scholarly journals ROLE OF SONOGRAPHY IMAGING IN MALE INFERTILITY

Author(s):  
Dr. Rajnikant Narsinhbhai Chauhan ◽  
Dr. Dileep Kumar Jha

Introduction: Infertility is known as major problem as life crisis for many couples. Investigation of male infertility is assuming greater importance with male factors implicated as it caused half of the infertile couples. Infertility is defined as infertility is a disease of reproductive system defined by failure to achieve the clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. It is also define as failure of couple to conceive after 12 months of regular intercourse without the use of contraception in women <35 years; and regular intercourse after 6 months without the use of contraception in women ≥ years. A recent report on the status of infertility in India, states that nearly 50% of infertility is related to the reproductive anomalies or disorders in the male. Male infertility include as pretesticular, testicular and post testicular causes. Common causes may be due to deficiencies in the semen and semen quality is used as a surrogate measure of male fecundity. Testicular causes are mainly cryptorchidism, varicocele exposure to gonadotoxins and post testicular causes which included disorders and obstruction of ejaculation and erectile dysfunction. There are many studies which found that sperm count of less than 10 million per milliliter is also suboptimal for fertility; however there is no cut off value of sperm count that is diagnostic of infertility. The common investigations done in evaluating fertility is Ultrasound examinations of scrotum and semen analysis. Ultrasound is a very useful modality for assessing the testicular size which is also related to condition like epididymo-orchitis, varicocele and undescended testis. Aim: The main aim of this study is to deteremine the used of ultra sonography in the evaluation of male infertility and to compared with clinical and surgical findings. Material and Methods: All the patients were referred to the Department of Radiology for transrectal and scrotal ultrasonography with high frequency transducer having a frequency of 7.5 MHz and Color Doppler wherever indicated. In this study all male patients with infertility and abnormal semen analysis and with the case of infertility with coincident scrotal findings on clinical examination were included. Transrectal ultrasound was done by positioned in left lateral decubitus position. On each side testis and epididymis was identified as completely as possible and compared for symmetry, size, texture and vascularity. Result: In this study patients with abnormality were found in highest number on clinical palpation and ultrasound was varicocele. In 18 cases Varicocele was detected on clinical examination and 24 cases in ultrasound. In 9 cases Hydrocele was detected in clinical examination and Ultrasound. In 5 cases epididymal cysts were detected in clinical findings and 6 cases were found in Ultrasound Findings whereas 2 cases of epididymitis  was found in ultrasound and only 1 case in clinical examination. Therefore the total number of abnormalities was found by ultrasound which was significantly greater as compared to physical examination. The p-value was 0.001 which shows statistically significant. Conclusion: Transrectal ultrasound enables high resolution imaging of prostate, seminal vesicles and distal vas deferens and is implicated in diagnosing the cause of obstructive azoospermia. Therefore Imaging plays an important complementary role to clinical examination and laboratory analyses for the detection of precise anatomy and level of abnormality.  Hence transrectal and scrotal ultrasound provides valuable information in the diagnostic evaluation of infertile men and pathological conditions can be detected on ultrasound compared to clinical palpation. Keywords: Infertility, Sonography, Transrectal, Testicular

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Yusuf TS ◽  
Panti AA ◽  
Ekele BA ◽  
Nwobodo EI

Background: Male infertility can occur when sperms are limited innumber or function. Infertility is a socially destabilizing and stigmatizing condition for couples but in our society many erroneously believe it is a problem from the female alone. Objectives: To evaluate the semen of infertilemale partners of couplesattending gynaecological clinic of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Methodology: This was a prospective study conducted at the gynaecological clinic of Usmanu Danfodiyo University Teaching Hospital Sokoto between 1stJanuary 2011 and 30th June 2011. For the purpose of this study all male partners of women who complained of inability to conceive after a period of a year or more of unprotected sexual intercourse were recruited into the study. Data was extracted and analyzed using SPSS (version 11). A P–value of less than 0.05 was considered significant. Results: There were 125 cases of male infertility recruited during the period. Majority of the male patients (51.2%) were aged 40 years and above. Considerable percentage of the patients (46.4%) presented with duration of Infertility of 5 years and above. The identified risk factors were a previous history of Urethral discharge (37.6%) and previous treatment of sexually transmitted infections (29.6%). Hypospermia (33%) and Asthenospermia (42.4%) were the commonest disorders of semen Parameters seen. Low sperm count was seen in (36.8%) of studysubjects, Azoospermia was observed in 8% while 16% of them had disorder of sperm morphology. Conclusion: The study shows that infertility is associated with relatively high rate of abnormal sperm volume, motility and count. In addition, genital tract infections are major associated factors. Therefore, efforts to address STIs through primary, secondary and tertiary preventive measures may make significant contributions to reducing the prevalence of male infertility in Sokoto State.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Richard Michael Blay ◽  
Abigail Duah Pinamang ◽  
Augustine E. Sagoe ◽  
Ewurama Dedea Ampadu Owusu ◽  
Nii Koney-Kwaku Koney ◽  
...  

