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Non-Specific Treatment to Improve Fertility

  • T. B. Hargreave
Part of the Clinical Practice in Urology book series (PRACTICE UROLOG)

Abstract

Specific abnormalities causing defective spermatogenesis are the exception rather than the rule. Certain clinics may attract a biased population; thus, an endocrinologist may find that a large percentage of his patients are infertile because of an endocrinological abnormality but this will reflect referral based on cases of delayed or abnormal puberty rather than infertility. In a general infertility clinic no difference has been found between fertile and infertile men with regard to 17-hydroxyandrogens and oestrogens (Walker et al. 1975) and in the dynamic response to hCG (Traub 1981). Seven only of the last 662 couples we have assessed at our clinic had established endocrinological problems. We have searched for abnormal hormonal profiles (Hargreave et al. 1977), isolated FSH deficiency (Hargreave et al. 1979) and for hyperprolactinaemia (Hargreave et al. 1981) without success. The only common positive finding is an association between falling sperm density, abnormal testicular histopathology and elevated FSH levels; thus in the majority of cases we cannot identify an hormonal basis for the problem.

Keywords

Congenital Adrenal Hyperplasia Seminal Plasma Male Infertility Artificial Insemination Semen Sample 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Amelar RD, Dubin L, Schoenfeld C (1980) Sperm motility. Fertil Steril 34: 197–215Google Scholar
  2. Amelar RD, Hotchkiss RS (1965) The split ejaculate; its use in the management of male infertility. Fertil Steril 16: 46–60PubMedGoogle Scholar
  3. Antoniou LD, Sudhakar T, Shalhoub RJ, Smith JC (1977) Reversal of uraemic impotence by zinc. Lancet II: 895–898Google Scholar
  4. Barwin BN (1974) Intrauterine insemination of husband’s sperm. J Reprod Fertil 36: 101–106PubMedCrossRefGoogle Scholar
  5. Behrman SJ, Kistner RW (1975) Artificial insemination. In: Behrman SJ, Kistner RW (eds) Progress in infertility. Little Brown, BostonGoogle Scholar
  6. Blair JH, Simpson GM, Kline NW (1962) Monoamine oxidase inhibitor and sperm production. JAMA 172: 192Google Scholar
  7. Brook AC, Ward MK, Cook DB, Johnston DG, Watson MJ, Kerr DNS (1980) Absence of a therapeutic effect of zinc in the sexual dysfunction of haemodialysed patients. Lancet II: 618–620CrossRefGoogle Scholar
  8. Brown JS (1975) The effect of orally administered androgens on sperm motility. Fertil Steril 26: 305–308PubMedGoogle Scholar
  9. Charny CW (1959) The use of androgens for human spermatogenesis. Fertil Steril 10: 557–570Google Scholar
  10. Cohen J, Delafontaine D (1978) Intérêt de l’insémination avec éjaculat fractionné dans les stérilités du couple. In: Emperaire JS, Auderbert A (eds) Premier Symposium sur I’I.A.C. et l’Hypofertilite’ masculine. I.A.R.R.H, Bordeaux, p 422Google Scholar
  11. Couture M, Ulstein M, Leonard J, Paulsen CA (1976) Improved staining method for differentiating immature germ cells from white blood cells in human seminal fluid. Andrologia 8: 61–66PubMedCrossRefGoogle Scholar
  12. Danscher G, Hammen R, Fierdinstad E, Rebbe H (1978) Zinc content of human ejaculate and the motility of sperm cells. J Androl 1: 576–581CrossRefGoogle Scholar
  13. Davis J, Clyman MJ, Decker A, Bronstein S, Roland M (1966) Effect of phenelzine on semen in infertility. A preliminary report. Fertil Steril 17: 221–225PubMedGoogle Scholar
  14. de Louvois J, Blades M, Harrison RF, Hurley R, Stanley VC (1974) Frequency of mycoplasma in fertile and infertile couples. Lancet I: 1073–1076CrossRefGoogle Scholar
