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Biomedical subjects

L J Rodriguez-Rigau

Publications and source records attributed to L J Rodriguez-Rigau.

At least 37 records · Page 2Linked to original sources

Evaluation and clinical application of a dextran-charcoal method for measuring bound testosterone in human plasma.

A method for rapidly determining bound and free testosterone in human plasma is evaluated and described, in which dextran-coated charcoal is used to separate bound and free testosterone. Intra- and inter-assay CV's were 1.9 and 3.8%, respectively. At least 50% of the "bound" testosterone was associated with species that behaved like sex steroid hormone-binding globulin on Sephadex G-25 chromatography and polyacrylamide gel electrophoresis. Bound and free testosterone concentrations were determined in normal men, normal women (during the menstrual cycle and during normal pregnancy), and in women with various degrees of hirsutism. We conclude that determining the circulating proportions of bound and free testosterone is helpful in the diagnostic evaluation of hirsutism in women, and in the investigation of normal and pathological conditions where androgen concentrations may be altered.

Charcoal↗

Testosterone levels in female partners of infertile couples. Relationship between androgen levels in the woman, the male factor, and the incidence of pregnancy.

Plasma testosterone levels were measured in the female partners of 146 consecutive infertile couples. The incidence of hyperandrogenism in the woman was correlated with ovarian function, incidence of pregnancy, male factor, and response of plasma testosterone levels to prednisone treatment. Over 70 per cent of the patients had pretreatment testosterone levels above 40 ng. per 100 ml. while after a minimum of two months of therapy approximately 80 per cent had levels below 40 ng. per 100 ml. High levels of plasma testosterone were associated with significant prolongation of the follicular phase of the cycle and increased incidence of amenorrhea or anovulation. An over-all pregnancy rate of 50.4 per cent resulted from the treatment. A direct relationship between pregnancy rates and sperm density as well as between pregnancy rates and degree of suppression of plasma testosterone after therapy was observed. These results demonstrate a high incidence of hyperandrogenism in female partners of infertile couples. The effectiveness of glucocorticoid treatment appears to be related to suppression of excessive androgen levels. The data also suggest that infertility is a relative state related to the fertility potential of each member of the couple. Improvement of the fertility potential of either member may result in conception.

Amenorrhea↗

The relation between plasma testosterone levels and the lengths of phases of the menstrual cycle.

Plasma testosterone levels were measured in 331 women of reproductive age. The incidence of clinical signs of hyperandrogenism (hirsutism, acne) was recorded. Ovulatory activity was evaluated clinically by basal body temperature and frequent observation of changes in the appearance of the cervical os and cervical mucus. Plasma testosterone levels were abnormally elevated in patients with clinical signs of hyperandrogenism. The highest mean testosterone levels were noted in the group of hyperandrogenic women with amenorrhea. Significant prolongation of the follicular phase and shortening of the luteal phase were demonstrated to be associated with clinical signs of hyperandrogenism and elevated plasma testosterone levels. Statistically significant correlations between plasma testosterone levels and duration of phases of the menstrual cycle were observed. Testosterone levels were directly related to the length of the follicular phase and inversely related to the length of the luteal phase. A significant inverse correlation between the lengths of the two phases of the menstrual cycle was also demonstrated. These results suggest an association between hyperandrogenism and prolongation of the follicular phase and shortening of the luteal phase of the menstrual cycle, possibly related to the high incidence of infertility and menstrual irregularity reported for hyperandrogenic women.

Adult↗

Effect of prednisone on plasma testosterone levels and on duration of phases of the menstrual cycle in hyperandrogenic women.

A group of 106 women of reproductive age with laboratory and clinical evidence of hyperandrogenism was treated with prednisone. The daily dosage varied between 7.5 and 10 mg. Ovulatory activity was assessed prior to and during therapy by basal body temperature and observation of changes in the cervical os and cervical mucus. Plasma testosterone levels were significantly suppressed by prednisone therapy. This was associated with initiation of ovulatory activity in 5 of 14 (35.7%) amenorrheic patients and 10 of 11 (90.9%) anovulatory patients. In 81 ovulatory patients, prednisone therapy resulted in statistically significant shortening of the follicular phase and lengthening of the luteal phase of the menstrual cycle. The mean length of the menstrual cycle was unchanged. Significant correlations between percentage suppression of plasma testosterone and shortening of the follicular phase or lengthening of the luteal phase were observed. Suppression of plasma testosterone by prednisone was maximal after 2 months of treatment, while the effect on the phases of the menstrual cycle was progressive with duration of treatment. The effects of prednisone at daily dosages of 7.5 or 10 mg were not significantly different. These results suggest that prednisone therapy in hyperandrogenic women exerts an effect on both phases of the menstrual cycle, possibly related to suppression of plasma testosterone levels.

Adult↗

Quantitative analysis of the seminiferous epithelium in human testicular biopsies, and the relation of spermatogenesis to sperm density.