Introduction. Male infertility is known to contribute about half of all infertility cases. In Ghana, the prevalence of male infertility is higher (15.8%) than in females (11.8%). Sperm quality is associated with the likelihood of pregnancy and known to be the cause of male fertility problems 90% of the time. Exposure to certain environmental factors reduces semen quality in men. The study examined the effects of environmental and lifestyle factors on semen quality in Ghanaian men. Materials and Methods. This was a cross-sectional study involving 80 apparent healthy adult males in their reproductive age. Participants were males referred to the laboratory (Immunology Unit of the Korle-Bu Teaching Hospital) for semen analysis test and/or culture and sensitivity. Participants were made to fill out a questionnaire which entailed selected environmental factors (accidents or trauma, exposure to chemicals, radiation, and heat) and lifestyle habits (including alcohol consumption, smoking, and whether participants sat more or less than 4 hours per day). Semen samples were then collected by masturbation into sterile containers and analysed in accordance with WHO guidance for semen analysis within 60 minutes after ejaculation and collection. Results. About 69% of participants had semen pH within the normal range compared to 15% whose pH were lower than 7.2. There was a significantly high number of immotile sperm cells ( p value = 0.017) in participants who sat for more than 4 hours as compared to those that sat for less than 4 hours in a day. Active sperm motility and viability showed significant increase ( p value = 0.002 and 0.009, respectively) in participants who kept their cell phones in their side pockets. Smoking produced a twofold decrease in sperm count as smokers had a significantly lower sperm count ( 12.28 ± 10.95 × 10 6 /ml) compared to the smoke-free ( 23.85 ± 22.14 × 10 6 /ml). For exposure to STDs, no significant differences were recorded among study groups concerning semen quality. Conclusion. Sperm quality in Ghanaian men is associated with lifestyle habits. Smoking and sitting for long hours influenced sperm motility and count, respectively. Knowledge of the factors that influence sperm quality in this geographical region can contribute to informed decisions on effective management of infertility in Ghanaian men.


2015 ◽  
Vol 22 (2) ◽  
pp. 156-162
Author(s):  
Uttam Karmaker ◽  
SM Mahbub Alam ◽  
Md Shafiqul Alam Chowdhury ◽  
Mohammed Mizanur Rahman ◽  
Md Nazmul Islam ◽  
...  

Background: The ideal method of varicocele treatment is a controversial issue. The present study was designed to compare the outcome of laparoscopic palomo and open inguinal varicocelectomy. Methods: The present quasi experimental study was conducted in the Department of Urology, Dhaka Medical College Hospital, Dhaka, between July 2010 and June 2012 to compare the outcome of open inguinal and laparoscopic Palomo approach of varicocelectomy. Purposively selected 50 patients were divided into equal two groups, Group A and Group B treated with open inguinal varicocelectomy and laparoscopic Palomo varicocelectomy respectively. Statistical analyses were done by using SPSS and p value <0.05 was considered as significant. Results: In the present study, mean age of the patients of Group A and Group B were 29.1 ± 2.0 and 28.9±1.5 years respectively. Among the patients of Group A developed neither hydroeele nor testicular atrophy, where as in patients of Group B 20% and 12% developed hydrocele and testicular atrophy respectively. The recurrence rate of varicocele was lower in the Group A than that in the Group B. The findings of semen analysis at 1st and 2nd follow up visits show that there was negligible improvement in semen quality in terms of sperm count, motility and morphology. Conclusion: Open inguinal varicocelectomy is better than laparoscopic palomo varicocelectomy. Although sooner return to work is achieved by laparoscopic varicocelectomy, complications are more frequent than the open inguinal method. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21527 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 156-162


