scholarly journals Obstrução Congénita dos Canais Ejaculadores: Diagnóstico e Resolução em Dois Casos de Sucesso

2013 ◽  
Vol 26 (5) ◽  
pp. 616
Author(s):  
Rui Amorim ◽  
Vitor Oliveira ◽  
Jorge Dias ◽  
Rui Freitas ◽  
Luis Ferraz
Keyword(s):  
Surgical Treatment ◽  
Physical Examination ◽  
Transurethral Resection ◽  
Sperm Count ◽  
Semen Analysis ◽  
Clinical Suspicion ◽  
Imaging Studies ◽  
Male Factor ◽  
High Importance ◽  
Reproductive Techniques

The ejaculatory ducts obstruction is an uncommon finding in the study of infertility male factor. We present two cases referred to our department for conjugal infertility, with proven male factor (low ejaculate volume and azoospermia). On physical examination there was no abnormality in both patients. Imaging studies demonstrated intra-prostatic cystic structure, causing ejaculatory ducts dilation. We performed transurethral resection of the ejaculatory ducts. Semen analysis 3 months postoperatively showed 1 case of normalization and 1 case of improvement in sperm count parameters. The couple 1 couple has 2 children, without medical assisted reproductive techniques. The couple 2 had one pregnancy after Intracytoplasmic Sperm Injection, from the ejaculate. This diagnosis depends on a strong clinical suspicion and is of high importance, since this disease has effective surgical treatment. The authors aim to highlight the relevance of the assessment andrological when studying marital infertility.

scholarly journals Differential Diagnosis of Azoospermia in Men with Infertility

2021 ◽  
Vol 10 (14) ◽  
pp. 3144
Author(s):  
Danilo L. Andrade ◽  
Marina C. Viana ◽  
Sandro C. Esteves
Keyword(s):  
Differential Diagnosis ◽  
Physical Examination ◽  
Detailed Analysis ◽  
Clinical Management ◽  
Semen Analysis ◽  
Testicular Biopsy ◽  
Nonobstructive Azoospermia ◽  
Sperm Cryopreservation ◽  
Imaging Studies ◽  
Detailed Medical History

The differential diagnosis between obstructive and nonobstructive azoospermia is the first step in the clinical management of azoospermic patients with infertility. It includes a detailed medical history and physical examination, semen analysis, hormonal assessment, genetic tests, and imaging studies. A testicular biopsy is reserved for the cases of doubt, mainly in patients whose history, physical examination, and endocrine analysis are inconclusive. The latter should be combined with sperm extraction for possible sperm cryopreservation. We present a detailed analysis on how to make the azoospermia differential diagnosis and discuss three clinical cases where the differential diagnosis was challenging. A coordinated effort involving reproductive urologists/andrologists, geneticists, pathologists, and embryologists will offer the best diagnostic path for men with azoospermia.

scholarly journals Impact of percutaneous embolization versus subinguinal microsurgical ligation on semen parameters in primary varicocele patients: comparative study

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Haytham M. Nasser ◽  
Ahmed Hussein ◽  
Gad M. Behairy ◽  
Mostafa Abdo
Keyword(s):  
Sperm Count ◽  
Semen Analysis ◽  
Statistical Significance ◽  
Semen Parameters ◽  
Male Factor ◽  
Percutaneous Embolization ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background Varicocele is an abnormally dilated pampiniform plexus of the veins within the spermatic cord and is considered the most common correctable cause of male factor infertility. Many approaches are described for treatment either surgical (tradition inguinal, subinguinal, and laparoscopic) or non-surgical percutaneous embolization. During the period from August 2017 to December 2018, we prospectively analyzed the preoperative and post-operative alteration of semen parameters (at 3 and 9 months) of the data collected from 63 patients with clinically evident varicocele referred to our tertiary hospital. Patients were divided into two groups: group 1, thirty-three patients who underwent subinguinal microsurgical ligation, and group 2, thirty patients who underwent percutaneous embolization. Results Sixty-three patients enrolled in this study were divided in two groups: group 1, patients who underwent surgery, and group 2, patients who underwent embolization; the mean age is 24.6 ± 1.27 years in group 1 and 23.7 ± 2 years in group 2; there was no statistically significant difference between the two groups as regards BMI, diabetes, hypertension, and smoking. Bilaterality was present in 15.2% of group 1 patients and 10% in group 2 patients (P value 0.06). Most of the patients were classified as grades 2 and 3 with no statistical significance regarding severity of the disease. Preoperative semen parameters for patients including sperm count, motility, and abnormal forms showed no statistically significant difference between the two groups. Post-intervention semen analysis was done twice during follow-up after 3 months and 9 months from the date of intervention. After 3 months, the semen parameters were improved in both groups in spite of the higher sperm count in group 2 but with no statistical significance. After 9 months follow-up, semen analysis showed persistent increase in sperm mobility in group 1 patients in comparison to group 2 patients. Both groups had better improvement in count of normal form with no statistical significant change. Conclusion Improvement of semen parameters while treating primary varicocele by either subinguinal microsurgery approach or percutaneous embolization shows equivalent outcomes.