  15. Derrick FC, Dahlberg В (1976) Male genital tract infections and sperm viablity. In: Hafez ESE (ed) Human semen and fertility regulation. CV Mosby, St Louis, pp 389–397Google Scholar
  16. Eliasson R (1976) Clinical examination of infertile men. In: Hafez ES (ed) Human semen and fertility regulation. CV Mosby, St Louis, pp 321–331Google Scholar
  17. Eliasson R, Mossberg B, Camner P, Afzelius ВA (1977) The immotile cilia syndrome. N Engl J Med 297: 1–6PubMedCrossRefGoogle Scholar
  18. Farris EJ, Murphy DP (1960) The characteristics of the two parts of the ejaculate and the advantages of its use for intrauterine insemination. Fertil Steril 11: 465–469PubMedGoogle Scholar
  19. Finnerty JC (1954) Effect of hyper- and hypoadrenocortical function on young fat deficient male rats. J Clin Endrocrinol Metab 14: 823Google Scholar
  20. Foss GL, Tindall VR, Birkett JP (1973) The treatment of subfertile men with clomiphene citrate. J Reprod Fertil 32: 167–170PubMedCrossRefGoogle Scholar
  21. Foulds GA (1958) Clinical research in psychiatry. J Ment Sci 104: 259–265PubMedGoogle Scholar
  22. Fowlkes DM, Dooher GB, O’Leary WM (1975) Evidence by scanning electron microscopy for an association between spermatozoa and T-mycoplasmas in men of infertile marriage. Fertil Steril 26: 1203–1211PubMedGoogle Scholar
  23. Gaunt R, Tuthill CH, Antonchak N, Leathern JH (1953) Antagonists to cortisone on ACTH-like action of steroids. Endocrinology 52: 407–423PubMedCrossRefGoogle Scholar
  24. Gernigon C, Kuntsmann J (1980) AIH for semen insufficiency: 119 cases. In: David G, Price WS (eds) Human artificial insemination and semen presentation. Plenum Press, New York, pp 529–537Google Scholar
  25. Gnarpe H, Friberg J (1972) Mycoplasma and human reproductive failure. I: The occurrence of different mycoplasmas in couples with reproductive failure. Am J Obstet Gynecol 114: 717–731Google Scholar
  26. Guillon G (1975) Erfahrungen mit Mesterolon bei Fertiliatatsstorungen des Mannes. Z Hautkr 50: 293–297PubMedGoogle Scholar
  27. Haesungcharern A, Chulavatnatol M (1973) Stimulation of human spermatozoal motility by caffeine. Fertil Steril 24: 662–665PubMedGoogle Scholar
  28. Halsted JA, Ronaghy HA, Abadi P, Haghshensass M, Amirhakemi GH, Barakat RM, Reinhold JG (1972) Zinc deficiency in man: the Shiraz experiment.Google Scholar
  29. Hansen KB, Hjort T (1980) Intrauterine insemination as a treatment of immunological infertility in the male. In: David G, Price WS (eds) Human artificial insemination and semen presentation. Plenum Press, New York, pp 549–555Google Scholar
  30. Hargreave ТВ, Kyle KF, Kelly AM, England P (1977) Prolactin and gonadotrophins in 208 men presenting with infertility. Br J Urol 49: 747–750PubMedCrossRefGoogle Scholar
  31. Hargreave ТВ, Kyle KF, Kelly AM, England P (1979) Releasing factors tests in men with oligozoospermia. Br J Urol 51: 38–42PubMedCrossRefGoogle Scholar
  32. Hargreave ТВ, Richmond J, Liakatas J, Elton R, Brown NS (1981) Searching for the infertile man with hyperprolactinaemia. Fertil Steril 36:630–632PubMedGoogle Scholar
  33. Hargreave ТВ, Torrance M, Young H, Harris AB (1982) Isolation of Ureaplasma mealyticum from seminal plasma in relation to sperm antibody levels and sperm motility. Andrologia 14: 223–227PubMedCrossRefGoogle Scholar
  34. Harris WA, Harden TE, Dawson EB (1979) Apparent effect of ascorbic acid medication on semen metal levels. Fertil Steril 32: 455–459PubMedGoogle Scholar
  35. Hartoma TR, Nahoul K, Netter А (1977) Zinc, plasma androgens and male sterility. Lancet II: 1125–1126CrossRefGoogle Scholar