Quantitative analysis of the seminiferous epithelium was performed in bilateral testicular biopsy specimens from 14 patients with sperm counts ranging from 0 to 89 million/ml. All Sertoli cells and germ cells within each seminiferous tubule cross-section were counted in all biopsies. Results were expressed either as number of cells per unit length of seminiferous tubule circumference or as number of cells per Sertoli cell. Results were correlated with sperm count (millions per milliliter), total sperm count (millions per ejaculate), and age. A significant correlation between sperm density and germ cell counts was demonstrated. Coefficients of correlation were higher when results were expressed per unit of tubular wall length than when expressed per Sertoli cell. In men with sperm counts below 5 million/ml the number of germ cells in the biopsy was lower than in men with higher sperm counts. Spermiogenesis appeared to be most affected. In this group of patients an adverse effect of age on spermatogenesis was noted.

Adolescent↗

A possible mechanism for the detrimental effect of varicocele on testicular function in man.

Seminiferous epithelium histology, Leydig cell density, and in vitro testosterone synthesis were quantitated in bilateral testicular biopsies from men with varying degrees of unilateral or bilateral varicoceles. Results were correlated with plasma levels of gonadotropins (follicle-stimulating hormone [FSH], luteinizing hormone [LH]) and testosterone (T), as well as with semen quality. In patients with bilateral varicoceles, spermatogenesis, Leydig cell density, plasma T levels, and in vitro T synthesis were significantly lower than in patients with unilateral varicoceles. Varicoceles appeared to affect maximally the latest stages of spermatogenesis. A negative correlation between FSH and LH levels and spermatogenesis was observed; however, a dissociation between the two gonadotropins occurred when spermatogenesis declined. Plasma T levels were within the normal range in all patients. The T:LH ratio was significantly correlated with spermatogenesis and sperm motility. Leydig cell density was abnormally low in oligospermic patients, and it was significantly correlated with in vitro T synthesis, spermatogenesis, sperm motility, and semen volume. Sperm count and motility were significantly correlated in this group of patients, suggesting a common pathophysiology for the effect of varicocele on spermatogenesis and sperm motility. This common pathophysiology appears to be disturbed Leydig cell function resulting in decreased testicular androgen production, in turn causing inadequate spermatogenesis and epididymal function.

Adolescent↗

Relationship of varicocele to sperm output and fertility of male partners in infertile couples.

Both partners of 455 infertile couples seen consecutively were evaluated. When indicated the female partners were treated. Six semen specimens from each male subject were analyzed. A varicocele was diagnosed in 23.7 per cent of the men. More than 60 per cent of the men with a varicocele had sperm counts less than 40 million per ml., while 67 per cent without a varicocele had sperm counts more than 40 million per ml. The mean and total sperm counts of men with a varicocele were significantly lower than those without a varicocele. However, the pregnancy rates were not significantly different. The pregnancy rate was 46 per cent in couples whose male partners underwent a varicocelectomy, not significantly different from the pregnancy rate achieved in couples when the varicoceles were not corrected surgically (51 per cent). Varicocelectomy resulted in improvement in sperm count only when preoperative counts were more than 10 million per ml. Pregnancy rates for couples in which a varicocelectomy did or did not result in improvement in sperm count or motility were identical (45.1 and 45.5 per cent, respectively). These findings suggest that in male partners of infertile couples the presence of a varicocele is associated with compromised semen quality but not with diminished fertility when the female partners are treated. This observation emphasizes the importance of considering infertility as a problem of a couple, rather than a specific disorder of one of the partners.

Cell Count↗

Suggestion of abnormal testicular steroidogenesis in some oligospermic men.

Androgen biosynthesis in the testis may be analyzed in some detail by means of techniques of in vitro incubation of small testicular biopsy specimens with suitable radiolabelled precursors. Sixty-six tissue specimens from 33 patients who underwent bilateral testicular biopsies because of infertility were incubated in vitro with [3H]pregnenolone in order to investigate the possibility of abnormalities in their steroid biosynthetic activity. As a normal control, testicular tissue obtained by testicular biopsy from a young normal volunteer was used. The distribution of metabolites in the incubates of testes from 8 infertile men differed greatly from the remaining 25 patients and the normal control. The major steroids formed from pregnenolone by the testes of those 8 men were 17-hydroxypregnenolone, dehydroepiandrosterone, 20alpha-dihydropregnenolone and and 20alpha-dihydro-17-hydroxypregnenolone. Very small amounts of delta4-3 oxo products (progesterone, 17-hydroxyprogesterone, androstenedione and testosterone) were formed suggesting a deficiency of 3beta-hydroxy-steroid-dehydrogenase activity in the testes of these 8 men, possibly related to the derangement of their spermatogenic function.

Adult↗

In vitro steroid metabolic studies in human testes I: Effects of estrogen on progesterone metabolism.

