[Probe (1989): (XXVIII), 3, 196]

Speman in the Management of Oligospermia

Srivastava, R.K., Lecturer in Anatomy,
Dayal, S.S., Professor and Head of the Anatomy Department,
Tewari, P.V., Reader in Anatomy,
and
Singh, R.C., Lecturer in Pharmacology Department,
G.S.V.M. Medical College, Kanpur, India.

ABSTRACT

Speman, an indigenous remedy, has been claimed to increase both the sperm count and motility. We, therefore, tried it as an adjuvant to antibiotic therapy in 130 cases of oligospermia with bacterial infection, who did not respond satisfactorily to the antibiotic alone.

It was observed that 63 out of 130 patients (48.46%) became normaspermic (60 million/ml) with this combined therapy. In 42 cases out of 130 (32.30%) treated with Speman + the appropriate antibiotic, normal motility was restored (> 60% motility).

Thirty six cases reported that their wives became pregnant following such combined therapy.

INTRODUCTION

Speman is a compound Ayurvedic preparation and has been widely used in the management of oligospermia. It has been tried alone (Dandapat et al, 1986, Khaleeludin et al, 1973, Limaye and Madkar 1984, Pardanani et al, 1976, Parikh 1971, Solepure and Deshkar 1979, Talaulikar and Nagarsekar 1976), and in combination with Tentex forte (Khandare et al, 1982, Rajasekharan 1979) and with zinc (Mathur and Kulshreshtha 1986).

In the present study we establish that bacterial infection in the male genital tract is an important cause of oligospermia. On treatment of 175 patients with the appropriate antibiotic we could find normal sperm count in only 55 cases and normal motility in 45 cases. The remaining cases showed only some increase in sperm count and motility even after 3 months of antibiotic therapy.

As Speman has been shown to increase both the sperm count and motility, it was used as an adjuvant to antibiotic therapy in 130 cases, who did not respond satisfactorily to antibiotic therapy alone.

MATERIAL AND METHODS

A thorough clinical examination of all the 175 cases was done. After 5 days of abstinence, the semen was collected by masturbation in a clean sterile petri dish in the laboratory observing all the aseptic precautions.

The following parameters were observed:

1. Hanging drop preparation for motility, clumping of sperms, pus cells and epithelial cells. 
2. The motility was observed by the method of Amelar, Dublin and Schoenfeld (1973) and was quantitated as percentage of motile sperms. 
3. A drop of semen was spread on the slid and was immediately fixed in 95% alcohol. The slides were then stained with Leishman’s stain and Gram’s stain. Then they were examined for pus cells and epithelial cells, bacilli and cocci. 

Bacteriological examination

All the samples which showed presence of pus cells, bacilli and cocci in the smear were cultured on blood agar for 48 hours and the sensitivity against the drug was determined.

All the cases were treated with appropriate antibiotics for a period of 3 months. The cases, which on semen examination and culture, did not show satisfactory improvement with antibiotic alone were given Speman in addition. This combination was given for 3 weeks. Then the antibiotic was withdrawn and Speman alone was continued for a total period of 4-6 months.

OBSERVATIONS AND RESULTS

The most common organism cultured was Staphylococcus aureus, found in 118 cases (90.6%) followed by E. Coli in 7 cases. (5.38%), Staphylococcus albicans in 3 (2.30%) and Proteus vulgaris in 2 (1.54%).

Thus it is evident that the organisms were most commonly sensitive to Gentamycin. So Gentamycin was used as the drug of first choice followed by Sporidex, Kanamycin being more toxic.

Antibiotic therapy was administered for 3 weeks followed by semen culture. It usually took 3-4 months for the semen to become sterile. When the semen became sterile, Speman was continued alone till the sperm count became normal, or for 6 months, whichever was less. Improvements in sperm count were seen upto 6 months of Speman therapy. Beyond this no further improvement in the sperm count was seen, so Speman was withdrawn.

It took at least 4 months for the sperm count to become normal. So the usual duration for Speman therapy should be around 4–6 months.

DISCUSSION

It is evident from Tables 1,2 and 3 that Speman increases the sperm count and motility significantly in cases of oligospermia of infective origin not responding well to antibiotic therapy alone.

Tables 1 and 2 show that after treatment with Speman + the appropriate antibiotic, 63 out of 130 patients (48.46%) became normospermic (60 million/ml), although all the cases showed improvement in sperm count, which was statistically significant as shown by the unpaired ‘t’ test (p < 0.0001).

Table 3 shows that in 42 cases out of 130 (32.30%) treated with Speman + the appropriate antibiotic, normal motility was restored (> 60% motility).

Table 3: Effect of Speman on sperm motility
After treatment with appropriate antibiotic alone		After treatment with Speman + antibiotic
Motility	No. of cases	Motility	No. of cases
10%	29	40–50%	21
		50–60%	8
10–20%	21	40–50%	14
		50–60%	7
20–30%	22	40–50%	13
		50–60%	9
30–40%	25