**5. Markers of male accessory glands and infection**

**3. Volume and seminal viscosity**

108 Spermatozoa - Facts and Perspectives

with monolateral PVE or prostatitis [50, 51].

HPV in the prostate secretion and the fertility [53].

**4. Male accessory glands and hormonal control**

cal, enzymatic or genetic factors have a role in this condition [52].

Low reference index of seminal volume in fertile men is 1.5 ml. The term hyperpermia is not included in the last manual of seminal analysis. In a previous study of healthy men, the 95th percentile of the skewed data distribution was 6.3 ml and nearly 50% of them had low sperm concentrations. Seminal volume increase (hyperspermia) has been associated to male accessory gland in patients with bilateral prostate-vesiculo-epididymitis (PVE) more than those

The prevalence of hyperviscosity in subfertile men is around 26.2%, and it may be mild, moderate or severe. Treatment may be completely successful only in subjects with mild hyperviscosity with a positive semen culture. In these subjects, progressive motility percentage, straight line velocity and linearity of sperm increase. Pathogenesis was strictly related to infective/inflammatory factors in only 48.0% of cases; therefore, it is possible that biochemi-

Human papillomavirus (HPV) has been detected in semen samples of infertile men, 10.5% of them showed only single type of virus, 5.7% corresponded to the high risk type and 6.1% were type low risk, in 6.1 were more than one type of HPV. Increase of semen viscosity was observed in the samples infected with the virus in single and multiple forms. Hypospermia, leukocytospermia and increased pH are found in infected samples with multiple types of HPV, probably the seminal changes are related to the negative effects of different forms of

Male accessory sex glands display a consistent pattern of differential sensitivity to androgens and estrogens and that these hormones may exert their action on different cell types within the organ [25]. The development and differentiation of the male reproductive system in the fetus are directed by the fetal testis through the production of testosterone and anti-Müllerian hormone. In the fetal testes, Leydig cells produce testosterone, a steroidal hormone that promotes the growth and differentiation of Wolff's ducts such as epididymis and prostate. At the same time, the Sertoli testicular cells produce the Anti-müllerian hormone (HAM) that causes the regression of the Müllerian ducts. The development of the external sexual organs is generated from the differentiation of the genital tubercle, eminence (protuberance) located in front of the cloaca of the embryo. The secretion of the enzyme 5-α-reductase allows the transformation of testosterone to dihydrotestosterone (DHT), a hormone that differentiates the genital tubercle to the male external sex organs [54]. However, the possible impact of other glucocorticoid hormones has been proposed in experimental animals. Betamethasone has been used for inducing fetal lung maturation. Some studies reported that prenatal treatment with this drug reduced testosterone levels in the male fetus. In adulthood stage of these animals, lower values of FSH and sperm quality were observed; seminal vesicle weight was decreased while Infection of male accessory glands (MAGI) can occur as prostatitis, prostatic-vesiculitis and prostate-vesiculo-epididymitis. MAGI can have a negative impact on the secretory function of the glands and on fertility. MAGI is often acquired as a urethral infection, it has a chronic course and it spreads to one or more accessory glands, being able to cover one or both sides, rarely causing obstruction of the seminal routes. The seminal alterations are more evident when the infection reaches two or more glands. The inflammatory response has been associated with the alteration of the seminal parameters when affecting function of the epididymis, seminal vesicles and prostate, especially by diminishing the antioxidant properties of the seminal plasma [61].

Several protein components of seminal plasma are produced by certain types of tissues of the male urogenital tract; therefore, the difference in the concentration of these semen proteins could be indicators of a specific organ disease. This concept is best illustrated by the value of prostate-specific antigen (PSA) as a marker of prostate diseases. The PSA was originally discovered in semen and was isolated from it and is the most used marker to identify prostate cancer, being higher in semen than in blood serum [62]. PSA is a serine protease that cleaves semenogelin by hydrolysis and thus liquefies the semen coagulum and facilitates sperm motility and capacitation [63].

Soufir evaluated the markers fructose, acid phosphatase and citric acid as tools in the differential diagnosis of infectious processes and hypogonadism. The decrease of markers suggested that it is necessary to evaluate hormonal status and to rule out infection of accessory glands, which can affect sperm function and inability to achieve pregnancy naturally [64]. Glandular markers tend to be low in the presence of leukocytes and most likely in infection; nevertheless, these are significantly lower in hypogonadism. An infection could cause permanent damage of the secretory epithelium, so even after treatment may remain low [65]. This implies that in cases of seminal vesicle, infection levels of seminal fructose may be increased or decreased.

