. However, there was no significant change in LH levels. CONCLUSIONS: Our experience in the management of the patients with HH suggests that hCG/hMG combination therapy might be effective in improving the sperm volume, sperm number, sperm motility, sperm morphology, plasma FSH, total testosterone level, and testicular volume. Thus hCG/hMG therapy seems a better choice in the patients with HH who want pregnancy.
Chorionic Gonadotropin ; Follicle Stimulating Hormone ; Gonadotropins ; Humans ; Hypogonadism ; Infertility, Male ; Luteinizing Hormone ; Male ; Plasma ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; Testosterone ; Virilism

OBJECTIVE: The aim of this study was to measure reactive oxygen species (ROS) production and total antioxidant capacity (TAC) in the seminal fluid of the male partners in couples undergoing intrauterine insemination and to evaluate correlations between these values and their semen parameters. METHODS: The study was conducted at Vamsam Fertility Center, Coimbatore, India and enrolled 110 male patients from whom semen samples were collected. ROS production was measured by a thiobarbituric acid reactive species assay, and TAC was measured by a 2,2-diphenyl-2-picrylhydrazyl free radical assay. The differences in the TAC and malondialdehyde (MDA) levels between the subfertile and fertile groups were analysed. Correlations between sperm parameters and TAC and MDA levels were statistically analysed, and cutoff values with respect to the controls were determined. All hypothesis tests used were two-tailed, with statistical significance assessed at the level of p < 0.05. RESULTS: A total of 87 subfertile and 23 fertile men were included in the study. The mean MDA level was significantly higher in the subfertile subjects than in the fertile subjects, and the mean antioxidant level was significantly lower in the subfertile subjects than in the fertile subjects. Seminal MDA levels were negatively associated with sperm concentration, motility, and morphology, whereas the opposite was seen with TAC levels. CONCLUSION: Measurements of seminal TAC and ROS are valuable for predicting semen quality, and hence predicting the outcomes of fertility treatment.
Family Characteristics ; Fertility ; Humans ; India ; Infertility, Male* ; Insemination ; Male ; Male* ; Malondialdehyde ; Reactive Oxygen Species* ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa*

BACKGROUND: This study was conducted to investigate the heat stress and semen quality among male workers in a steel industry in Iran and investigate the relationship between heat stress indices and semen parameters. METHODS: The study was conducted on workers exposed (n = 30) and unexposed (n = 14) to heat in a steel industry. After obtaining a brief biography of the selected employees, scrotal temperature, oral temperature, and environmental parameters were measured, and their semen samples were analyzed according to the procedure recommended by the World Health Organization. The heat stress indices, including wet-bulb globe temperature (WBGT) and predicted heat strain (PHS), in their workplace were calculated according to environmental parameters (ISO 7243:1989 and 7933:2004, respectively). RESULTS: Time-weighted averages of WBGT and PHS (35.76°C and 491.56 w/m2 w m 2 , respectively) for the exposed group were higher than threshold limit values. The mean difference of environmental, physiological, and semen parameters (exception: pH of semen), and also WBGT and PHS indices were statistically significant (p < 0.05) between the two groups. Mean semen parameters were in the normozoospermic range. WBGT and PHS indices showed significantly “negative” correlation with physiological parameters (scrotal and oral temperature) and most semen parameters (semen volume, sperm morphology, sperm motility, sperm count; p < 0.05); moreover, the correlation of WBGT with these parameters was stronger than PHS. CONCLUSION: Semen parameters of the studied workers exposed to heat were in the borderline level of normozoospermic range, and their semen parameters were significantly lower than controls. For better assessment of occupational environment concerning physiological and semen parameters in steel industries, WBGT can be a more useful index.
Cross-Sectional Studies* ; Hot Temperature* ; Humans ; Hydrogen-Ion Concentration ; Iran ; Male ; Semen Analysis* ; Semen* ; Sperm Count ; Sperm Motility ; Spermatozoa ; Steel* ; Threshold Limit Values ; World Health Organization

PURPOSE: To analyze the differences of semen parameters in Korean young population for three periods from 2002 to 2013. MATERIALS AND METHODS: A total of 516 semen samples were collected from Korean men presenting for infertility, varicoceles or other infectious problems for three periods from 2002 to 2012: January 2002-December 2003, January 2007-December 2008, and January 2012-December 2013. A standard World Health Organization procedure for semen analysis was performed for assessment of semen concentration, volume, motility, morphology, and pH. RESULTS: A total of 160, 162, 194 men constituted the study populations in 2002 to 2003, in 2007 to 2008, and in 2012 to 2013, respectively. The overall sperm parameter results suggested a statistically significant difference between 2002 to 2003 and 2012 to 2013 except pH. However, considering the data from 2007 to 2008, there were no trends in changes in overall semen parameters. Negative correlations were observed in all semen parameters with increasing age in all patients, except for pH. In addition, semen volume, motility, and morphology had higher negative correlation coefficients with age, from 2002 to 2013, serially. CONCLUSIONS: There were no significant changes in the semen parameters of Korean men from 2002 to 2013. In addition, semen volume, motility, and morphology showed higher negative correlation coefficients with age from 2002 to 2013, serially.
Adolescent ; Adult ; Aging/pathology ; Aging/physiology ; Humans ; Hydrogen-Ion Concentration ; Infertility, Male/diagnosis ; Male ; Retrospective Studies ; Semen ; Semen Analysis/methods ; Sperm Count ; Sperm Motility ; Spermatozoa/cytology ; Young Adult

