Much has been published about smoking and alcohol intake influencing male fertility, sperm parameters and reproductive outcome. However, there is no conclusive agreement about the effects of cigarette smoking and alcohol use on these outcomes and thus no generally accepted guidelines. The combined effect of cigarette smoking and alcohol intake, though, has not been rigorously investigated. Because alcohol consumption and smoking are often seen together, this study focuses on the effect of smoking and drinking habits separately and combined on semen parameters, such as volume, sperm count, motility and morphology, and on pregnancy outcome. These suggested toxic effects are studied in a group of subfertile, asthenozoospermic men (<10% motile spermatozoa), compared with a group of 'proven fertile', healthy men. The extreme asthenozoospermic group has especially been chosen because of the suspected effect, that is, oxidative stress, on sperm motility. In our study, we found that cigarette smoking and alcohol intake did not differ between the subfertile and fertile group. In conclusion, cigarette smoking and alcohol consumption do not appear to significantly affect sperm parameters, such as volume, sperm count, motility and morphology or pregnancy outcome in our study population.
The effect of alcohol on spermatogenesis and sperm morphology has been of interest to many andrologists. Six adult male vervet monkeys were utilized to evaluate the effect of ethanol on semen quality. A decrease of the percentage of normal spermatozoa was observed after 10 months of exposure to alcohol.
From 1 May 1984 to 30 April 1985 177 laparoscopies were performed; 684 oocytes were obtained and a fertilization rate of 85% per oocyte achieved. There was a pregnancy rate of 24.3% per embryo transfer (ET) and 20.9% per laparoscopy after 152 patients were subjected to ET. The ET technique at Tygerberg Hospital, using the Tomcat catheter, is described. An introducer--the FT introducer--designed to overcome technical difficulties in selected patients in passing the Tomcat catheter is described. Technical problems are easily overcome with this introducer. In 26 patients (17.1%) ET was performed using this instrument and 8 pregnancies resulted (a pregnancy rate of 30.7% per ET). This pregnancy rate indicates the value of the instrument.
Obesity appears to be associated with male reproductive dysfunction and infertility, although this has been inconsistent and inconclusive. Insulin and leptin are known mediators and modulators of the hypothalamus-pituitary-testes axis, contributing to the regulation of male reproductive potential and overall wellbeing. These hormones are also present in semen influencing sperm functions. Although abdominal obesity is closely associated with insulin resistance (hyperinsulinaemia), hyperleptinaemia and glucose dysfunction, changes in seminal plasma concentrations of insulin, leptin and glucose in obese males has not previously been investigated. This small case controlled study assessed serum and seminal concentrations of insulin, leptin and glucose in obese (BMI > =30; n = 23) and non-obese (BMI < 30; n = 19) males. Following a detailed medical history and examination, participants meeting the inclusion criteria were entered for data analysis. Body parameters such as BMI, waist and hip circumference and the waist hip ratio were measured. Serum and semen samples were collected and assayed for insulin, leptin and glucose. Semen samples also underwent a standard semen analysis, with sperm mitochondrial membrane potential (MMP) and DNA fragmentation (DF). Obesity was associated with increased serum and seminal insulin and leptin, with no significant difference in seminal glucose. Serum and seminal concentrations of insulin and leptin were positively correlated. Furthermore, obesity was associated with decreased sperm concentration, sperm vitality and increased MMP and DF, with a non-significant impact on motility and morphology. Hyperinsulinaemia and hyperleptinaemia are associated with increased seminal insulin and leptin concentrations, which may negatively impact male reproductive function in obesity. Insulin was also found to be highly concentrated in the seminal plasma of both groups. This data will contribute to the contradictive information available in the literature on the impact of obesity and male reproduction.
CASE REPORT Mr S.R. who is 41 years old attended our special outpatient consultation for urogenital infections. He complained of an infertile partnership of 24 months although he had ovulationoptimized intercourse. His 32-year-old spouse was apparently healthy (as shown by the results of the gynecological examination). He reported a history of bacterial prostatitis with several courses of antibiotic therapy. The last diagnosis was chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) NIH III b at the urological examination. The first clinical examination demonstrated a swollen caput epididymidis on both sides (palpation, sonography), normal testicular volumes and normal testosterone (T), follicle stimulating hormone (FSH), and luteinizing hormone (LH). The ejaculate analysis (twice) according to WHO demonstrated the following three key point results: oligozoospermia with <10 million spermatozoa/mL (twice), leukocytospermia (>1×106 PPL/mL), elastase in seminal plasma >1000 ng/mL. Ejaculate culture was sterile.
'%3e%3cpath fill='%23001489' d='M0 0v6h9V0z'/%3e%3cpath fill='%23e03c31' d='M0 0v3h9V0z'/%3e%3cg stroke='%23fff' stroke-width='2'%3e%3cpath id='d' d='m0 0 4.5 3L0 6m4.5-3H9'/%3e%3cuse xlink:href='%23b' stroke='%23ffb81c' clip-path='url(%23c)'/%3e%3c/g%3e%3cuse xlink:href='%23d' fill='none' stroke='%23007749' stroke-width='1.2'/%3e%3c/g%3e%3c/svg%3e)
