Luis Schwarzstein

Effect of the Phosphodiesterase Inhibitor Pentoxyfylline on Human Sperm Motility

Einfluß des Phosphodiesterase‐Inhibitors Pentoxyphyllin auf die Motilität menschlicher Spermatozoen

Pentoxifylline (BL 191) by Oral Administration in the Treatment of Asthenozoospermia

Pentoxyphyllin (BL 191) in der Behandlung der Asthenozoospermie bei oraler Applikation

Response of Luteinizing Hormone and Follicle-Stimulating Hormone to Different Doses of Synthetic Luteinizing Hormone-Releasing Hormone by Intramuscular Administration in Normal and Oligospermic Men: Preliminary Report

The response of LH and FSH levels to intramuscularly administered synthetic LH-RH was studied in two healthy volunteers and three oligospermic patients. Four tests with 50, 100, 250, and 500 mug of LH-RH, respectively, were carried out on each subject at 8 am; the interval between tests was one week. The serum levels of LH and FSH were determined by radioimmunoassay (double-antibody method) before each injection, and 60, 120, 180, and 240 minutes after each injection. No differences in the basal values of either hormone were observed. In both oligospermic and normal men, maximal responses were obtained with doses between 100 and 250 mug. With 500 mug, levels decreased rather than increased. Maximal peaks occurred between 60 and 180 minutes after injection. In the two normal subjects, the responses of LH and FSH were similar. Two of the three oligospermic patients showed discordant responses. From the results, we can assume that LH-RH doses between 100 and 250 mug should be used as a basis for chronic treatment.

Human Menopausal Gonadotropins in the Treatment of Patients with Oligospermia

12 men aged 25-33 years with primary sterility were treated with human menopausal gonadotropin (HMG). Testicular tissue obtained at biopsy showed 6 patients had abnormal sperm only at the spermiogenic stage while the other 6 had more severe conditions including abnormalities of the spermatogonia and spermatocytes and modifications of the tubular walls. Im injections of HMG were given 3 times a week for 30 to 270 days. 6 patients were treated with HMG and human chorionic gonadotropin (HCG) simultaneously. Spermatograms were made every 30 days. Initial sperm concentrations were all below 20 million/ml. In 5 of the 6 men with abnormal sperm only at the spermiogenetic stage sperm counts became greater than 30 million/ml and remained so during the treatment period. 2 of these 5 produced a pregnancy. Of those with more severe changes only 1 produced 30 million/ml and for only a single test. The optimal dose of HMG was not determined. Testicular biopsies are recommended before treatment with HMG for oligospermia.

Diagnostic and Therapeutic Use of LH-RH in the Infertile Man

I would first like to acknowledge the organizers of this Symposium for their kind invitation. I am highly honoured by the opportunity given to me to join my efforts to those of colleagues working in the same field.

The Last Word — For Now

In this book we have been treated to a potpourri of therapeutic approaches to the difficult problem of male infertility. In the “olden” days there were therapies (used even now) that were hailed as being important tools in our treatment armamentarium. These included vitamin E, triiodothyronine, and others. We have since learned that vitamin E doesn’t work because subfertile men are not vitamin E-deficient; triiodothyronine will not work unless thyroidal insufficiency can be proven and even then thyroid treatment may not alter spermatogenesis. It may be that some of the treatments described in this book will fall into the “vitamin E” category — “It may not work, but at least we’re doing something.” It may be reasonable to raise skepticism about the present or future value of some of the treatments described here. But the editors felt it was important to include those modes of therapy that appear rational and that have been subjected to at least a modicum of scientific critique.