[Sperm characteristics in infertile consulting patients at a Tunisian center].
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Biomedical subjects
Publications and source records attributed to H Ben Ali.
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Samples of sperm have been obtained from 95 who consulted us for infertility. In each case seminal plasma was examined for levels of alpha-1,4-glucosidase and L-carnitine. Our results have led us to fix the threshold value of 42.6 mlU per ejaculate for alpha-1,4-glucosidase and 960 nanomoles of L-carnitine below those levels that we thought occur where the origin of the oligospermia is obstructive (series 1 patients). In series 2 patients the cause of the oligospermia purely being secretory, there is normal epididymal function and therefore the excretory doubts are proven. It is not impossible to have both pathologies because we have found this in men of the intermediate groups C and D. We have found that there is a correlation between the presence of epididymal pathology and a drop in epididymal markers which can be found in severe oligospermia (which can be epididymal in origin and not testicular). Also when there is non abnormalities in the spermogram. This last situation can occur in "invisible" abnormalities of spermaturation in the epidymus.
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Glucosidase (alpha G) activity was measured in sperm free seminal plasma from 1200 patients consulting for primary infertility, in whom clinical examination of epididymides revealed some abnormalities and histories of genital infections. They constituted the group with epididymal pathology (P) that was compared with a reference group (R) of 246 men without any epididymal pathology. The distribution of alpha G was significantly different between the two groups, even if we considered only the subjects in group P with normal sperm count (PN: 353 men: p less than 10(-6). 15.9% of subjects in group PN exhibited alpha G values as low as vasectomized men, versus 1.2% in group R. A linear relationship was established between alpha G and sperm content in both groups, but alpha G activities were systematically lower in group P (y = 0.19 x + 64) than in group R (y = 0.30 x + 86). There was no correlation between alpha G and the percent of sperm motility. On the contrary, we found statistically more clinical epididymal abnormalities in cases of decreased alpha G activity than in cases of normal alpha G activity (p less than .01).