Semen Parameter Profile of Infertile Men Visiting Andro-Urology Clinic

Surgical treatment or varicocele embolization (VE) with sclerosing or mechanical embolic agents have been shown to improve the semen parameters of infertile men. The aim of this study was to evaluate the impact of VE using N-butyl cyanoacrylate (NBCA) glue on semen parameters in infertile men. From January 2014 to June 2018, infertile adult patients with stage 3 varicocele and an initial semen analysis showing at least one abnormal semen parameter, and who were successfully embolized with NBCA Glubran®2 glue, were retrospectively recruited. The availability of a second semen analysis after VE was mandatory for patient inclusion. The primary endpoint was the change in total sperm number (TSN) after VE. The other parameters of interest were progressive and total sperm motilities (Smot) at 1 h (H1), sperm vitality (SV) and morphology (SMor). One hundred and two patients were included. Eight patients presented null TSN before and after VE. Among the remaining 94 patients, a significant improvement in the median TSN after VE was shown (31.79 × 106/ejaculate [IQR:11.10–127.40 × 106/ejaculate] versus 62.24 × 106/ejaculate [IQR:17.90–201.60 × 106/ejaculate], p= 0.0295). Significant improvement in TSN was found for the 60 oligo- or azoospermic patients (p = 0.0007), whereas no significant change was found for the 42 patients with normal initial TSN (p = 0.49). Other parameters, such as progressive and total SMot, SV and SMor, also significantly improved after VE (p = 0.0003, 0.0013, 0.0356 and 0.007, respectively). The use of NBCA glue as an embolic agent for VE in infertile men with stage 3 varicocele significantly improves the semen parameters.

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Baseline FSH Predicts Semen Parameter Response in Infertile Men on Clomiphene Citrate

Journal of Men s Health ◽

10.31083/jomh.v11i5.14 ◽

2015 ◽

Vol 11 (5) ◽

pp. 22

Keyword(s):

Clomiphene Citrate ◽

Semen Parameter ◽

Infertile Men

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Evaluation of a serum 17-hydroxyprogesterone as predictor of semen parameter(s) improvement in men undergoing medical treatment for infertility

Canadian Urological Association Journal ◽

10.5489/cuaj.6846 ◽

2020 ◽

Vol 15 (7) ◽

Author(s):

Thiago Fernandes Negris Lima ◽

Evgeniya Rakitina ◽

Ruben Blachman-Braun ◽

Ranjith Ramasamy

Keyword(s):

Medical Therapy ◽

Semen Quality ◽

Intrauterine Insemination ◽

Sperm Concentration ◽

Rank Test ◽

Motile Sperm ◽

Semen Parameter ◽

Infertile Men ◽

Quality Upgrading ◽

17 Hydroxyprogesterone

Introduction: The goal of medical therapy for infertile men with testosterone deficiency (TD) is to improve intratesticular testosterone (ITT). There is a gap in knowledge to identify those who will respond with semen parameter(s) improvement. We hypothesized that serum 17-hydroxyprogesterone (17-OHP) — a marker of ITT — can be used to predict improvement of semen parameter(s). Methods: Between July 2018 and January 2020, we conducted a prospective study of 31 men with primary infertility, TD, and secondary hypogonadism receiving clomiphene citrate (CC) and/or human chorionic gonadotropin (hCG) for three months. We assessed baseline and followup hormones, including testosterone, 17-OHP, semen parameter(s), and demographics. Semen quality upgrading was based on assisted reproduction eligibility: in-vitro fertilization (<5 million), intrauterine insemination (IUI) (5–9 million), and natural pregnancy (>9 million). Variables were compared using the Mann-Whitney U or Wilcoxon rank test. Results: Twenty-one men received CC and 10 received CC/hCG. Median followup was 3.7 (3.3–5.1) months. Sixteen men upgraded semen quality. Six of 10 men with baseline total motile sperm count (TMSC) of 0 had motile sperm after treatment, and 11/20 men with TMSC<5 upgraded semen quality into TMSC>5 range. Low 17-OHP was the only factor that predicted semen quality upgrading. Men with 17-OHP ≤55 ng/dL upgraded semen quality and improved hormones, whereas men with 17-OHP >55 ng/dL did not upgrade semen quality. Conclusions: Medical therapy for infertile men with TD resulted in the improvement of sperm concentration, TMSC, testosterone, and 17-OHP. Semen quality upgrading appears to be more significant in patients with low 17-OHP, suggesting that ITT can be used as a biomarker to predict semen parameter(s) improvement.

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