Infertility

2019 ◽  
pp. 555-580
Author(s):  
John Reynard ◽  
Simon F Brewster ◽  
Suzanne Biers ◽  
Naomi Laura Neal
Keyword(s):  
Semen Analysis ◽  
Treatment Options ◽  
Testicular Biopsy ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Vasectomy Reversal ◽  
Reproductive Techniques ◽  
New Material ◽  
Pros And Cons ◽  
Red Flag

Male factor infertility is outlined in an easily digestible format to provide clear information on this sometimes less familiar topic, starting with the basics of male reproductive physiology, the hypothalamic–pituitary–testicular axis, and spermatogenesis. This chapter includes a review of the aetiologies of abnormal sperm counts (with particular emphasis on azoospermia and oligospermia), relevant clinical assessment, and key male factor infertility investigations such as semen analysis, hormone measurement, karyotying, imaging, and testicular biopsy. The chapter explains the management options for the infertile male and couple, including information on the different assisted reproductive techniques. The chapter covers additional important clinical and exam topics, including varicoceles, indications for repair in males of different ages, red flag signs that should trigger further investigation, and the treatment options of embolization and surgical repair. The fourth edition also includes the addition of new material exploring the pros and cons of vasectomy and vasectomy reversal.

scholarly journals DNA fragmentation index and its correlation with other sperm parameters in 4833 infertile males

2018 ◽  
Vol 7 (9) ◽  
pp. 3718
Author(s):  
Priya S. Patil ◽  
Satish M. Patki ◽  
Shweta S. Patki ◽  
Ujjwala S. Patki
Keyword(s):  
Dna Fragmentation ◽  
Sperm Motility ◽  
Sperm Count ◽  
Semen Analysis ◽  
Pearson Correlation ◽  
Significant Negative Correlation ◽  
Male Factor ◽  
Fragmentation Index ◽  
Success Of Treatment ◽  
Dna Fragmentation Index

Background: Semen analysis forms the basic investigation for male factor of infertility. According to WHO Manual sperm values of normalcy are decreasing. Recent studies have highlighted newer parameters of sperm playing their role in the outcome of pregnancy. The aim was to study the DNA fragmentation index (DFI) and to know its correlation with other sperm parameters.Methods: A total of 4833 cases underwent routine semen analysis along with the DFI. The statistical analysis was done using SPSS using t test and ANOVA test.Results: It was observed that 52% infertile males presented late for treatment. All parameters showed a decline with advancing age. There was definite correlation between sperm count and sperm motility as well as morphology. The DFI showed significant negative correlation with sperm count. Pearson correlation showed positive correlation between DFI and sperm motility and morphology.Conclusions: The study highlights the need for increasing awareness about male factor of infertility. A thorough semen analysis along with DFI can help the clinician to explain the couple in a better way about the choice of ART and success of treatment.

scholarly journals ASSOCIATION OF VARICOCELE WITH OLIGOSPERMIA AND AZOSPERMIA

1969 ◽  
Vol 3 (2) ◽  
pp. 303-307
Author(s):  
NAIK ZADA ◽  
SHAFI ULLAH KHAN ◽  
RIAZ AHMAD KHAN
Keyword(s):  
Sperm Count ◽  
Human Subjects ◽  
Semen Analysis ◽  
Cross Sectional Study ◽  
Semen Parameters ◽  
Male Factor ◽  
Cross Sectional ◽  
Seminal Parameters ◽  
The Mean ◽  
Age Range

OBJECTIVE: To determine the frequency of abnormal semen parameters among patients presenting withvaricocele1METHODS:It was a descriptive cross-sectional study conducted at the Department of Urology Institute ofkidney diseases Hayat Abad Medical Complex Peshawar and Cenna hospital Saidu Sharif Swat. The studywas carried out on 139 human subjects with clinical evidence of varicocele between age range of 15-45years.The diagnosis of varicocele was based on palpable and/or visible scrotal lump of testicular veins(pampiniform plexus) and was diagnosed on the basis of clinical examination. Semen analysis was carriedout in all these patients and information wascollected on pre designed proforma.RESULTS:The study included a total of 139 patients with varicocele. The mean age of patient was 30 years(15-45) among the patients having symptoms of varicocele. The Mean ±SD for duration of varicocelesymptoms was 9.32 ± 9.70 months. 6.5% (n=9) patients were having azoospermia and 20.1% (n=28)patients had oligozoospermia.CONCLUSION: Patients with varicocele have poor seminal parameters in terms of sperm count i.e.oligozoospermia and azoospermia responsible for male factor infertility in majority ofcases.KEYWORDS:varicocele;seminal parameters;sperm count, infertility

scholarly journals Prevalence and Patterns of Male Infertility Based on Semen Analysis in Patients Visiting Massawa Hospital; Eritrea: Cross-Sectional Study; 2020

