evaluation of the morphology of sperm in urine of adolescent boys
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I N T E R N A T I O N A L J O U R N A L O F A N D R O L O G Y
7 (1984) 348-351
Institute of Endomkology and Department of Clinical EpuEaiology. The Chaim Sheba Medical Center, Tel Hashomer and
Deparhent of Obstetrical Gynaecologyl, Beilinson Hospital, Petmh Tikva, Israel
Evaluation of the morphology of sperm in urine
of adolescent boys
R. Weissenberg, M. Hirschl, J. Shemesh, M. Modan and B. Lunenfeld
The morphology of spermatozoa in the first morning void of boys aged 12- 16 years was evaluated. The results suggest that the number of cells having normal morphology increases with advancing age. Thus, the percentage of boys with greater than 45% normal sperm was 26% at the age of 12-13, increasing to 5 1 76 at the age of 15- 16.
Kq words: spermatozoa - post-ejaculatory urine - sperm morphology.
An early observation by Baldwin (1928) that spermatozoa could be detected in post-ejaculatory urine specimens (PEUS) prompted several studies (Richardson & Short 1978; Hirsch et al. 1979) aimed at estimating the age of onset of sperm emission (spermarche).
Results of a recent longitudinal study conducted on 155 school boys aged 1 1 to 16 who collected morning void during 5-10 consecutive days (Hirsch et al. 1984) indicated that the median age of spermarche was around the 13th birthday. The aim of the present study was to compare sperm morphology at age 12- 13 (around the age of spermarche) to that at age 15-16 when spermatogenesis is well established.
Received on October 19th, 1983.
We have shown previously in a study comprising 84 individuals that the morphology of sperm in the PEUS reflects that in the respective ejaculate (Weissenberg et al. 1984). We have, therefore, studied sperm morphology in adolescent boys by observing their morphology in urine.
Materials and Methods
First morning void was obtained from 67 boys aged 12-16 years in whom sperm were detectable in urine. The urine was centrifuged at 1800-2000 RPM for 15 min within 1-2 h of collection. The supernatant was decanted, and the sediment re-suspended in 0.2-0.5 ml saline containing 1% Eosin Y . Slides of the re- suspended material were prepared, and the sperm present counted and examined at a magnification of X 1000. Only 23 boys aged 12- 13 and 29 boys aged 15- 16 years whose samples contained at least 10 sperm were included in the analysis. Spermatozoa were evaluated morphologically for gross head, midpiece and tail abnormalities. Statistical comparison of the percentage of normal cells in the 2 age groups was made using the non-parametric Mann-Whitney U-test.
The distribution of normal spermatozoa in different age groups is represented in Fig. 1. The percentage of boys aged 12-13 years with more than 45% normal sperm was 26% (6/23) as compared to 51.7% (15/29) in boys aged 15-16 and this difference was statistically significant (P < 0.03). By comparing these results to values obtained for a group of 44 normal healthy men in their early twenties, it was found that in the latter 71 % had > 45% normal forms. The mean percentage of normal forms in this group was 54 k 8.5%. However, 45% normal forms was found to be the low range of normality in this group. It is of interest to note that in a group of 33 couples attending our infertility clinic who eventually proved to be fertile, the mean number of normal forms in the husbands sperm was 44.2 k 9%. Among this group, 50% had > 45 % normal forms.
The sperm types observed in the urine of adolescents are similar to those seen in the adult population; however, some samples present bizarre structural defects in head shape, which are less frequently found in adult semen samples and do not fit the germinal cell classification proposed by MacLeod (1970), or its modification by Belsey et al. (1980). They include bulges of one or more sides of the head, flower-shaped head with no visible acrosome, twisted and bent head and head with a prominent acrosome defect. In many sperm several defects could be observed.
A G E 12-13 15- I6
Fig. I . The percentage of normal spermatozoa in the first morning void of boys age 12- 13 and
15- 16 years.
These preliminary results indicate that around the period of spermarche the percentage of cells considered normal by prevailing concepts is low. The percentage of normal cells increases with age but at 15- I6 years is s t i l l lower than in the early twenties. A correlation between the percentage of abnormal sperm and infertility is generally accepted. Our results, even though based only on morphology suggest lower fecundity around spermarche which increases gradually during adolescence. On the other hand, the percentage of abnormal sperm may be high in some fertile men and low in some infertile ones. This indicates that cell morphology is only one of the parameters that determine fertility. Moreover, the relatively high percentage of cells defined as abnormal (according to accepted criteria) in healthy men in their early twenties suggests that cells which deviate from the definition of normality may still have normal physiological function.
Further studies are needed to determine more precisely the morphological characteristics which are associated with infertility.
This study was supported by the World Health Organization (WHO) Division of Family Health.
Baldwin B T (1928): The determination of sex maturation in boys by laboratory method. J Comp Psycho1 8: 39.
Belsey M A, Eliasson R, Gallegos A J. Moghissi K S, Paulsen C A & Prasad M R N (1980): Laboratory manual for the examination of human semen and semen-cervical mucus interaction. Press Concern, Singapore.
Hirsch M, Shemesh J, Modan M & Lunenfeld B (1979): Emission of spermatozoa. Age of onset. Int J Androl2: 289.
Hirsch M, Lunenfeld B, Modan M, Ovadia J & Shemesh J (1984): Spermarche, the age of onset of sperm emission. Submitted for publication.
MacLeod J (1970): The significance of deviations in human sperm morphology. In: Rosenberg E & Paulsen C A (eds). The Human Testis, p 48 1. Plenum Press.
Richardson D W & Short R V (1978): The time of onset of sperm production in boys. J Biosoc Sci. Suppl5: 15.
Weissenberg R, Rozenman H, Hova M, Modan M & Lunenfeld B (1984): The diagnostic value of sperm in post ejaculatory urine. Int J Androl7: 000.
Authors address: Dr. B. Weissenberg, Institute of Endocrinology, Chaim Sheba Medical Center Tel Hashomer, Israel.