Biomedical subjects
H H Pusch
Publications and source records attributed to H H Pusch.
[Andrology for the gynecologist].
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[Development of an electronic calculator for gestational age in prenatal care].
The development of a portable electronic gestation calculator enables the obstetrician for the first time to recall all relevant data for his daily routine work from an electronic memory. This is useful not only for the calculation of the duration of pregnancies or the determination of delivery data, but also includes all relevant information from ultrasound biometry of the fetus. This paper presents the experience with this new electronic device, 'Babycomp', and comments on its design, technical features, functions and performance. The device has been thoroughly tested especially with respect to its suitability for practical purposes. Compared with the widely used disk for pregnancy calculations, the 'Babycomp' has a wide range of advantages for all users working in the field of obstetrics and reproductive medicine.
[The psychosocial background of sterile patients].
The psychosocial background of 300 childless couples from the Infertility Clinic of the Department of Gynecology and Obstetrics, University of Graz, was evaluated by means of a questionnaire and statistical analysis of data from their files. Points of special interest were problems such as interactions of the couple, motivations for the desire of children, psychosomatics, andrological investigation within the gynecological department, sexual habits and motivation and compliance concerning investigations and treatment. 72% of the questionnaires were returned. 50% of the sterile couples preferred to attend the infertility clinic together. 26% felt restrictions in their sexual behaviour due to the unrealized desire of children, 48% expected improvements in their partnership if they could have children. Compliance of male partners concerning the regular intake of prescribed medicaments was 83%, 63% accepted to stop smoking in cases of pathospermia.
The importance of an early diagnosis of fertilization disorders.
Typical possibilities of abnormal development in human oocytes cultured and fertilized in vitro were studied using phase-contrast microscopy. All oocytes were checked three times for maturity, fertilization and embryo development. A total of 180 non-cleaved oocytes and 30 embryos originating from polypronuclear oocytes are described. It is concluded that an exact inspection at the fertilization check is essential to avoid the transfer of abnormally developing oocytes and embryos.
[Motility of spermatozoa and its significance for fertilization in vivo and in vitro].
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Evaluation of sperm motility by laser--Doppler-spectroscopy in an in-vitro fertilization programme.
Laser-Doppler-spectroscopy represents a new, fast and reliable technical method for the assessment of several parameters of sperm motility including the percentage of spermatozoa which are motile, and mean spermatozoal velocity. Serial measurements of these parameters in routine andrological work permit standards for four main spermiogram diagnoses to be established. Laser-Doppler-spectroscopy was used to verify alterations in the motility of spermatozoa after capacitation in an in-vitro fertilization programme. An enhancement of 16% for total sperm motility and 36% for mean spermatozoal velocity could be observed. The results of in-vitro fertilization after various spermigram diagnoses, combined with long-term observations of mean spermatozoal velocity, may be considered as another step towards the elucidation of sperm-oocyte interactions. Comparisons between the development of embryos revealed significant differences between normo- and asthenozoospermic men versus oligozoospermic patients.
Absence of HLA class I and class II antigens as well as beta 2-microglobulin from normal and pathological human spermatozoa.
Human spermatozoa from 87 donors with normal or pathologic semen specimen were examined for the expression of HLA-class I and class II antigens as well as beta 2-microglobulin (beta 2m) using a panel of monoclonal antibodies in an indirect immunofluorescence test. The results make it very unlikely that HLA-class I and class II molecules as well as beta 2m are expressed on human sperm cells.
[Diagnosis of a toxic liver lesion based on spermiographic changes].
8% of andrological patients are exposed to harmful substances at work. Testicular function can be impaired by mechanical and thermic irritation, but, above all, many chemical substances have a detrimental effect on spermatogenesis. A case is presented of a 23 year-old painter who showed a significant rapid decrease in sperm quality in spite of a course of treatment with mesterolone. The toxic agents were nitro lacquer thinners and resin dispersions, which had caused toxic liver damage, as seen from the raised liver enzyme activities. The elimination of the noxious substances resulted in a normalization of liver enzyme activities and a restitution of fertility.
Serum FSH, LH, and testosterone in humans after physical exercise.
The serum levels of FSH, LH, and testosterone were determined by radioimmunoassay in 63 men before, during, and after maximal and submaximal physical short- and long-term exercise (800-n running, climbing, 36-k cross-country skiing). In the 800-meter run, significant elevations of FSH, LH, and testosterone were observed, while in all other field and laboratory test (climbing, 36-km cross-country skiing, maximal stepwise bicycle and treadmill ergometry, 90-min submaximal bicycle ergometry) the hormone levels remained unchanged or were decreased. In contrast to FSH and LH, which did not show any clear modification with duration or intensity of exercise or with the state of training, changes of testosterone in the endurance field test (36-km cross-country skiing) seemed to be training dependent. In highly endurance-trained subjects, there was an increase and in less well-trained subjects a decrease of testosterone for equal distances and intensities of exercise.
[Perforating sigmoid diverticulitis in monozygotic twins].
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Serum progesterone patterns in male subfertility.
Serum progesterone was evaluated in 455 men attending the infertility clinic, Department for Gynecology and Obstetrics, University of Graz, Austria. The progesterone values of azoospermic, oligozoospermic, teratozoospermic and asthenozoospermic patients were compared to a group of normozoospermic men. No significant differences were found between normozoospermic men and patients with impaired semen quality, in subgroups of oligozoospermia and between obstructive azoospermia and azoospermica due to primary testicular failure.
Treatment of asthenozoospermia with HCG.