A technique of incubation of testicular tissue in vitro with radiolabeled precursors was applied in the investigation of the steroid biosynthesis by testes of four young men after long-term, high-dose estrogen treatment. A positive correlation between plasma and testicular steroid levels, and in vitro capacity of the testes to metabolize progesterone was demonstrated. Estrogen administration produced a very significant inhibition of plasma and testicular levels of testosterone. The in vitro synthesis of testosterone from progesterone was very severely impaired; especially 17alpha-hydroxylation of progesterone. 20alpha-hydroxysteroid-dehydrogenase activity was found to be increased after estrogen treatment, both in vivo and in vitro. These findings suggest that testicular 17alpha-hydroxylase activity (and possibly also 17-20 lyase activity) is either under gonadotropin regulation, or is directly suppressed by estrogen. This could result by decreased enzyme synthesis, direct enzyme inhibition or affectation of the cofactors or cytochromes necessary for the enzymatic activity. 20alpha-reduction of C21-steroids would represent an alternative pathway for their catabolism, not regulated by gonadotropin or not affected by estrogen, that would be significant in situations with reduced 17alpha-hydroxylase activity.

Adult↗

Frequency distribution of sperm counts in fertile and infertile males.

In this study the frequency distribution of sperm counts and total sperm counts from more than 4000 allegedly fertile males were compared with those of husbands in 1000 infertile couples. Significant differences were observed only at the lower end of the scale (sperm counts below 10 million/ml and total sperm counts below 25 million/ejaculate). Frequency distributions of sperm counts above 10 million/ml or total sperm counts above 25 million/ejaculate revealed little difference between the fertile and infertile groups. These data suggest that, unless other parameters are found to be abnormal, sperm counts and total sperm counts above 10 million/ml and 25 million/ejaculate, respectively, probably are not major factors in a couple's infertility.

Cell Count↗

Relation between indices of semen analysis and pregnancy rate in infertile couples.

Both partners of 198 consecutive infertile couples were evaluated. Studies in the female included clinical evaluation of ovulation for a minimum of two menstrual cycles, investigation of tubal patency, and evaluation of sperm survival in cervical mucus. Six semen specimens were analyzed from each male. Laparoscopy, scrotal exploration, and testicular biopsies were performed as required. Where indicated, the female was treated intensively. The only therapy offered to the males was ligation of varicoceles, if present. The couples were grouped on the basis of sperm counts, total sperm counts, motile sperm counts, and total motile sperm counts, and the incidence of pregnancy was computed. Pregnancy rates of approximately 50% occurred in couples where sperm counts or total sperm counts were in the range of 5 to 60 million/ml or 25 to 200 million/ejaculate, respectively. When sperm counts were over 60 million/ml or total sperm counts over 200 million/ejaculate, pregnancy rates increased to above 70%. These observations emphasize the importance of considering infertility as a problem of a couple rather than as a specific disorder of one of the partners. These data also demonstrate a lack of direct correlation between sperm density in the ranges of 5 to 60 million/ml and pregnancy rates in couples where the wife is treated intensively.

Cell Count↗

In vitro steroid metabolic studies in human testes. II: Metabolism of cholesterol, pregnenolone, progesterone, androstenedione and testosterone by testes of an estrogen-treated man.

The effect of long-term in vivo estrogen treatment on in vitro steroidogenesis by the testes of a young man was investigated. In vitro incubation of testicular tissue of this man with 3H-pregnenolone, 3H-progesterone, 3H-androstenedione and 3H-testosterone demonstrated suppression of 17-hydroxylase activity, with little or no effect of the treatment on delta5-3beta-hydroxysteroid oxidoreductase, 5alpha-reductase and aromatase. Increased 20alpha-hydroxysteroid oxidoreductase activity was observed. Determination of intratesticular steroid concentrations led to similar conclusions.

Adult↗

Relationship between the results of sperm analysis and GIFT.

In vitro fertilization (IVF) and GIFT have been proposed as therapeutic approaches in infertile couples where a significant male factor is present. To date, few published data are available relating the success rate of GIFT to the severity of the male factor. In this report the results of the first 172 GIFT cases were analyzed. The overall pregnancy rate was 18.0%. The relationship between the occurrence of pregnancy and sperm count (millions/ml), total sperm count (millions/ejaculate), % motility, motile sperm count (millions/ml) and total motile sperm count (millions/ejaculate) were examined. Significant direct correlations were observed between the clinical pregnancy rate and sperm count, total sperm count, motile sperm count and total motile sperm count. Motile sperm count and total motile sperm count had the best correlations with clinical pregnancy rates, which were over 24.0% in groups with motile sperm counts exceeding 40 X 10(6) cells/ml or total motile sperm counts greater than 100 X 10(6)/ejaculate. The clinical pregnancy rates were 12.5% and 7.7%, respectively, for groups with motile sperm counts under 10 X 10(6)/ml and total motile sperm counts below 25 X 10(6)/ejaculate. No correlation was found between percent motile cells and pregnancy rate. Results of the sperm penetration assay using zona-free hamster eggs were available in a subpopulation of 27 patients. No significant correlation between this sperm penetration assay and pregnancy rate could be demonstrated. The incidence of chemical pregnancy showed a significant negative correlation with the total motile sperm count, indicating a higher incidence of early pregnancy wastage in cases of oligozoospermia.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