sodium-bicarbonate and Infertility--Male

The normal physiologic processes of emission and ejaculation require coordination of neurophysiologic, anatomic, and, in certain cases, psychological phenomena. Disruption of any component, from the embryologic development of the müllerian duct through the medications used for nonrelated systemic disease, can alter the efficient function of ejaculation. Evaluation of the urologic patient who has any of a number of abnormal ejaculatory states requires an understanding of the many possible mechanisms of failure. The majority of these men need evaluation because of a possible male-factor infertile marriage. The potential for improvement is significant, given the development of improved techniques to stimulate ejaculation and the promise shown by extracorporeal fertilization techniques such as in vitro fertilization and gamete intrafallopian tube transfer. These patients deserve complete assessment and optimization of any factors that will enable them to achieve their goal of procreation.

Topics: Adolescent; Adult; Animals; Bicarbonates; Ejaculation; Female; Humans; Infertility, Male; Male; Pregnancy; Sexual Dysfunction, Physiological; Sodium; Sodium Bicarbonate; Sympathomimetics

To design a new method for oral preparation of urine for sperm retrieval after retrograde ejaculation (RE) and to test the motility of sperm exposed to prepared and unprepared urine.. In vitro testing of urine conditions and sperm motility.. Assisted conception unit at a teaching hospital in the United Kingdom.. Ten healthy volunteers to provide urine and sperm specimens from men attending the unit for semen analysis.. Various solutions of sodium bicarbonate and sodium chloride were drunk by a single subject until a suitable regimen was achieved. This regimen (called the Liverpool solution) was then tested on 10 volunteers. Samples of sperm were then added to prepared urine, unprepared urine, and culture medium, and the motility was analyzed.. Urinary pH and osmolarity, sperm motility.. Urine produced by the 10 volunteers had a mean pH of 7.47 (range, 7.23-7.79) and a mean osmolarity of 289 mOsmol/L (range, 225-412 mOsmol/L), similar to that of medium. The progressive motility of sperm exposed to the unprepared urine was reduced (42.4% of sperm in medium), whereas that in the prepared urine was similar to that in the control medium.. Liverpool solution can be used in any unit treating couples with RE, and it is a noninvasive and inexpensive regimen that may optimize urine pH and osmolarity for sperm survival after RE.

Topics: Administration, Oral; Culture Media; Drinking; Ejaculation; Humans; Hydrogen-Ion Concentration; Infertility, Male; Male; Osmolar Concentration; Sodium Bicarbonate; Sodium Chloride; Sperm Motility; Spermatozoa; Time Factors; Urine

Both the adenylate cyclase activity and the motility of human sperm were stimulated by bicarbonate with the same concentration dependency. The correlation between bicarbonate levels in semen and the motility of sperm from the patients with male infertility was investigated. Bicarbonate in semen was found to originate mainly from the seminal vesicles, and a significant positive correlation was observed between bicarbonate levels and volume of semen. The motility of infertile sperm was also found to correlate positively to the seminal levels of bicarbonate. These results suggest that the lowered levels of bicarbonate in semen are at least in part responsible for the poor sperm motility in infertile patients, as a result of the failure in the activation of sperm adenylate cyclase.

Topics: Acid Phosphatase; Adenylyl Cyclases; Bicarbonates; Fructose; Humans; Infertility, Male; Male; Semen; Sodium; Sodium Bicarbonate; Sperm Motility