2021 ◽  
Author(s):  
Berhe Tesfai ◽  
Fitsum Kibreab ◽  
Hailemichael Gebremariam ◽  
Liwam Abraham
Keyword(s):  
Male Infertility ◽  
Sperm Motility ◽  
Sperm Count ◽  
Semen Analysis ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Cross Sectional ◽  
Semen Volume ◽  
Primary Type ◽  
Study Participants

Abstract Background Semen analysis is the first step to identify male factor infertility. World Health Organization estimates that male factor accounts for 50% of couple sub-fertility. The objective of this study was to determine the prevalence and patterns of male factor infertility based on semen analysis in patients visiting Massawa Hospital with infertility complaints. Methods It was a retrospective, descriptive cross sectional hospital based type of study with a census sampling method. Patient’s medical records and hospital laboratory register were used to retrieve semen analysis results of patients from June 2018 to June 2020. Ethical approval was obtained from the Ministry of Health Research and Ethical Review Committee. Confidentiality of patients records kept was secured and consent was obtained from study participants to use their data. Results were presented in frequency, tables and p value < 0.05 was considered significant. Results A total of 112 patients data was analyzed in the study with 49.1% were aged between 20 to 30 years. The prevalence of male factor infertility in these patients was found to be 42% and 79.5% of them had primary type of infertility. Of the study participants; 63 (56.3%), 72 (64.3%) and 70 (62.5%) had sperm count < 15 million sperms/ml, sperm motility < 40 % and morphology of < 60% respectively. One tenth, 15 (13.4%) of the patients had a semen volume of < 1.5ml/ejaculate, out of which 13(86.7%) had primary type of infertility. Moreover; 72 (64.3%) patients had total sperm count/ejaculate of < 39 million and 59 (82%) of these had primary type of infertility. In addition; 50.8% and 50% of patients aged 20 to 30 years had a sperm count < 15 million/ml and sperm motility of < 40% respectively. Conclusion The prevalence of male factor infertility was slightly higher and was dominated with primary infertility. Most patients had lower sperm count, sperm motility but higher semen volume, and majority of the patients with abnormal sperm results were aged between 20 to 30 years. Further prospective researches to determine the risk factors for male infertility and introducing assisted type of fertility in Eritrea are highly recommended.

scholarly journals The Impact of Intense Exercise on Semen Quality

2016 ◽  
Vol 11 (3) ◽  
pp. 654-662 ◽  
Author(s):  
Paweł Jóźków ◽  
Marco Rossato
Keyword(s):  
Physical Activity ◽  
Semen Quality ◽  
Sperm Count ◽  
Semen Analysis ◽  
Semen Parameters ◽  
Male Factor ◽  
Recreational Athletes ◽  
Increasing Demand ◽  
Male Reproductive Health ◽  
The Impact

With expanding knowledge on the health benefits of exercise, there is an increasing demand for information on the andrological consequences of participating in sports. These consequences are especially important in the context of infertility problems worldwide. The so-called “male factor” is reported in up to 50% of couples having trouble with conception. The answer to the question, “Is physical activity good for male reproductive health?” is not straightforward. A number of studies have suggested that significant changes in semen parameters may occur due to sports training of certain types, intensities, and durations. The changes to these parameters vary in scope, direction, and magnitude. Findings in recreational athletes have also differed from those in professional athletes. This review of the current literature suggests that intense physical activity may affect the semen concentration, as well as the number of motile and morphologically normal spermatozoa. Training at higher intensities and with increased loads seems to be associated with more profound changes in semen quality. In recreational athletes, exercise has either a positive or neutral effect on semen parameters. Due to many limitations (e.g., global sperm count trends, concerns about the quality control of sperm evaluations, and new standards for semen analysis), comparisons among historical data and their interpretation are difficult.

scholarly journals Understanding Male Infertility for Promising ART

2021 ◽  
Author(s):  
Mahrukh Hameed Zargar ◽  
Faisel Ahmad ◽  
Mohammad Lateef ◽  
Tahir Mohiuddin Malla
Keyword(s):  
Male Infertility ◽  
Physical Examination ◽  
Semen Analysis ◽  
Reproductive Technology ◽  
Male Factor ◽  
Traditional Assessment ◽  
Assisted Reproductive Treatment ◽  
Natural Conception ◽  
The Cost ◽  
Invasive Techniques

