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WHO laboratory manual for the examination of human semen and semen-cervical mucus interaction. 2nd ed.
Cambridge, England, Cambridge University Press, 1987. , 67 p.The WHO Special Programme of Research, Development and Research Training in Human Reproduction has revised its manual designed to standardize procedures for the examination of human semen. This revised manual, for instance, describes a simplified method for screening the morphology of cellular elements other than spermatozoa; the previous method now appears in the section on optional procedures. WHO has also included methods to determine the presence of spermatozoa antibodies. The manual has guidelines on measurement of biochemical components of seminal plasma to evaluate the secretory function of accessory glands (e.g., fructose indicates secretory function of the seminal vesicles). Even though these biochemical tests may not mark a man's fertility, they demonstrate the functional state of these glands. Besides, someday they may even help assess the possible effects of xenobiotic factors and of disease. Some researchers believe adenosine triphosphate levels are linked to spermatozoal function and that the zona free hamster oocyte test can determine the ability of human spermatozoa to join with the oocyte; so WHO has listed protocols for these 2 tests. The manual also has protocols to assess the ability of spermatozoa to penetrate cervical mucus in vitro: the microscopic method and the capillary tube test. WHO believes that determining this ability is important when evaluating the fertility of a couple. The Standard Procedures section on collection and examination of human semen considers appearance, volume, consistency, pH, motility, preparation and grading, agglutination, sperm viability, sperm count, and testing for antibody-coating of spermatozoa. The section on sperm cervical mucus interaction examines volume, consistency, ferning, spinnbarkeit, cellularity, pH, and in vivo and in vitro tests. It hopes that researchers will adapt the standard procedures presented in this manual to improve quality control between laboratories and allow aggregation of data from several sources for analysis.
PLANNED PARENTHOOD IN EUROPE: REGIONAL INFORMATION BULLETIN. 1986 Autumn; 15(2):3-13.This paper, prepared for European planned parenthood associations, reviews the range of political and ethical reactions to new reproductive technologies. Planned parenthood federations are committed to ensure that women and human living material are protected both from unethical scientific manipulation and exploitation for profit and that candidates for infertility treatment are given appropriate counseling. Within these limits, research into the causes and treatment of infertility has been encouraged. On the other hand, so-called pro-life forces challenge research in this area on the grounds that the sanctity of human life may be violated. A more recent development has been the emergence of feminist opposition to reproductive research on the grounds that it threatens to lead to the expropriation of women as childbearers. The potential removal of reproduction from people is viewed as a further devaluation of women's status and concern is voiced that pre-embryo screening may take the form of benign eugenics. Feminists further argue that in vitro fertilization services are disproportionately available to white, middle-class women. Finally, it is feared that the incorporation of sex preselection into the population programs of Third World countries will become possible as a logical extension of current importation to developing countries of chemical contraceptives (eg Depo-Provera) regarded as unsuitable for use in the US. In the face of such arguments, both from pro-life and feminist forces, planned parenthood federations are urged to be clear about potential uses and abuses of the new reproductive technologies.
London, International Planned Parenthood Federation, 1979. 58 p.This International Planned Parenthood report states the agency's policy position on management of infertility, and then briefly goes on to cover the following topics, in handbook form: 1) epidemiology of infertility; 2) etiology of infertility; 3) proper infertility counseling; 4) prevention (trauma avoidance and early treatment of diseases); 5) diagnostic techniques for the couple, man, and woman; 6) treatment of infertility in women and men; 7) use of artificial insemination, both with donor's semen and partner's semen; and 8) the place of adoption within the community of infertile couples. Prevalence of infertility is placed at an international average of 10%, though places such as Cameroon have rates as high as 40%. The factors influencing infertility are divided into 3 groups: 1) socio-cultural, 2) sexually transmitted diseases, and 3) other diseases and disorders. Causes of female infertility include: ovulation dysfunction; tubal obstruction or dysfunction; uterine actors such as fibroids, polyps, or developmental abnormalities; cervical abnormalities; vaginal factors, such as severe vaginitis or imperforate hymen; endocrine and metabolic factors, particularly thyroid disturbances, diabetes, adrenal disorder, severe nutritional disorders (anemia), or other systemic conditions; and repeated pregnancy wastage. Male causes include poor semen quality; ductal obstruction; ejaculatory disturbances (i.e., failure to deliver sperm to vagina); emotional stress (may lead to hypogonadism); and genetic factors (Klinefelter syndrome). Causes specific to the couple include lack of understanding of reproductive physiology, immunoloigcal incompatibility, nutritional deficiencies, and psychogenic factors.
In: Morris, N. and Arthure, H. Sterilization as a means of birth control in men and women. London, Peter Owen, 1976. p. 80-100Vasectomy was 1st used at the start of the 20th century and became prominent in the 1950s in family planning programs in Asian countries. The secondary sex characteristics do not change after vasectomy, and there is normal erectile power, libido, orgasm, and ejaculatory volume. Spermatogenesis continues normally in men following vasectomy, and plasma testosterone levels remain unchanged. Vasectomy involves cutting both vasa deferentes through an incision in the scrotum which is usually performed with local anesthesia without hospitalization. Preliminary counseling is necessary so that both partners understand the nature and effects of the operation. Semen banks may be used when available for men undergoing vasectomy. There is no evidence for the greater efficiency of 1 technique over the other. Patients must submit sperm samples for examination after 8-12 weeks and then every 4 weeks until 2 consecutive specimens are negative. Possible complications include: 1) a vasovagal reaction; 2) skin discoloration; 3) edema of the scrotal skin, 4) postoperative pain, 5) infection; 6) ulceration and gangrene of the scrotal skin, and 7) hydrocele or epididymo-orchitis. Successful reanastamosis of the vas deferens with reappearance of sperm can be accomplished in 50-80% of the patients, and the semen is not of quality to insure impregnation in 1/4 of these cases.