(The Antiseptic (1984): 612)

Management of Oligozoospermia, Asthenospermia and Necrozoospermia

by Treatment with Speman
Limaye, H.R., M.D., D.G.O.,
Associate Professor in Obstetrics & Gynaecology, and
Madkar, C.S., M.D.,
Lecturer in Obstetrics & Gynaecology,
B.J. Medical College and Sassoon General Hospitals, Pune.

INTRODUCTION
It has been an observed fact that contribution of the male factor in the causation of infertility is
almost equal to that of the female. The male factor includes many causative entities, out of which
abnormal semen is one of the important causes of infertility. Oligozoospermia and asthenospermia
are the two important entities which can be improved by drug treatment.
Different manufacturers have claimed different drugs to improve the quantity and quality of semen.
Speman (a compound of indigenous drugs) of The Himalaya Drug Co., is reported to be effective in
improving sperm count and motility, though its exact pharmacological action has not yet been
proved. Hence we selected the first indigenous drug Speman for trial in our patients having
oligozoospermia, asthenospermia and necrozoospermia.
MATERIAL AND METHODS
Two hundred and sixty-two (male) patients were included in this trial. A total of 662 male partners
were investigated in the infertility clinic. Their semen was examined twice at weekly intervals with
two days abstinence before the actual collection of semen. The semen was collected in sterilised
wide mouth bottles by masturbation in the laboratory and examined within an hour and half.
COMPOSITION
Each tablet of Speman contains:
Orchis mascula
Lactuca scariola
Hygrophila spinosa
Mucuna pruriens
Exts. Parmelia perlata
Argyreia speciosa
Tribulus terrestris
Leptadenia reticulata
Suvarnavang (Mosaic Gold)

65 mg
16 mg
32 mg
16 mg
16 mg
32 mg
32 mg
32 mg
16 mg.

OBSERVATIONS
Out of the 662 patients who underwent semen examination, 400 were within normal limits, while
262 had abnormalities in semen as shown in Table 1 and they were included in our study.
Table 1: Showing the various types of disorders
Total no.
of patients
262
(100%)

Azoospermia

Oligozoospermia

Asthenospermia

Necrozoospermia

38
(14.5%)

93
(35.5%)

119
(45.40%)

12
(4.60%)

Table 2 shows the presence of infection in different grades of oligozoospermia.

Total no.
of patients
93
Presence of infection

Table 2: Showing presence of infection in various grades of oligozoospermia

Severe
Moderate
Mild
oligozoospermia
oligozoospermia
oligozoosperma
12
30
51
9
27
19
(75%)
(90%)
(37.25%)

Table 3 shows the presence of infection in different grades of asthenospermia.

Table 3: Showing presence of infection in various grades of asthenospermia
Total no. of patients
Grade 0 motility
Grade 1 motility
Grade 2 motility
119
9
39
71
Presence of infection
6
36
23
(66.66%)
(92.30%)
(32.39%)

Table 4 shows the presence of infection in the 12 necrozoospermia patients.

Table 4: Showing presence of infection in necrozoospermia
Total no. of patients
:
12
Presence of infection
:
12 (100%)

After excluding 38 patients of azoospermia the remaining 224 patients were screened for infection.
One hundred and thirty-two patients, i.e. 58.92%, showed presence of infection. (Presence of 5 pus
cells or more in semen per high power field is taken as positive for infection). All these 132 patients
were primarily treated with long-acting sulpha preparations for a period of one week or in some
cases for two weeks. Clearance of the infection was confirmed by repeated semen examination. Eight
patients did not respond even after two courses of long-acting sulphas for two or more weeks. Their
semen samples were collected after prostatic massage and subjected to culture and sensitivity tests.
They were treated with appropriate antibiotics to clear the infection. Once the infection was cleaned
they were treated with two tablets of Speman, 3 times a day for 3 months (since the spermatogenesis
cycle extends over 75 to 82 days).
After 3 months of Speman treatment, they were subjected to semen examination with the same
precautions. The following observations were then noted.
Table 5 shows the improvement in sperm count in 93 patients of oligozoospermia.
Table 5
Total no. of
patients treated
93
Improvement after
treatment

Severe
oligozoospermia
12
3
(25%)

Moderate
oligozoospermia
30
14
(46.66%)

Mild
oligozoospermia
51
29
(56.88%)

Table 6 shows the improvement in sperm motility in 119 patients of asthenospermia.

Total no. of patients treated
119
Improvement after treatment

Table 6
Grade 0motility
Grade 1 motility
9
39
3
19
(33.3%)
(48.7%)
(Two patients grade 2 and
(10 patients grade 2 9
one patient grade 1)
patients grade 3)

Grade 2 motility
71
42
(59.15%)
(24 patients grade 3, 18
patients grade 4)

Table 7 shows the improvement in necrozoospermia patients.

Table 7
Total no. of patients
No. of patients showing improvement
after treatment

12
3
(25%)
(All 3 patients of grade 2 motility)

DISCUSSION
Out of 224 patients on Speman with prior antibiotics wherever required, 113 showed overall
improvement (50.45%).
In the oligozoospermia group the overall improvement was 49.46% (46 patients out of 93). In severe
oligozoospermia the improvement was not that dramatic. It is probable that the presence of infection
in the majority of semen samples with low count could be hindering the action of Speman. But in the
moderate and mild varieties the improvement was definitely encouraging and remarkable.
In the asthenospermia group the over-all improvement was 53.78% (64 patients out of 119). In the
grade 2 motility group, improvement was observed in a good per cent of cases, i.e. 59.15%, while
in the grade 0 and grade 1 groups, the results were neither hopeless nor very encouraging. It is
probable that these unsatisfactory results were due to the high incidence of infection which might
have similarly hindered the action of Speman.
No side-effects or any toxicity were observed in any of the patients.
CONCLUSION
We opine that the indigenous compound Speman, which is free from any toxicity or side-effects, is
worth trying in cases of oligozoospermia, asthenospermia and necrozoospermia after prior treatment
with appropriate antibiotics wherever necessary.
ACKNOWLEDGEMENT
We are really thankful to our colleagues who have helped us in undertaking this long, complicated
study. We also thank the Dean, B.J. Medical College, Pune, for allowing us to use the clinical
material for this work and publish our clinical work.
REFERENCES
1. Banerjee, N., Probe (1973): 4, 177.
2. Bhargava, N. C., Ind. J. Derm. Vener., (1970): 1, 62.
3. Khaleeludin, K., Probe (1973): 4, 203.
4. Mukherjee, M., Probe (1973): 4, 201.
5. Talaulikar, V. R., Mediscope (1976): 1, 9.
6. Vaze, V. H., Probe (1970): 4, 159.