A study was undertaken during the past 2 years of patients who visited the infertility clinic of this hospital. The patients included those with male infertility, scrotal mass, scrotal pain or impotence. These patients were studied by means of reviewing the clinical applications of 'Scrotogram' and the following results were obtained. A total of 122 cases underwent a 'Scrotogram' study and among them 80 cases were diagnosed as varicocele, which included 14 cases( 18%) of subclinical varicocele which are difficult to be diagnosed by initial physical examination. There was statistical significance in the varicocele index between the control group and the Grade I varicocele group(p<0.01) and between the control group and subclinical varicocele group(p<0.01), and between the Grade I and Grade II group.(p<0.01), and between the Grade II and Grade II group(p<0.05). Among 66 clinical varicocele patients, 63 cases(80% ) were diagnosed by varicocele index, and 54 cases(82% ) were diagnosed by static image. A combination of the above two methods allowed 61 cases(92%) to be diagnosed. Among 48 patients who underwent high ligation of internal spermatic vein, 25 patients were subject to postoperative follow-up 'Scrotogram', which revealed 12 cases with excellent results, 8 cases with good results, and 5 cases with poor results. The average varicocele index before and after surgery was 1.78 and 1.24 and there were statistical significance(p<0.01). There was statistical significance, in sperm count and motility between the control group and clinical varicocele group(p <0.01) and between the control group and subclinical varicocele group(p <0.01). However, there appeared no statistical significance in semen character between the clinical varicocele and subclinical varicocele group. Among the 13 patients who were subject to postoperative follow-up semen analysis 11 patient showed improved results, and there was marked improvement in sperm count(p<0.05). There was slight improvement in sperm motility and morphology but showed no statistical significance. At present, 2 patients were impreged. Among 110 patients with infertility and olieoasthenoteratozoospermia, 22 were initially diagnose as varicocele by physical examination only, and 7 patients were diagnosed as subclinical varicocele after a 'Scrotogram' was taken. In conclusion, the 'Scrotogram' is able to identify varicocele objectively, and also identify subclinical varicocele which is an important contributing factor to male infertility. Also, this method of study is able to assess the postoperative result of varicocele accurately.
Erectile Dysfunction ; Follow-Up Studies ; Humans ; Infertility ; Infertility, Male ; Ligation ; Male ; Physical Examination ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; Varicocele ; Veins

Since March 1978, 78 men, husbands of infertile couples who consulted our Severance Hospital Urologic department were instructed to collect seminal fluid samples after at least 3 days of abstinence. Of these 78 patients 28 (35.9%) demonstrated aspermia. The remaining 50 patients were evaluated with past history and physical examination. The semen was examined for liquefaction, volume, sperm motility, morphology, and WBC count. The results were as follows: 1. The mean age was 31.8 years and mean period of infertility was 3.4 years. 2. 34% of the patients had suffered from urethritis, or epididymitis. 3. Varicoceles were found in 14% of the patients. 4. The mean pH of the specimens was 7.4, time of liquefaction was 13.9 minutes and in all of the patients did liquefaction occur within 30 minutes. 5. The volume of the ejaculate averaged 3.4 ml, and in 6% of the patients the volume was below 1 ml. 6. The sperm concentration averaged 60.5 million/ml and 34% had concentrations less than 20 million. The total number of spermatozoa per ejaculate averaged 205.8 million and 26% had total sperm counts under 50 million. 7. Ployspermia was found in 2 men (4%) 8. The mean percentage of active sperm was 53.7% 9. The motile sperm count averaged 31.1 million/ml and the total motile sperm per ejaculate averaged 107.6 million. 10. The percentage of oval cells or normal sperm averaged 68.1% 11. In patients with WBC more than 5/HPF in semen, mean sperm motility (42.0%) was lower than that of the other group (60.3%) 12. According to the fertility index, infertile was 6%, subfertile 44%, relative fertile 30% and highly fertile 20%. 13. In patients with varicocele, mean of the sperm motility was lower than that of patients without varicocele.
Aspermia ; Epididymitis ; Family Characteristics ; Fertility ; Humans ; Hydrogen-Ion Concentration ; Infertility ; Male ; Physical Examination ; Semen Analysis ; Semen ; Sperm Count ; Sperm Motility ; Spermatozoa ; Spouses ; Urethritis ; Varicocele

PURPOSE: The purpose of this study is to evaluate the preoperative factors that influenced postoperative sperm concentration after vasovasostomy. MATERIALS AND METHODS: We retrospectively reviewed 97 consecutive single-layer vasovasostomy procedures performed by a single surgeon between March 2003 and September 2010. The patients were stratified into three groups based on sperm concentration at 1 month follow-up: group I-azoospermia, group II-oligospermia, and group III-normal. We evaluated the preoperative factors that may have influenced sperm concentration at postoperative 1 month. Patients with serial semen analysis were divided into four groups according to the change in postoperative sperm concentration at the 6-month visit: group II-N-from oligospermia to normal, group II-O-from oligospermia to oligospermia, group III-O-from normal to oligospermia, group III-N-from normal to normal. We compared the pregnancy rate among the four groups. RESULTS: The mean obstructive interval was 9.69 years in group I, 6.02 years in group II, and 7.82 years in group III. There were significant differences found among the groups (p=0.035). There was significantly different change in sperm concentration, sperm motility, and sperm morphology between each of the groups. A total of 32 patients underwent serial semen analyses at 1 month, 3 months, and 6 months after vasovasostomy. There was no significant difference in patient age, obstructive interval, or follicle-stimulating hormone among the groups. The natural pregnancy rate in group II-O was lower than that in group II-N, and in group III-O was lower than that in group III-N. However, there was no significant difference among each of the groups. CONCLUSIONS: The sperm concentration after vasovasostomy was significantly related to the obstructive interval between vasectomy and reversal.
Follicle Stimulating Hormone ; Humans ; Male ; Oligospermia ; Pregnancy Rate ; Retrospective Studies ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; Vasectomy ; Vasovasostomy