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An increased frequency of abnormal sperm morphology in men with CPA was also found in a study (n = 40) of men in the United States receiving levonorgestrel-releasing intrauterine system (LNG-IUS) in a retrospective study (19). Of the 40 men evaluated, 20 (83%) had abnormal sperm morphology. The mean age of men in the study was 47 years; mean testosterone level was 2.8 nmol/L; mean LH level was 1.2 nmol/L; and there no difference in baseline sperm characteristics between the four groups of men. prevalence abnormal sperm morphology in the four treatment groups was not significantly different from that found in the control group, with exception of the first group: men in this group were on the levonorgestrel-releasing intrauterine system and had normal sperm concentrations. The prevalence of abnormal sperm morphology in men who were never on the LNG-IUS was also not significantly different from that found in control men from the same population (19).
In a study of 397 couples enrolled in a randomized placebo-controlled trial of LNG-IUS in 8–12–year-old couples the United Kingdom (20), it was found that a total of 17 (13.4%) the couples had abnormal sperm morphology. After adjustment for age, there was no significant difference between these groups in terms of the overall proportion couples affected by abnormal sperm morphology (13.4% vs. 11.7%). In contrast, a study of 20 men with CPA who were not on the LNG-IUS, there was a significant difference in the proportion of sperm with abnormal morphology between those receiving LNG-IUS and placebo (16.7% vs. 2.9%; P = 0.04) (19). In addition, although the overall prevalence of abnormal sperm morphology was low in the first treatment group, this frequency was much higher in the second group (14.8% vs. 1.9%; P = 0.003) (19).
In two studies, normal levels of serum FSH and LH were found in men with CPA (n = 24) (21, 22). In the study of 18 men with CPA, FSH values were normal for the first year after initiation of the study. 3 or 4 months of treatment, however, serum FSH values were elevated at both 10–15 and 30–36 months after initiation of LNG-IUS therapy. These studies also revealed a significant association between serum FSH levels and abnormal sperm morphology. In a case–control study of 523 cases male infertility, a significant increase in abnormal sperm morphology was observed in patients having a normal FSH level (n = 643) compared with those having a serum FSH value ≥1.2 x 106 IU/L
discount pharmacy warehouse online (n = 479) (23).
Treatment effects on male
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A number of studies have examined the effect of treatment on testosterone levels and semen quality. In both the United Kingdom and States (23–26), abnormal sperm morphology was associated with reduced levels of testosterone (P < 0.0001 and P = 0.013, respectively) (Table 3). In contrast, a recent study the United Amlodipine 60 Pills 10mg $89 - $1.48 Per pill Kingdom showed no association between the level of testosterone or estradiol and sperm concentration (27).
TABLE 3 Treatment group No. of patients Number cases Characteristica Serum LH (nmol/L)b FSH (IU/L)c P value Treatment group No. of patients Number cases Characteristica Serum LH (nmol/L)b FSH (IU/L)c P value Treatment group No. of patients Number cases Characteristica Serum LH (nmol/L)b FSH (IU/L)c P value Treatment group No. of patients Number cases Characteristica Serum LH (nmol/L)b FSH (IU/L)c P value View Large.
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