Cyclophosphamide-induced disturbance of gonadotropin secretion manifesting testicular damage

1992 ◽  
Vol 126 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Jantine JG Hoorweg-Nijman ◽  
Henriette A Delemarre-van de Waal ◽  
Frans C de Waal ◽  
Henk Behrendt

Gonadal function was evaluated in 23 men (aged 14.8–28.8 years) treated in childhood with cytotoxic drugs for a solid tumour. Group 1 (N = 14) had been treated with non-alkylating drugs only, while group 2 (N=9) received the alkylating drug cyclophosphamide in addition (range 3.8–19.5 g/m2). Median age at the start of treatment was 4.6 years (range 0.6–16.1) in group 1 and 13.9 years (range 3.7–16.9) in group 2. Data of the patients were compared with a reference group consisting of 14 normal men. Almost all patients of both groups showed normal development of puberty; 13 of the 14 men in group 1 showed normal hormonal values. In group 2, basal LH and FSH as well as the LH and FSH responses to GnRH showed higher levels compared to those of a reference group (p<0.001). Correlation analysis showed an evident correlation between the total dose of received cyclophosphamide and the basal FSH level (r=0.78; p=0.002), the FSH response to GnRH (r=0.73; p=0.002) and the LH response to GnRH (r=0.67; p=0.002). There was no correlation between the hormonal parameters and the doses of the other cytotoxic drugs. Semen analysis showed azoospermia in four boys of group 2 and in none of group 1. Two patients in group 2 had an elevated FSH response to GnRH while their semen analysis was normal. Conclusions: (1) There is a dose-response relationship between the basal FSH. the LH and FSH responses to GnRH and the dose of cyclophosphamide. In all cyclophosphamide-treated patients the FSH response to GnRH increased. (2) Increased gonadotropin secretion can be found while semen analysis is normal; an increased FSH response to GnRH can be the first manifestation of testicular damage. (3) Evaluation of gonadotropins, both basal and stimulated LH and FSH values, is an easy and useful method for following up gonadal function in cyclophosphamide-treated men, especially for detecting early and subtle testicular damage.

Author(s):  
Haytham M. Nasser ◽  
Ahmed Hussein ◽  
Gad M. Behairy ◽  
Mostafa Abdo

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.


1989 ◽  
Vol 67 (11) ◽  
pp. 3219-3226 ◽  
Author(s):  
Bernard R. Baum ◽  
A. Pat Tulloch ◽  
L. Grant Bailey

This study was based on 148 accessions representing 39 species of Hordeum. SEM ultrastructural morphology of waxes was based on individual spikelets, whereas waxes' chemical composition was assessed from whole plants. When all the data, in the form of individual accessions, were subjected to various cluster analyses methods, no groupings were revealed. But when the data were first summarized by species and then subjected to clustering, two polythetic groups of species were detected. Group 1 is characterized by species with 40–60% average alcohol content and by the common presence of diketones, whereas group 2 is characterized by species with 61 – 80% average alcohol content, by the total absence of hydroxy-β-diketone, and almost all species without β-diketone. The chemical data were then subjected to classificatory discriminant analysis to assess if a single previously unclassified accession could be identified into one of the two groupings. The nature of the differences between the two groupings was described by means of a canonical discriminant analysis. Mostly only plates and filaments were detected, and in many accessions the filaments were widened, appeared platelike, and were characteristic for one group. Presence of β-diketone varied within species. Hordeum violaceum was found to be unique in chemical composition.


2019 ◽  
Vol 20 (4) ◽  
pp. 39-44
Author(s):  
S. Sh. Khayat ◽  
E. E. Bragina ◽  
E. A. Arifulin ◽  
E. M. Lazareva ◽  
T. M. Sorokina ◽  
...  

The study objective is to analyze the content of spermatozoa with single and double-stranded DNA breaks in different age groups.Materials and methods. The level of DNA fragmentation was studied in 300 ejaculate samples obtained from 266 sub- or infertile men. The group 1 included 150 samples obtained from 131 patients under the age of 45 (21–44 years), the group 2 included 150 samples obtained from 135 patients above the age of 45 (45–68 years). Mean ages were 34.8 ± 3.9 and 48.6 ± 3.1 years, respectively. The number of sperm with fragmented DNA was evaluated using the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) method on ejaculate smears. The number of spermatozoa with >15 % of fragmented DNA was considered elevated. Standard semen analysis was performed in 117 and 97 men from the groups 1 and 2, respectively.Results. The number of sperm with fragmented DNA varied in ejaculated samples from 1.5 to 64.5 %. Mean number of sperm with DNA breaks in the group 1 (12.0 ± 6.0 %) was significantly lower than in the group 2 (16.1 ± 8.3 %, p <0.05). Mean sperm count in the ejaculate of the group 1 (267.0 ± 198.7 million) was significantly higher than in the group 2 (201.0 ± 162.9 million, p = 0.02).Conclusion. We revealed that in men over the age of 45 years, the percentage of spermatozoa with DNA fragmentation is higher than in men under 45 years of age, it may indirectly indicate an increased level of reactive oxygen species in the seminal plasma in older patients. 


