R. Weissenberg

Controlled trial of high spermatic vein ligation for varicocele in infertile men

OBJECTIVE To determine whether high ligation is an effective treatment for infertile men with clinical varicocele. DESIGN A randomized, controlled trial of high spermatic vein ligation was carried out. The patients were treated and observed for 3 years. SETTING Infertility treatment clinic and andrology laboratory in a hospital. PATIENTS Infertile men with abnormal semen analysis because of varicocele only. INTERVENTION High ligation 1 year postrecruitment (group A) and at the beginning of the study (group B). RESULTS Among the 20 couples in group A, 2 pregnancies (10%) were achieved within the 1st year of observation period. During the year after high ligation, there were 8 pregnancies (44.4%), and during the 2nd year after high ligation, there were 4 more pregnancies (22.2%). In group B, 15 pregnancies (60%) occurred within the 1st year after operation. Three pregnancies (12%) and 1 pregnancy (4%) occurred during the 2nd and 3rd year, respectively. After operation in all patients of both groups, there was significant improvement in semen parameters, regardless of pregnancy occurrence. The difference in pregnancy rate (PR) between the operated group B and nonoperated group A during the 1st year of study was found to be highly significant. CONCLUSIONS It is concluded that in a population of infertile men presenting varicocele as the only demonstrable factor of infertility, the varicocele is clearly associated with infertility and reduced testicular function, and its correction by ligation improves sperm parameters and fertility rate. Furthermore, the highest PR in both groups occurred during the 1st year postoperation.

The human Pim-2 proto-oncogene and its testicular expression

In this study we describe the cloning of a human gene, encoding a protein that shares 90% identity and 93% similarity at the primary structure level, with the mouse Pim-2 gene. The gene was designated hPim-2. Structural features suggest that like the mouse Pim-2, hPim-2 is also a serine threonine kinase. At the RNA level, two hPim-2 transcripts were identified. The first, 2.2 kb, is highly expressed in hematopoietic tissues and in leukemic and lymphoma cell lines (K-562, HL-60 and RAJI). It also shows considerable high levels in testis, small intestine, colon and human colorectal adenocarcinoma cells (SW480). A second transcript, 5.0 kb in size, could be detected only in spleen, thymus, small intestine and colon and in the K-562 and RAJI cell lines. In situ hybridization analysis of biopsies taken from testes of men with complete or partial spermatogenesis revealed that the gene is expressed in primary spermatocytes. In the absence of germ cells, signal could be detected over specific cells in the well developed interstitial region. These results suggest a role for hPim-2 in proliferating cells as well as during meiosis. A possible connection between hPim-2 and apoptosis is discussed.

Differences in concanavalin A-FITC binding to rat spermatozoa during epididymal maturation and capacitation.

Rat spermatozoa from the caput epididymis and cauda epididymis, but not from the testis, demonstrated a crescent of greenish fluorescence on the convex surface of the sperm head, as observed by fluorescence microscopy after staining with concanavalin A-fluorescein isothiocyanate. The percentage of spermatozoa displaying this fluorescent zone decreased during incubation under capacitating conditions, both in vivo and in vitro, suggesting that a glycoprotein zone that is capable of binding concanavalin A was removed or altered during the capacitation period.

Semen Quality and Hormonal Status of Patients Following Testicular Torsion

Summary: 16 patients, 4 months to five years following unilateral torsion of the testis were evaluated as to semen quality and hormonal status.

Hegemony and Homogeneity: Donor Choices of Israeli Recipients of Donor Insemination

This article explores the relevance of hegemony theory to choices of sperm donors made by Jewish Israeli recipients of donor insemination (DI). The context is the objectification of ‘the Natural’ through hegemonic images of mass consumption. The study, which was conducted in a major Israeli hospital, examined physiological features (height, eye colour, skin colour) of the most popular donors. In the highly familistic society of Israel, recipients’ choices conformed to images of their own ‘natural family’. Within the limits of the family’s looks, choices revealed a convergence of specific type of physiognomy - that of the hegemonic Ashkenazi man. While recipients tended to reproduce their own appearance they often ‘compromised’ it towards the kind of looks constructed as desirable in the mass media. The choice of donors by DI recipients presents an extreme case in which people construct their own family by incorporating hegemonic ideals of mass consumption.

