Aluminium, cadmium and lead concentrations in the spermatozoa and seminal plasma of 27 employees of two industrial companies, a refinery and a polyolefin factory, and 45 consecutive sperm donor candidates at a sperm bank were studied using atomic absorption measurements. The relationship between metal concentration and parameters of semen analysis was studied. A high concentration of aluminium in spermatozoa was correlated with decreased sperm motility. The concentrations of cadmium and lead were low and did not show any correlation with parameters of semen analysis. Aluminium may be one of the environmental pollutants causing impaired semen quality. The mean sperm concentrations were similar in the factory employees (96 x 10(6)/ml), in the sperm donor candidates of the comparison group (104 x 10(6)/ml) and in 352 donor candidates at the sperm bank of the Family Federation of Finland (107 x 10(6)/ml) between May 1993 and May 1995.
A total of 29 infertile couples (group A) with male antisperm antibodies detected by the mixed antiglobulin reaction (MAR) and partly by flow cytometry (n = 21) were treated using an intracytoplasmic sperm injection (ICSI) technique to assist fertilization. In all, 22 of them had shown a poor fertilization rate (6%) in previous in-vitro fertilization (IVF) treatments. The fertilization and cleavage rates in ICSI, 79 and 89% respectively, were similar to those in a MAR-negative group (group B; n = 20) injected because of male infertility (68 and 93% respectively). A third group (group C; n = 37) with male immune infertility was treated by conventional IVF. All these couples had at least one oocyte fertilized, but the overall fertilization rate (44%) in group C was significantly poorer (P < 0.001) than that in the two ICSI groups. However, the embryo quality was lower in group A compared with that in the other groups. A total of 13 pregnancies resulted in group A (46%), of which five ended in miscarriage. None of the six pregnancies (30%) in group B aborted during the first trimester. These results reveal, for the first time, that ICSI offers a good chance of fertilization for couples with male immunological infertility. However, post-fertilization events may compromise these results because of factors not yet clearly understood.
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