Author(s):  
Hyunsoo Kim ◽  
Kijeong Kim ◽  
Sohee Shin

The aim of this study was to investigate the cardiometabolic risk factors (CRFs) in community dwelling men based on a combination of body mass index (BMI) and waist circumference (WC). This cross-sectional study was based on 867 males between the ages of 20 and 71 years. Subjects were categorized into 4 groups by BMI and WC (Group 1, BMI < 25 kg/m2 and WC < 90 cm; Group 2, BMI < 25 kg/m2 and WC > 90 cm; Group 3, BMI > 25 kg/m2 and WC < 90 cm; and Group 4 BMI > 25 kg/m2 and WC > 90 cm). The proportion of subjects with a normal weight with high WC was 3.2%. Among normal weight men with the high range of WC, significantly high Odds ratios (ORs) and 95% CI were found for hypertriglyceridemia (3.8, 1.8–8.2) and high blood glucose (3.2, 1.5–6.9). The probability that the general obesity group (Group 3) had one CRF was around twice that of the reference group (Group 1) (1.9 to 2.1 times), but Group 2 had probability more than 4 times higher (4.3 to 4.6 times). In community dwelling adult men, normal weight with high waist circumference was associated with the highest cardiometabolic risk. In conclusion, follow-up screening of those with high WC may be necessary to detect and prevent cardiometabolic diseases, particularly for men with a normal weight.


2018 ◽  
Vol 1 (1) ◽  
pp. 129-136
Author(s):  
Badereddin Mohamad Al-Ali ◽  
Emma Persad ◽  
Andreas Lunacek ◽  
Christof Mrstik ◽  
Eugen Plas

Introduction: Many studies suggest that varicoceles are associated with hypogonadism and varicocele repair can increase testosterone levels and improve erectile function.Aim: The aim of this retrospective study was to analyze the impact of varicocele and varicocele surgery on testosterone level, semen quality, and erectile function.Methods: Our study included 265 infertile males with a clinical varicocele. This group was divided into three groups: group 1 (193) patients who did not receive surgery, group 2 (72 patients) who were operated on according to the Palomo procedure and group 3 (28 patients), who acted as a control group without a varicocele. All patients completed the International Index of Erectile Function IIEF-5 (German version) and underwent semen analysis. Serum testosterone, follicle stimulating hormone (FSH), and luteinizing hormone (LH) were measured at inclusion into the study and after surgery.Main outcome measures: Changes in semen quality, erectile function, and serum hormones after surgery.Results: The IIEF-5 scores in groups 1 and 2 were 21.01 ± 2.2; and 21.74 ± 1 respectively, and the resulting t-test for equality of variance was significant (p < 0.0001). Total testosterone level in groups 1 and 2 were 3.16 ± 0.37 and 3 ± 0.01, respectively, and the resulting t-test for equality of variance was significant (p < 0.0001). The results of the semen analysis were better in group 2 (after surgery) (28.6%, p < 0.001) in comparison to group 1. Interestingly, pre-operative serum testosterone levels were lower in patients with later improvement of semen analysis (p = 0.05). Body mass index (p = 0.8), pre-operative serum FSH (p = 0.9), LH (p = 0.2), and nicotine consumption (p = 0.6) were similar in both the group that saw improvement and the group with no change in semen quality.Conclusion: Semen quality improved in 28.6% of patients after varicocele surgery. Erectile dysfunction (ED) improved after varicocele surgery. We report that lower pre-operative serum testosterone level might be a possible indicator for successful surgical outcome.


2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Mustafa Gökhan Köse ◽  
Kadir Önem ◽  
Mehmet Çetinkaya ◽  
Erkan Karadağ ◽  
Emre Arpali

Objective. To investigate the question of whether duration of pain before surgery ultimately affects sperm parameters after varicocelectomy.Methods. Fifty patients with painful grade-3 varicocele were investigated prospectively. The patients were divided into two groups according to their symptom period. The patients having had grade-3 varicocele for less than 1 year were included in Group-1 (Ge,n=25). Twenty-five patients who had painful grade-3 varicocele for more than 1 year (Gs,n=25) were classified in Group-2. Semen analysis was performed after 3 days of sexual abstinence twice a month. Total sperm concentration (TSC), rapidly progressive motility (SPa), and slow or sluggish motility (SPb) rates were noted. Pain was evaluated by using 10 cm visual analogue scale (VAS).Results. Postoperative TSC and %SPb were significantly higher in both groups (P=0.01). There was no difference between two groups for preoperative and postoperative TSC, %SPa, % and SPb values. VAS significantly declined in both groups (P=0.005). This postoperative decline was not significant for intergroup comparison.Conclusions. Our results show that increase in semen quality and decrease in the pain after microsurgery varicocelectomy do not depend on the duration of the preoperative pain.