Spermatogenesis in the golden hamster during the first spermatogenic wave: A flow cytometric analysis

In the present study propidium iodide was used as a fluorescent dye to stain DNA of cells of hamster testicular origin and fluorescent intensities were analyzed by flow cytometry. We used hamster testicular cells from the first spermatogenic wave to observe the consecutive appearance of the different types of cells during puberty. At 12 days postpartum (dpp) diploid cells (including spermatogonia) predominated and some tetraploid cells were also present. Tetraploid spermatocytes increased dramatically by 21 dpp. The first haploid cells appeared at 21 dpp but substantial numbers were first present at 23 dpp. Immature haploid cells predominated at 32 dpp. Elongating condensing spermatids appeared at 34 dpp and spermatozoa began to leave the testis to enter the epididymidis at 36–38 dpp marking the end of the first round of spermatogenesis. Using acridine orange staining flow cytometry, chromatin condensation was followed by measuring fluorescence decrease from early round spermatids to spermatozoa obtained from the initial segment and from the cauda epididymides. The major portion of sperm chromatin condensation (88–90%) in the hamster occurred in the testis and only 10–12% occurred during epididymal sperm maturation. Spermatozoa in the initial segment of the epididymidis of the hamster contained a small amount of RNA that was no longer present in sperm of the cauda epididymidis, indicating that RNA was lost during epididymal sperm maturation in this species. Mol. Reprod. Dev. 55:205–211, 2000.

ATP content in human semen and sperm quality.

Five semen characteristics (count, motility, normal forms, bovine cervical mucus penetration, and ATP) were evaluated in patients attending the infertility clinic. Multiple regression analysis indicated that the only characteristic independently affecting ATP concentration was sperm count, whereas motility and percent normal forms had no additional contribution to ATP level. Penetration into bovine cervical mucus did not depend on ATP levels. Comparison of semen characteristics in the same group between patients who have impregnated their wives and those who have not indicated that with respect to count, motility, morphology, and ATP the only sperm characteristic independently predicting fertility was motility. ATP measurements have limited value in the evaluation of semen quality.

Successful GnRH Treatment in a Patient with Kallmann's Syndrome, who previously failed HMG/HCG Treatment/Erfolgreiche GnRH‐Behandlung bei einem Mann mit Kallmann‐Syndrom bei vorher erfolgloser HMG‐HCG‐Behandlung

Summary: A successful GnRH treatment for hypogonadotropic hypogonadism is described. A 40 year old infertile patient due to Kallmanns syndrome, associated with obesity and NIDDM, was treated with HCG (5,000 IU/week) for 8 years. In an attempt to induce spermatogenesis HMG (75 IU/daily) was added for 2 years. During the combined gonadotropin treatment semen analysis indicated an improvement from azoospermia to 2 × 106 sperm/ml. Since semen quality remained poor and obviously no pregnancy was achieved, the last regime was replaced by a pulsatile GnRH treatment (5 mcg/90 minutes). Following 6 months sperm count increased up to 15 × 106 associated with normal motility and morphology. Patients wife conceived after the second intrauterine insemination and delivered a full term healthy baby.

Immunosuppressant Material in Human Seminal Fluid

Human seminal plasma from normal or patients with abnormal parameters of the ejaculates contains an inhibitory material that expresses potent in vitro inhibitory activity on PHA-M-induced blast transformation and NK activity. Using the test of inhibition of NK activity, the semen samples from individuals with higher concentrations of fructose had higher inhibitory activity. The results described herein suggest that inhibitory activity for blast transformation may be present in the prostatic fluid while the NK inhibition aspects are correlated with the vesicle-marker (fructose). Inhibition of the immune responses by human seminal plasma of the effector functions indicates the interesting implication that soluble factors may indirectly protect against or promote human autoimmune infertility disease.

Effect of testicular torsion on contralateral testis and fertility in mature rats.

The effect of unilateral testicular torsion on the contralateral testis and the fertility rate was studied in Charles River adult rats. Animals were divided into groups that underwent a sham operation or torsion and ligation of the left testicular vessels followed by orchiectomy after 24 h, orchiectomy after 48 h, release of the ligature after 24 h, release of the ligature after 48 h, and no further treatment following ligation. Another group of animals underwent unilateral orchiectomy. After 8 weeks animals were allowed to mate and were sacrificed 2 weeks later. The results did not point to either histological alterations in the contralateral testis or impairment of fertility in any group of treatment compared with the control.