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Use of methenamine hippurate in male infertility
Abstract:
In sperm-freezing for infertility patients with low sperm counts, we found that semen containing high numbers of white blood cells, greater than 15 to 20 per high-power field, was both poor in quality and difficult to freeze. In examining these patients carefully, we found that many had smoldering prostatitis and some an overt history of prostatitis. We treated them with methenamine hippurate using various methods and found that by decreasing the white blood cell count in their semen, we could frequently improve the semen quality, particularly sperm motility, also achieve pregnancies in some cases.
Insights
High white blood cell counts in semen indicate poor quality and freezing difficulties for infertile men. Treating prostatitis with methenamine hippurate improved semen quality and motility, leading to successful pregnancies.
Area of Science:
- Reproductive Medicine
- Urology
- Andrology
Background:
- Semen quality is crucial for male fertility and successful sperm cryopreservation.
- Elevated white blood cell counts in semen (pyospermia) are associated with impaired sperm function and reduced fertility outcomes.
- Prostatitis is a potential underlying cause of pyospermia, affecting semen parameters.
Purpose of the Study:
- To investigate the impact of high white blood cell counts in semen on sperm quality and cryopreservation success in infertile patients.
- To explore the relationship between pyospermia, prostatitis, and semen parameters.
- To evaluate the efficacy of methenamine hippurate treatment in improving semen quality and fertility in affected men.
Main Methods:
- Analysis of semen samples from infertile patients undergoing sperm freezing, focusing on white blood cell counts.
- Clinical evaluation for prostatitis in patients with elevated white blood cell counts.
- Treatment of patients with prostatitis using methenamine hippurate.
- Assessment of semen parameters (including sperm motility) before and after treatment.
- Monitoring of pregnancy outcomes.
Main Results:
- Semen with high white blood cell counts (>15-20 per high-power field) exhibited poor quality and freezing challenges.
- A significant proportion of these patients had underlying prostatitis (smoldering or overt).
- Methenamine hippurate treatment led to a decrease in seminal white blood cells.
- Improved semen quality, particularly sperm motility, was observed post-treatment.
- Pregnancies were achieved in some cases following treatment.
Conclusions:
- Elevated seminal white blood cells are indicative of poor semen quality and cryopreservation issues in infertile men.
- Prostatitis is a common comorbidity in men with pyospermia and impaired semen parameters.
- Methenamine hippurate treatment can effectively reduce white blood cell counts, improve sperm motility, and potentially restore fertility.
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