30 patients with isolated asthenozoospermia received a treatment with 5000 I.U. Human-Chorionic-Gonadotropin (HCG) a week intramuscularly for twelve weeks. Pretreatment basal levels of FSH, LH and testosterone were in normal or low normal range. 16 males responded to therapy, the total motility of spermatozoa increased significantly from 34% to 40%. In spite of a decreased sperm density and morphologic quality 6 pregnancies occurred. This result strengthens the interpretation, that sperm motility is the most important factor for fertilization. HCG therapy must be considered as an additional approach for treating motility disturbances, especially in cases with high sperm densities.
Experiences with the electronic spermcounter in andrologic routine work.
Evaluation of semen samples is a time consuming process, which can be facilitated significantly by means of the electronic spermcounter. The device represents a microcomputer system operating with three main functions: Counter function, morphologic function and timer function. In order to quantify the advantages of the electronic apparatus it was compared with a mechanical handheld counter and a mechanical blood-cell counter. Determinations of sperm density and morphologic analysis of stained specimen consumed significantly less time when the sperm counter was used. The advantages of the timer function, while apparent, could not be quantitated and expressed in numbers. The electronic spermcounter makes microscopic evaluations of semen samples faster, easier and more reliable. Thus the device is useful for those dealing routinely with numerous spermiograms, i.e. andrologists, veterinarians and other working in the field of reproduction.
The importance of sperm motility for the fertilization of human oocytes in vivo and in vitro.
Motility behaviour of spermatozoa in 289 ejaculates was investigated by laser-Doppler-spectroscopy in the andrology-laboratory of the University Hospital for Gynecology and Obstetrics, Graz/Austria. Conventional spermiograms, performed on the same ejaculates, permitted comparisons between estimated motility and laser-measurements, comprising the following parameters: Total sperm motility, mean sperm velocity, percentages of progressive motile spermatozoa and mean progressive velocity. In order to elucidate the importance of sperm motility for the fertilization of oocytes in vivo and in vitro, ejaculates of six different groups of patients were evaluated. In vivo: 173 patients from the andrologic outpatient service (group A); 38 patients from the andrologic outpatient service, whose wives became pregnant (group B) and 20 donors with recently proved fertility (group C). In vitro: 8 patients, whose ejaculates failed to fertilize the oocytes (group D); 39 patients with successful fertilization (group E) and 12 patients with ongoing, clinical pregnancy of their wives after ivF (group F). In addition, motility behaviour was assessed in native ejaculates 24 hours after ejaculation, as well as changes in sperm motility after capacitation. Statistical evaluations of group comparisons revealed a good correlation between estimated results and laser measurements. Mean sperm velocity and progressive sperm motility are the most selective parameters within the group differences in oligozoospermic ejaculates. Besides motility, morphology is of importance in vivo as well as in vitro. Based on the results of measurements obtained in the different groups, the following guidelines for standard values in laser-Doppler-spectroscopy are proposed: Total sperm motility greater than 53%; mean sperm velocity greater than 42 microns/sec.; progressive sperm motility greater than 34% and mean progressive velocity greater than 68 micron/sec. If these values are not reached, medical treatment is recommended.
Oral treatment of oligozoospermia with testosterone-undecanoate: results of a double-blind-placebo-controlled trial.
30 patients with normogonadotrophic oligozoospermia from 1-20 mill/ml (group A) and 30 men with a sperm density from 210-40,0 mill/ml (group B) from the andrologic laboratory of the University Clinic for Gynecology and Obstetrics, Graz, Austria were treated with a 120 mg testosteron-undecanoate per os for 100 days. One randomized half of the patients received a placebo in a double blind manner. Conventional spermiograms were supplemented by extended morphologic analysis and motility determinations by laser-Doppler-spectroscopy. Statistical evaluation of data revealed no differences between verum and placebo group before treatment. After therapy significantly higher levels of testosterone could be observed in the verum group. Statistical calculations of differences between spermiogram parameters before treatment, after treatment and six weeks thereafter revealed significant improvements of sperm morphology in group A and B as well as significantly lower numbers of spermatozoa with head-deformations. A reduction of tail deformities could be observed at the control spermiogram six weeks after end of treatment. Besides improvements of sperm morphology, enhancements of sperm density could be observed in the verum group; sperm motility remained generally unchanged. During the duration of the trial four pregnancies (1 abortion) occurred in the placebo group, six females became pregnant in the verum group: five belonged to group A (1 x gemini), one pregnancy occurred in group B.
[Results of low-dose treatment of oligozoospermia with clomiphene citrate].
30 oligozoospermia patients from the andrologic outpatient service of the University-Hospital for Gynecology and Obstetrics, Graz, Austria, received a treatment with clomiphene-citrate. A doses of 25 mg daily was given for 25 days, followed by a break of 5 days. This treatment cycle was repeated three times, providing a total of 4 months of therapy. Rigid criteria of selection were applied for the patients in this trial, pretreatment serum levels of FSH, LH, testosterone, prolactin and estradiol had to be in normal or low-normal range. After treatment FSH, LH and testosterone were re-evaluated and a semen analysis was performed. Six to eight weeks afterwards another spermiogram was done. A significant raise of sperm density was observed immediately after treatment and at the control 6-8 weeks after therapy. Motility and morphologic quality remained unchanged after the therapeutic course. Fructose content of seminal plasma raised significantly 6-8 weeks after therapy. FSH, LH and testosterone increased also on a significant level. 6 pregnancies could be achieved, no negative side effects of treatment had to be registered.