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JANET BROTHERTON and G. BARNARD

Summary.

The mean plasma testosterone level after 6 to 17 months in seven adult males receiving 100 mg oral cyproterone acetate daily, was 267 ± 125 ng/100 ml (±S.D.) with a range of 99 to 518. This represents a reduction of only 65% from the normal controls. Plasma androstenedione levels showed a mean of 125 ± 93 ng/100 ml (±S.D.) with a range of 52 to 162 which is within the normal range. The same dose of cyproterone acetate given to two female volunteers from Day 5 of the menstrual cycle for 10 days caused a reduction in urinary total oestrogen and pregnanediol to levels inconsistent with ovulation. With the addition of 0·05 mg ethinyloestradiol from Day 5 for 21 days, as in the `Reverse Sequential Regime', ovulation appeared to be inhibited in all the ten cycles studied. There were regular `withdrawal bleedings'. When the oestrogen was continued alone, ovulation returned in both women and after the cessation of all steroid treatment their normal pattern of hormone excretion continued. These results are discussed in relation to the possible mechanism of action of cyproterone acetate.

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JANET BROTHERTON and G. BARNARD

Summary.

A Coulter counter, Model ZB Industrial, was calibrated for the size distribution of cells. A method was then developed for the counting and sizing of human spermatozoa after the removal of contaminating matter with Zaponin. For twenty-five men with normospermia (>40×106 spermatozoa/ml semen) the mean sperm size was a volume of 25·6 μm3 or a diameter of 3·65 μm, both in terms of an equivalent sphere. The size distribution was positively skewed with a mode at a volume of 19·4 μm3 or a diameter of 3·33 μm. A number of these specimens showed gross structural abnormalities on microscopic examination and it was very difficult to define a normal semen specimen. There were three men with Grade I oligospermia (>30×106 spermatozoa/ml) and twenty-five men with Grade II oligospermia (>20×106 spermatozoa/ml). Of the latter, eighteen showed a peak (mode) in the size distribution similar to that found in the cases of normospermia and Grade I oligospermia, except that the peak was less sharp and often shifted significantly from the normal range of values. Samples from the remaining seven showed no peak. Below 12×106 spermatozoa/ml which was taken as the dividing line for Grade III oligospermia, none of the curves showed a peak. The smooth curves indicated a greater degree of abnormality, as was shown by microscopical examination. As the sperm count in the series gradually decreased, the proportion of abnormal forms gradually increased. The various abnormalities could not be identified in terms of the known developmental stages in normal spermatogenesis. There were nine cases of azoospermia, but the Coulter counter was not useful for specimens of <5×106 spermatozoa/ml. When an adjustment was made to cut out particles above a volume of 35 μm3 and below a volume of 14 μm3, the Coulter and haemocytometer counts showed an almost exact correlation. These results are discussed in relation to the possible benefits of weak androgen therapy for oligospermia and the possible genetic abnormalities involved.