Diagnostik und Therapie von Fertilitätsstörungen des Mannes

The paper describes a new and rapid method forregistration of spermatogenesis in human testes: the testicular biopsy score count. Each tubular section is given a score from 10 to 1 according to presence or absence of the main cell types arranged in the order of maturity. Presence of spermatozoa scores 10, 9 or 8; spermatids (and no further) 7 or 6; spermatocytes (and no further) 5 or 4; only spermatogonia 3, only Sertoli cells 2 and no cells 1. The theoretical background of the score count method is discussed and it is emphasized that tissue heterogeneity, being a main point in most conditions, is exposed and evaluated by the method. Normal values are given and results obtained in 335 cases including a great variety of forms of male hypogonadism are presented. Patognomonic score counts leading to immediate diagnosis at a glance are obtained in many instances. A high correlation between testicular biopsy score count and sperm count is found and it is concluded that by this method it has for the first time become possible in man to correlate endocrine conditions with the functional state of the testicular tissue.

The objective of this study was to develop a relatively simple test to evaluate the functional integrity of the membranes of human spermatozoa. As in some other species, human spermatozoa 'swell' under hypo-osmotic conditions due to the influx of water and the expansion of the membranes. A mixture of equal parts of fructose and sodium citrate (150 mosmol) with calculated ionic strength of 0.15 resulted in a maximal number of clearly identifiable swollen spermatozoa. Only small variations were seen when different aliquants of the same semen samples were separately evaluated. A high correlation (r = 0.94) was obtained between expected and observed values of swollen spermatozoa when known amounts of heat-treated spermatozoa, unable to undergo swelling, were added to untreated spermatozoa. A good correlation (r = 0.90) was also observed between the % spermatozoa in a semen sample that were capable of undergoing swelling and the % of denuded hamster oocytes that were penetrated by capacitated spermatozoa from the same semen sample. By contrast, the correlations between % sperm swelling in ejaculates and % normal sperm forms, % motile spermatozoa and % spermatozoa that do not stain with eosin-Y (supravital stain) in the same ejaculates were 0.30, 0.61 and 0.52, respectively. Therefore, the hypoosmotic swelling technique to evaluate the functional integrity of the sperm membrane appears to give high repeatability and accuracy and is closely correlated to the in-vitro fertilizing ability of spermatozoa. It may be a useful addition to the standard semen analysis.