  36. Heckel NJ, Rosso WA, Kestel L (1951) Spermatogenic rebound phenomenon after administration of testosterone propionate. J Clin Endocrinol 11: 235–245PubMedCrossRefGoogle Scholar
  37. Heller CG, Nelson WO, Hill IB, Henderson E, Maddock WO, Jungck EC, Paulsen CA, Mortimore GE (1950) Improvement in spermatogenesis following depression of the human testis with testosterone. Fertil Steril 1: 415–422PubMedGoogle Scholar
  38. Heller CG, Rowley MJ, Heller GV (1969) Clomiphene citrate: a correlation of its effect on sperm concentration and morphology, total gonadotrophins, ICSH, estrogen and testosterone excretion and testicular cytology in normal men. J Clin Endocrinol Metab 29: 638–649PubMedCrossRefGoogle Scholar
  39. Henkin RI (1976) Trace elements in endrocrinology. From: Symposium on trace elements. Med Clin North Am 60: 779–797PubMedGoogle Scholar
  40. Horne DD, Maddock CL (1952) Vitamin A therapy in oligospermia. Fertil Steril 3: 245–250PubMedGoogle Scholar
  41. Hoskins DD, Casillas ER (1975) The function of cyclic nucleotides in mammalian spermatozoa. In: Hamilton DW, Green RO (eds) Handbook of physiology, Section 7, Vol 5, Male reproductive system. American Physiological Society, Washington, p 453Google Scholar
  42. Idriss WM, Patton WD, Taymor ML (1978) On the etiologic role of Ureaplasma urealyticum (T-mycoplasma) infection in infertility. Fertil Steril 30: 293–296PubMedGoogle Scholar
  43. Insler V (1977) Evaluation and treatment of cervical mucus diseases leading to infertility In: Parke DV, Elstein M (eds) Mucus in health and disease. Plenum Press, New York, p 477Google Scholar
  44. Jackaman FR, Ansell ID, Ghanadian R, McLoughlin PVA, Lewis JG, Chisholm GD (1977) The hormone response to a synthetic androgen (Mesterolone) in oligozoospermia. Clin Endocrinol 6: 339–345CrossRefGoogle Scholar
  45. Jeffries WMcK, Weir WC, Weir DR, Prouty RL (1958) The use of cortisone and related steroids in fertility. Fertil Steril 9: 145–166Google Scholar
  46. Jungling ML, Bunge RG (1976) Treatment of spermatogenic arrest with arginine. Fertil Steril 27: 282–283PubMedGoogle Scholar
  47. Katz DF (1980) Freeze preservation of isolated population of highly motile spermatozoa. In: Davis G, Price WS (eds) Human artificial insemination and semen presentation. Plenum Press, New York, pp 557–563Google Scholar
  48. Kupperman HS, Epstein JA (1958) Endocrine therapy of sterility. Am Practitioner 9: 547PubMedGoogle Scholar
  49. Kvist U (1980) Sperm nuclear chromatin decondensation ability. An in vitro study on ejaculated human spermatozoa. Acta Physiol Scand (Suppl) 486: 1–24Google Scholar
  50. Lamensdorf H, Compere D, Begley G (1975) Testosterone rebound therapy in the treatment of male infertility. Fertil Steril 26: 469–472PubMedGoogle Scholar
  51. Lunenfeld В (1978) Diagnosis and treatment of functional infertility. In: Lunenfeld B, Insler V (eds) Infertility. Grosse Verlag, BerlinGoogle Scholar
  52. Lutwak-Mann С (1958) Dependence of gonadal function upon vitamins and other nutritional factors. Vitam Horm 16: 35–75PubMedCrossRefGoogle Scholar
  53. McDonald JH, Heckel NJ (1956) The effect of cortisone on the spermatogeneic function of the human testis. J Urol 75: 527–529PubMedGoogle Scholar
  54. Macleod J (1965) The semen examination. Clin Obstet Gynecol 8: 115CrossRefGoogle Scholar
  55. Macleod J, Gold RZ (1951) The male factor in fertility and sterility. III. An analysis of motile activity in the spermatozoa of 1000 fertile men and 1000 men in infertile marriage. Fertil Steril 2: 187PubMedGoogle Scholar