Infertility is a serious problem of not being able to conceive despite regular intercourse for more than a year. Natural conception is seen to be achieved in 80%–85% of couples. About 15% of couples suffer infertility with male factor contributing to almost 50% of cases. Paradoxically, on traditional assessment, the underlying etiology of male contribution towards infertility remains unrecognized in 30% of the patients and thereby grouped as idiopathic. Diagnostics of male infertility cannot therefore be limited to usual semen analysis only. The spectrum of the recent research encourages the experts in the field to approach the Clinical, Molecular and cytogenetic shades associated with the problem besides secondary factors like life style and environment. Clinical assessment sums the medical history and physical examination of the affected individual. Molecular and cytogenetic analysis help gain new insights in understanding the problem and thereby an advantage for a successful assisted reproductive treatment (ART). Given the cost and burden ART puts in and prior to application of any invasive techniques, understanding precisely the etiology associated with male infertility is essential for the fertility specialist to circumvent inefficient or any unproductive steps in the fertilization process besides helping in counseling patients on their chance of success with the use of reproductive technology.

scholarly journals Contribution of Ayurveda in the Management of Ksheena Shukra Vikara with Special Reference to Asthenozoospermia: A Case Report

2021 ◽  
pp. 140-149
Author(s):  
Manju Mohan ◽  
Sawarkar Punam ◽  
Sawarkar Gaurav
Keyword(s):  
Case Report ◽  
Male Infertility ◽  
Sperm Motility ◽  
Clinical Symptoms ◽  
Sperm Count ◽  
Single Case ◽  
Semen Analysis ◽  
Male Factor ◽  
Sperm Analysis ◽  
Patient Reported

Background: Male Infertility is one of the burning issues now a day’s nevertheless disregarded reproductive health problems in India. Incidences of this issue expands day by day because of the disturbing lifestyle pattern. Almost 30-40-% of infertility cases found to be related to male factor. Asthenozoospermia is the most common identifiable anomaly related to male infertility found in semen analysis having reduced motility of sperm. Aim and Objectives: To assess the efficacy of Ayurvedic management (Shodhana and Shamana Chikitsa) in the management of Ksheena Shukra Vikara w.s.r. to Asthenozoospermia. Methods: It is a single case study. A 33-year-old male patient who was already diagnosed with Asthenozoospermia for three years approached to Pancharkarma OPD. Sperm motility was only 12%. The patient was treated with Shodhana Chikitsa (Vamana and Virechana with Mahatiktaka Ghritapana and Dashmooladi Niruha Vasti and Uttarvasti with Vidaryadi Ghrita followed by Shamana Chikitsa (Tab Neo Charak Pharmacy, Tab Addyzoa, Chandraprabha Vati, Paripathadi Kashaya, Ashwagandhadi Yamaka, Avipattikar Churna) approximately 3 months. After 3 months, patient-reported improvement. Results: Assessment of the patient with clinical symptoms and sperm analysis report was done following 3 months. Sperm motility increased up to 40% with increment in sperm count.  Conclusion: This case report provides us a guideline that infertility associated with Asthenozoospermia can be treated successfully by adopting basic Ayurveda Siddhanta's.

scholarly journals Semen analysis and sperm function parameters in patients with infertility in Navi Mumbai and Panvel region

2019 ◽  
Vol 8 (11) ◽  
pp. 4169
Author(s):  
Surekha Bhalekar ◽  
Shweta Ganorkar ◽  
Hemant Bhalekar ◽  
Prakash Roplekar
Keyword(s):  
Sperm Count ◽  
Semen Analysis ◽  
Male Partner ◽  
Age Groups ◽  
Clinical Problem ◽  
Semen Parameters ◽  
Sperm Function ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Cross Sectional

Background: Although semen analysis is routinely used to evaluate male partner in infertile couples, infertility and problems of impaired fecundity have been a concern through ages and is also a significant clinical problem today, which affects 8-12% of couples worldwide. Aim of the study was to study different semen parameters in male factor infertility (MFI) and thus increasing the awareness regarding same.Methods: This is cross sectional study conducted between period of September 2016 to December 2018. Semen of 150 patients were studied and results were analysed as per recent WHO (2010) criteria.Results: The present study included 150 patients whose age ranged from 24 to 51 years. Patients were divided into different age groups and sperm count was studied in each group. Abnormal sperm morphology was studied with respect to sperm head, neck, tail defects and combined defects. Sperm deformity index (SDI) and Teratozoospermic index (TZI) were calculated. Other parameters including semen volume, pH, liquefaction time, sperm vitality and motility were also studied which showed significant variations. Conclusions: Although semen analysis is first and most informative investigation for evaluation of male factor infertility, studying individual semen parameters and sperm function and increasing its awareness in general population especially in developing countries is equally important. Besides, it is necessary to acknowledge its limitation with respect to collection, processing, evaluation and biological variation of samples. Also, a normal semen analysis may not prove successful fertility potential of an individual.

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