2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Vasan Sathya Srini ◽  
Srinivas Belur Veerachari

Varicocele in infertile males is associated with Leydig cell dysfunction and hypogonadism. The effect of varicocelectomy on serum testosterone level is not yet established. We analysed 200 heterosexual infertile men diagnosed to have clinical varicocele they were divided into two groups: group 1 (100 men) had microsurgical varicocelectomy, and group 2 (100 patients) underwent assisted reproduction procedures. All participants had semen analysis, serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and total testosterone (TT), measured both at recruitment time and 6 months later. In group 1, the mean TT level increased significantly after varicocelectomy (1.644±0.029to2.461±0.0198 ng/dL,P<0.0001) and testicular size correlated with the mean change in TT (P=0.001). No similar change was found in group 2. Out of the 100 patients in group 1, 78 had postoperative normalization of TT unlike only 16 men in group 2.


2021 ◽  
Vol 93 (2) ◽  
pp. 227-232
Author(s):  
Caner Ediz ◽  
Muhammed Cihan Temel ◽  
Suna Şahin Ediz ◽  
Serkan Akan ◽  
Serkan Yenigürbüz ◽  
...  

Background: This study aimed to determine the contribution of color Doppler ultrasonography (CDUS) performed before varicocelectomy to the success of surgical treatment and to evaluate the correlation between CDUS findings and semen parameters. Methods: A total of 84 patients diagnosed with grade 3 left varicocele in our clinic between 2016 and 2018 were evaluated. The patients in whom the decision for varicocelectomy was based on only physical examination (PE) findings and abnormal semen analysis (SA) were defined as Group 1, while the patients undergoing varicocelectomy based on PE, CDUS and SA findings were defined as Group 2. The patients diagnosed with varicocele based on PE and CDUS findings who were included in a followup protocol due to normal semen parameters were defined as Group 3. Results: In Group 1, there was a total of 28 patients and the mean number of ligated internal spermatic veins was 4.53 (range, 2-10). In Group 2, there was a total of 30 patients and the number of ligated internal spermatic veins was 3.76 (range, 1-8). No statistically significant difference was found between Group 1 and 2 in terms of the number of internal spermatic veins ligated during varicocelectomy. No statistically significant correlation was found between semen parameters and the number of veins ligated during varicocelectomy in Group 1 and 2 and between semen parameters and CDUS findings group 2 and 3. Conclusions: In patients with primary grade 3 varicocele, diagnosed by physical examination there is no need for additional imaging in primary cases.


2021 ◽  
Vol 8 ◽  
Author(s):  
Dong Hyuk Jung ◽  
Yong Jae Lee ◽  
Byoungjin Park

Background: An increased hemoglobin (Hb) level may have detrimental effects on hepatic steatosis (HS) as well as cardiovascular disease (CVD). We investigated Hb's effect on incident ischemic heart disease (IHD) risk in the context of hepatic steatosis (HS).Methods: We assessed 17,521 non-diabetic participants and retrospectively screened for IHD using the Korea National Health Insurance data. High Hb was defined as Hb levels ≥16.3 g/dL in men and 13.9 g/dL in women (&gt;75th percentile). The participants were divided into five groups: reference (group 1), mild HS only (group 2), mild HS and high Hb (group 3), severe HS only (group 4), and severe HS and high Hb (group 5). We assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional hazards regression models over 50 months from the baseline survey.Results: During the follow-up period, 330 (1.9%) participants developed IHD (310 angina pectoris and 20 myocardial infarction). Compared with the reference group (group 1), the HRs for IHD were 1.04 (95% CI, 0.75–1.46) in group 2, 1.14 (95% CI, 0.70–1.85) in group 3, 1.58 (95% CI, 1.08–2.32) in group 4, and 1.79 (95% CI, 1.15–2.80) in group 5, after adjusting for IHD risk factors.Conclusions: We found the combined effect of HS and Hb levels on the incidence of IHD.


2019 ◽  
Vol 47 (9) ◽  
pp. 4134-4142 ◽  
Author(s):  
Dong-liang Zhu ◽  
Hong-guo Zhang ◽  
Rui-xue Wang ◽  
Yu-ting Jiang ◽  
Rui-zhi Liu

Objective This study aimed to re-evaluate the clinical value of a 4% cut-off threshold of sperm morphology in in vitro fertilization (IVF) in a cohort of a Northeastern Chinese population. Methods A total of 375 IVF cycles that met strict inclusion criteria were included. These cycles were conducted with semen analysis and oocyte fertilization. A total of 188 embryo-transferred cycles proceeded. According to sperm morphology, 375 cycles were divided into group 1 (329 cycles, <4% normal sperm morphology rate [NSMR]) and group 2 (46 cycles, ≥4% NSMR), and 188 transferred cycles into group A (151 cycles, < 4% NSMR) and group B (37 cycles, ≥4% NSMR). Results The fertilization and normal fertilization rates were significantly lower in group 1 than in group 2. The normal fertilization rate was significantly correlated with an NSMR < 4% or ≥4%, but the fertilization rate was not significantly correlated with the NSMR. No significant differences were found in pregnancy outcomes between groups A and B. Conclusions This study suggests that infertile patients with an NSMR < 4% are more likely to have a poor normal fertilization status in IVF.


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