  56. Macleod J, Hotchkiss RS (1942) Distribution of spermatozoa and of certain chemical constituents in human ejaculate. J Urol 48: 225–229Google Scholar
  57. Maddock WO, Chase JD, Nelson WO (1953) The effects of large doses of cortisone on testicular morphology and urinary gonadotrophin, estrogen and 17-ketosteroid excretion. J Lab Clin Med 1: 608–614Google Scholar
  58. Makler A (1978) A new multiple exposure photography method for objective human spermatozoal motility determination. Fertil Steril 30: 192–199PubMedGoogle Scholar
  59. Mancini RE, Lavieri JC, Muller F, Andrada JA, Saraceni DJ (1966) Effect of prenisolone upon normal and pathologic human spermatogenesis. Fertil Steril 18: 500–513Google Scholar
  60. Mauss J (1974) The results of the treatment of fertility disorders in the male with mesterolone or a placebo. Arzneim Forsch 24: 1338Google Scholar
  61. Mellinger RC, Thompson RJ (1966) The effect of clomiphene citrate in male infertility. Fertil Steril 17: 94–103PubMedGoogle Scholar
  62. Michelson L, Roland S, Koets P (1955) The effects of cortisone on the infertile male. Fertil Steril 6: 493–505PubMedGoogle Scholar
  63. Misurale F, Cagnazzo С, Sorace A (1969) Asthenospermia and its treatment with HCG. Fertil Steril 20: 650PubMedGoogle Scholar
  64. Moghissi KS, Gruber JS, Evans S, Yanez J (1977) Homologous artificial insemination: a reappraisal. Am J Obstet Gynecol 129: 909–915PubMedGoogle Scholar
  65. Moore CR, Samuels LT (1931) The action of the testis hormone in correcting changes induced in the rat prostate and seminal vesicles by vitamin В deficiency or partial inanition. Am J Physiol 96: 278–288Google Scholar
  66. Nelson CMN, Bunge RG (1974) Semen analysis: evidence for changing parameters of male fertility potential. Fertil Steril 25: 503–507PubMedGoogle Scholar
  67. Nikkanen V (1978) The effects of mesterolone on the male accessory sex organs, on spermiogram, plasma testosterone and FSH. Andrologia 10: 299–306PubMedCrossRefGoogle Scholar
  68. Padron RS, Nodarse M (1980) Effects of amitryptyline on semen of infertile men. Br J Urol 52: 226–228PubMedCrossRefGoogle Scholar
  69. Palti Z, (1970) Clomiphene therapy in defective spermatogenesis Fertil Steril 21: 838–843PubMedGoogle Scholar
  70. Paulson DF (1977) Clomiphene citrate in the management of male hypofertility: predictors for treatment selection. Fertil Steril 28: 1226–1229PubMedGoogle Scholar
  71. Pryor JP, Blandy JP, Evans P, Shaput de Saintonge DM, Usherwood M (1978) Controlled clinical trial of arginine for infertile men with oligozoospermia. Br J Urol 50: 47–50PubMedCrossRefGoogle Scholar
  72. Queseda EM, Dukes CD, Deen GH, Frnaklin RR (1968) Genital infection and sperm-agglutinating antibodies in infertile men. J Urol 90: 106–108Google Scholar
  73. Reyes IF, Faiman С (1974) Long-term therapy with low-dose cis-clomiphene in male infertility: Effects on semen, serum, FSH, LH, testosterone and estradiol, and carbohydrate tolerance. Int J. Fertil 19: 49–55PubMedGoogle Scholar
  74. Rohleder HO (1934) Test tube babies. Panurge Press, New YorkGoogle Scholar
  75. Rönnberg L (1980) The effect of clomiphene citrate on different sperm parameters and serum hormone levels in preselected infertile men: A controlled double-blind cross-over study. Int J Androl 3: 479–486PubMedCrossRefGoogle Scholar
  76. Ross LS, Kandel GL, Prinz LM, Auletta F (1980) Clomiphene treatment of the idiopathic hypofertile male: high-dose alternate-day therapy. Fertil Steril 33: 618–623PubMedGoogle Scholar
  77. Rowley MJ, Heller CG (1972) The testosterone rebound phenomenon in the treatment of male infertility. Fertil Steril 23: 498–504PubMedGoogle Scholar
