THE SPERMATIC FLUID of a normal man consists predominantly of the secretions

Transcription

1 The ph of Human Ejaculate JAN RABOCH, M.D., and J. skachov A, RNDr. THE SPERMATIC FLUID of a normal man consists predominantly of the secretions of the seminal vesicles and of the prostatic gland. According to Huggins the ratio of the secretions of these accessory sexual glands is approximately 2:1. The prostatic secretions are slightly acid; the ph of the whole ejaculate is usually stated to be in the range or In the case of an increased quantity of ejaculate, it has been suggested, the reaction may be more alkaline. 2 It was the purpose of the study reported here to test this view by examining groups of patients having only Sertoli cells, who as a rule have a larger average quantity of spermatic fluid than those with normospermia, and to compare ph values obtained in the pathologic group with those found in the ejaculates of chromatin-positive men, in whom there is a tendency toward decreased secretory activity of the accessory sexual glands. 4 Finally a group of 13 patients was examined whose ejaculates consisted predominantly of prostatic secretions. METHODS The sex-chromatin pattern was determined by evaluating smears of the buccal mucosa. As a rule, in a given instance only one testicle was subjected to biopsy. All ejaculates were obtained by masturbation in our consulting room. In 90% of the cases 3-10 days of sexual continence were observed before examination. The first ph determination was performed 5 min. after ejaculation by means of the EK ph -meter (of Czechoslovakian production). \ Standard solutions included the following: (1) a 6:4 mixture of Mj15 Na 2 HP0 4 and Mj15 KH 2 P0 4 (ph, 6.98); (2) a 7:3 mixture of the same constituents (ph, 7.17); and (3) 0.01 molar borax (Na 2 B H:!O; ph 9.20). The values of these solutions were checked by means of the phmeter made by Radiometer Copenhagen. During examination the samples were kept at room temperature exposed to the air. From the Sexological Institute and Central Biochemical Laboratory, Charles University, Prague, Czechoslovakia. 252

2 VoL. 16, No.2, 1965 EJACULATE PH 253 MATERIAL The distribution of subjects participating in the study is indicated in Table 1. In the group of patients whose ejaculate contained predominantly secretions of the prostate gland, surgical exploration of 9 of 13 patients showed that this finding was the result of agenesis of the spermatic ducts and of the seminal vesicles. All chromatin-positive men and also patients with a bioptic finding of only Sertoli cells had azoospermia. In the normal group we included men with appropriate findings on palpation of the genitals, whose sperm analyses were within normal limits: There was always more than 1.5 ml. of spermatic fluid, the number of spermatozoids per milliliter was higher than 40 million, their motility was good or fair, and the percentage of morphologically defective forms did not exceed 30%. RESULTS The results of our investigations are summarized in Table 2. The lowest mean ph value occurred in the group of patients whose ejaculates consisted predominantly of prostatic secretions; the difference from the values of the other three groups was statistically highly significant (at the 1% level). The differences between the mean values of these three groups (i.e., patients with "true" Klinefelter syndrome, those with Sertoli cells only, and the normospermic men) were not statistically significant. These findings were valid for ph values both 5 and 20 min. following collection of the ejaculates. In all groups of subjects the mean ph values after 20 min. were higher than those observed after 5 min. The mean differences were not statistically significant, so that the average increase of values in all four groups of ejaculates was approximately the same. In the normospermic group a comparison of the ph values found after 5 min. and those observed 4 hr. after semen TABLE 1. Distribution of Subjects Studied by Diagnoses A,qe of patient.~ ( Jfr.) No. of Group pauent. llange Average No. of studie. Predominantly prostatic secretions "True" Klinefelter syndrome Normal Sertoli cells only

3 Mean value S.D. r TABLE 2. ph Values of Spermatic Fluid in Subjects Studied'* Subjects with predominantly prostatic Subjects with "true" secretions Klinefelter syndrome Normal subjects a: y z a: y z a: y z a: Subjects having only Bertoli cells y z *"a:" refers to quantity of ejaculate in milliliters; y, to ph 5 min. after ejaculation; z, to ph after 20 min.; r, to correlation coefficient be- tween a: and y or a: and z.

4 VoL. 16, No.2, 1965 EJACULATE PH 255 collection was carried out. The mean increase amounted to 0.27, S.D., 0.13, indicating a statistically highly significant change (at the 1% level). Comparison of the variability of ph values showed that both 5 and 20 min. after semen collection this value was significantly higher (at the 1% level) in the group of patients whose ejaculates contained predominantly prostatic secretions than in the other three groups of patients, whose spermatic fluid contained vesicular secretions. The statistical analysis further showed that the correlation r between the quantity of ejaculate and the ph values 5 and 20 min. after ejaculation was not significant in all groups of subjects. DISCUSSION The secretory activity of accessory sexual glands in man depends directly on the hormonal activity of the testicles, as well as on other factors. We assume that the tendency toward a smaller average quantity of spermatic fluid in the group of patients with "true" Klinefelter syndrome and that toward a greater quantity of ejaculate in patients having only Sertoli cells reflect the different hormonal conditions in these disturbances. We have ascertained, however, that differences in ph values of spermatic fluid, both 5 and 20 min. after ejaculation, in these pathologic groups and in normal men as well are not statistically significant. Also, the correlation between the quantity of ejaculate and the ph value was not statistically significant in all groups studied. We may perhaps conclude, therefore, that the altered and different hormonal conditions in chromatin-positive men and in patients having only Sertoli cells, showing various degrees of secretory activity of accessory sexual glands, do not measurably influence the ph values of the ejaculate. SUMMARY The hydrogen-ion concentration was determined by means of a ph-meter 5 and 20 min. after ejaculation in azoospermic ejaculates of chromatin-positive patients, of men having only Sertoli cells, in men with normospermias, and in 13 patients whose semen consisted predominantly of prostatic secretions. The mean ph values of ejaculates consisting mainly of prostatic secretions were significantly lower than those of the other groups and for the most part did not exceed the value of 7. The ph values of ejaculates from subjects with the "true" Klinefelter syndrome, who often show a lowered secretory activity of accessory sexual

5 256 RABOCH & SKACHOVA FERTILITY & STERILITY glands, did not differ significantly from those observed in patients having only Sertoli cells, who exhibited a tendency toward an increased quantity of spermatic fluid, or from those found in normospermic men. The correlation between the quantity of spermatic fluid and the ph values was not statistically significant in any of the four groups investigated. Sexological Institute Charles University Karlovo nam. 32 f III Prague 2, Czechoslovakia REFERENCES 1. HuGGINS, C. The physiology of the prostate gland. Physiol. Rev. 25:281, KuHNAU, J., and NowAKowsKI, H. Untersuchungen tiber Ejakulatzitronensaure beim Menschen. Endokrinologie 40:1, MANN, T. The Biochemistry of Semen. Methuen, London, RABOCH, J., and HoMOLKA, J. Acid phosphatases in the ejaculate of men with disturbances of somatosexual development. Fertil. & Steril. 12:368, ScHUERMANN, H., and DOEPFMER, R. Fertilitiitsstorungen beim Manne. Springer, Berlin, 1960.