**6. Conclusions**

**Author details**

Mérida, Venezuela

pp. 78-81

**References**

Lozano Hernández Jesús Ricardo

University Press; 2010

The study of secretory products of male accessory glands in conjunction with correct seminal evaluation may help to exclude the high percentage of idiopathic infertility. Infectious or post-infectious processes in the epididymis, prostate and seminal vesicles can alter the semi-

Male Accessory Glands and Sperm Function http://dx.doi.org/10.5772/intechopen.74321 111

The evaluation of compounds of the seminal plasma is useful to understand the process of natural fertilization and to achieve pregnancy naturally when the causes of infertility in man have been clearly established. These evidences suggest that the components of the seminal plasma participate in key events related to sperm function, fertilization and embryonic development in the female reproductive tract. However, the subject of sperm interaction and seminal plasma should continue to be studied to help explain the failure rates in assisted reproduction techniques.

Cátedra de Fisiopatología, Facultad de Farmacia y Bioanálisis, Universidad de Los Andes,

[1] Drabovich AP, Saraon P, Jarvi K, Diamandis EP. Seminal plasma as a diagnostic fluid for male reproductive system disorders. Nature Reviews. Urology. 2014;**11**(5):278-288 [2] WHO Laboratory Manual for the Examination of Human Semen and Semen-cervical Mucus Interaction. Vol. 74, N° 3, September 2014. 5ª edition. Cambridge: Cambridge

[3] Jones R, Lopez Kristin. Human Reproductive Biology. Colorado: Elsevier Inc.; 2014.

[4] Lozano-Hernández R, Vivas-Acevedo G. Análisis Bioquímico del Plasma Seminal. En:

[5] Cobellis G, Ricci G, Cacciola G, Orlando P, Petrosino S, Cascio MG, Bisogno T, De Petrocellis L, Chioccarelli T, Altucci L, Fasano S, Meccariello R, Pierantoni R, Ledent C, Di Marzo V. A gradient of 2-arachidonoylglycerol regulates mouse epididymal sperm

[6] Meccariello R, Chianese R, Ciaramella V, Fasano S, Pierantoni R. Molecular chaperones, cochaperones, and ubiquitination/deubiquitination system: Involvement in the production of high quality spermatozoa. BioMed Research International. 2014;**2014**:561426.

Manual Básico del Semen. México: Ed Prado; 2013. pp. 81-98

cell start-up. Biology of Reproduction. 2010;**82**(2):451-458

DOI: 10.1155/2014/561426. Epub 2014 Jun 19. Review

nal plasma quality and the physiology of spermatozoa.

Address all correspondence to: ricardolozanoh@hotmail.com

Male accessory glands infection may alter the elasticity in semen. Changes in levels of oxidative products in semen are related to seminal viscosity. Hyperviscosity has been associated with reactive oxygen species (ROS) generation, levels of cytokines TNF-α, IL-6 and IL-10 and seminal leucocyte concentration, and whether ROS production was related to the extent of infections/inflammations at one PR (prostatitis) or two PV (prostato-vesiculitis) male accessory glands. ROS production in PV was higher than in prostatitis. Seminal IL-10 levels in PV and PR patients were lower than those found in the controls. In PR men, the levels of hyperviscosity are positively related to TNF-α; the seminal hyperviscosity is associated with increased oxidative stress in infertile men and increased pro-inflammatory interleukins in patients with male accessory gland infection, more when the infection was extended to the seminal vesicles [66]. Seminal hyperviscosity is often associated with prostate infection, reduce citric acid and asthenozoospermia [52, 66]. These alterations have been reversed when properly treated with antibiotics, decreasing the concentration of leukocytes and proinflammatory cytokines. Around one-third of cases of seminal hyperviscosity does not respond to treatment with antibiotics because viscosity depends on other glandular factors that have not yet been clarified [52].

Many compounds secreted by the male reproductive tract may be important in the study of infertile man. It is advisable that before choosing any technique of assisted reproduction, the causes of infertility in man are more accurately evaluated, especially in cases of idiopathic infertility. Disorders of the male accessory glands are often associated with bacterial infections. These alterations must be carefully treated with the antibiotic therapy to which these bacteria show susceptibility [67]. The diagnosis and antibiogram would allow controlling resistance to antibiotics, but taking into account that when there is infection of the glands, antimicrobials have limited efficacy because they are anatomical compartments with barriers that can limit their reach, such as blood-prostatic barrier. Tissue lesions are greater as time progresses, for example prostatitis responds faster to treatment than prostate-vesiculitis and prostate-vesicle-epididymitis, that is, more glands are involved as time progresses [68]. In addition, it is possible to find the compartment of some microorganisms that tend to encapsulate or attach more strongly to the glycocalyx of the extracellular matrix of the gland or probably because of changes in local pH of seminal vesicles (alkaline) or prostate (acid), between others that limit antimicrobial efficacy [64]. Treatment of subclinical infections and secretory failure of male accessory glands can improve sperm physiology to achieve spontaneous pregnancies. It should be noted that the cost of assisted reproduction reflects a much lower percentage of live births than other less costly techniques for many infertile couples. Assisted reproduction already accounts for as many as 5% of live births in some European countries [69] so it is not negligible to investigate the factors that modulate the function of gametes.