  78. Schachter A, Goldman JA, Zukerman Z (1973) Treatment of oligozoospermia with the amino acid arginine. J Urol 110: 311–313PubMedGoogle Scholar
  79. Scheller AMCM, Beek JHMJ (1974) The use of clomiphene treatment for male sterility. Fertil Steril 25: 407–410Google Scholar
  80. Schill WB, Braun-Falco О, Haberland GL (1974) The possible role of kinins in sperm motility. Int J Fertil 19: 163–167PubMedGoogle Scholar
  81. Schoenfeld C, Amelar RD, Dubin L (1975) Stimulation of ejaculated human spermatozoa by caffeine. Fertil Steril 26: 158–161PubMedGoogle Scholar
  82. Scottish Infertility group (1982) Randomised trial of clomiphene citrate and vitamin С for male infertility Br J Urol 54: 780–784CrossRefGoogle Scholar
  83. Shulman S, Harlin В, Davis P, Reyniak JV (1978) Immune infertility and new approaches to treatment. Fertil Steril 29: 309–313Google Scholar
  84. Steiman PR, Taymor ML (1977) Artificial insemination homologous and its role in the management of infertility. Fertil Steril 28: 146PubMedGoogle Scholar
  85. Steinberger E (1977) Male reproductive physiology. In: Cockett ATK, Urry RS (eds) Male infertility. Grune and Stratton, New YorkGoogle Scholar
  86. Stewart BH (1966) The infertile male: a diagnostic approach. Fertil Steril 17: 783–791PubMedGoogle Scholar
  87. Szöllösi J, Falkay G, Sas M (1978) Mesterolone treatment of patients and pathospermia. Int Urol Nephrol 10: 251–256PubMedCrossRefGoogle Scholar
  88. Tanphaichitr N (1977) In vitro stimulation of human sperm motilitv bv acetvl carnitine. Int J Fertil 22: 85–91PubMedGoogle Scholar
  89. Teague NS, Bovarskv S, Glenn JF (1971) Interference of human spermatozoa motilitv bv Escherichia coli. Fertil Steril 22: 281–285PubMedGoogle Scholar
  90. Traub AI (1981) An evaluation of the HCG stimulation test in the investigation of male infertility. Br J Urol 53: 274–276PubMedCrossRefGoogle Scholar
  91. Ulstein M (1973) Fertility of husbands at homologous insemination. Acta Obstet Gynecol Scand 52: 5–8PubMedCrossRefGoogle Scholar
  92. Usherwood MM (1980) AIH for cases of spermatozoa antibodies and oligozoospermia. In: David G, Price WS (eds) Human artificial insemination and semen presentation. Plenum Press, New York, pp 539–547Google Scholar
  93. van Zyl JA, Menkveld R., van Kotze Wm, Retief AE, var Niekerk WA (1975) Oligozoospermia: a seven-year survey of the incidence, chromosomal aberrations, treatment and pregnancy rate. Int J Fertil 20: 129–132PubMedGoogle Scholar
  94. Vermeulen A. and Comhaire F. (1978) Hormonal effects of an anti-estrogen, tamoxifen, in normal and Oligospermic men. Fertil Steril 29: 320–327PubMedGoogle Scholar
  95. Vigesky RS, Glass AR (1981) Effects of Δ-testolactone on the pituitary-testicular axis in Oligospermic men. J Clin Endocrinol Metab 52: 897–902CrossRefGoogle Scholar
  96. Walker MS, Grant JK, Scott R, Sinclair R (1975) 17-Hydroxyandrogens and oestrogens in the plasma of normal and infertile men. J Reprod Fertil 45: 155–158PubMedCrossRefGoogle Scholar
  97. Wieland RG, Ansari AH, Klein DE, Doshi NS, Hallberg MC, Chen JC (1972) Idiopathic oligospermia: Control observations and response to cis-clomiphene. Fertil Steril 23 471–474PubMedGoogle Scholar
  98. Wilkins L, Cara J (1954) Further studies on the treatment of congenital adrenal hyperplasia with cortisone. V. Effects of cortisone therapy on testicular development. J Clin Endocrinol Metab 14: 287–296PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1983

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  • T. B. Hargreave

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