Author(s):  
Namrata V. Padvi ◽  
Pooja P. Singh ◽  
Kishore M. Nadkarni ◽  
Prabhakar M. Singh

Background: Male contributes about 50% for cases with combined male and female infertility. When the cause is not known, it is term as idiopathic infertility. It affects 25% of men. Many advances have been made in reproductive medicine which provides great opportunities, couples which were considered untreatable now have got chance to have their own babies. Various ART procedures like ICSI have been proven as an efficient therapy in severe male factor infertility. However, the cost per cycle and complications such as multiple gestations cannot be ignored. Medical management of infertility can be specific or empirical depending on etiology. Specific medical management is use when certain etiology is identified. However, in absence of specific etiology use of empirical medical treatment can be attempted in order to improve treatment results. In this study our aim is to evaluate the effect of human chorionic gonadotropin (hCG) and antioxidants on semen parameters in men with idiopathic male infertility.Methods: Thirty men with abnormal semen parameters were included in study. Patients were treated with injection hCG-2000 IU three times a week for three months along with the antioxidants. After 3 months of treatment repeat semen analysis were performed and results were compared with pre-treated seminal parameters.Results: Results showed significant increase in sperm count (p value ≤ 0.001), total motility (p value=<0.001), and progressive forward motility (p value = <0.001), while no significant difference is seen in rest of the parameters.Conclusions: Use of hCG and antioxidants in idiopathic male infertility can significantly improve seminal parameters in idiopathic male infertility.


2020 ◽  
Vol 26 ◽  
Author(s):  
Abdulqader Fadhil Abed ◽  
Yazun Bashir Jarrar ◽  
Hamzeh J Al-Ameer ◽  
Wajdy Al-Awaida ◽  
Su-Jun Lee

Background: Oxandrolone is a synthetic testosterone analogue that is widely used among bodybuilders and athletes. However, oxandrolone causes male infertility. Recently, it was found that metformin reduces the risk of infertility associated with diabetes mellitus. Aim: This study aimed to investigate the protective effects of metformin against oxandrolone-induced infertility in male rats. Methods: Rats continuously received one of four treatments (n=7) over 14 days: control DMSO administration, oxandrolone administration, metformin administration, or co-administration of oxandrolone and metformin. Doses were equivalent to those used for human treatment. Subsequently, testicular and blood samples were collected for morphological, biochemical, and histological examination. In addition, gene expression of the testosterone synthesizing enzyme CYP11A1 was analyzed in the testes using RT-PCR. Results: Oxandrolone administration induced male infertility by significantly reducing relative weights of testes by 48%, sperm count by 82%, and serum testosterone levels by 96% (ANOVA, P value < 0.05). In addition, histological examination determined that oxandrolone caused spermatogenic arrest which was associated with 2-fold downregulation of testicular CYP11A1 gene expression. However, co-administration of metformin with oxandrolone significantly ameliorated toxicological alterations induced by oxandrolone exposure (ANOVA, P value < 0.05). Conclusion: Metformin administration protected against oxandrolone-induced infertility in male rats. Further clinical studies are needed to confirm the protective effect of metformin against oxandrolone-induced infertility among athletes.


2017 ◽  
Vol 63 (4) ◽  
pp. 332-335 ◽  
Author(s):  
Leonardo de Souza Alves ◽  
Francisco Batista de Oliveira

Summary Introduction: Varicocele disease is well-known cause of infertility in men. The presence of spermatic varices veins create a hostile environment to spermatogenesis. It results in reduced quality of the sperm production and in some cases can determine a total absence of sperm. The varicocelectomy procedure in patients with non-obstructive azoospermia (NOA) can raise the rates of sperm in the semen analysis. A positive rate for sperm, even if very low, may be sufficient to enable the capture of sperm intended for in-vitro fertilization without the use of donor sperm. Objetive: To evaluate the raise of sperm in NOA patients with varicocele disease who were submitted to a bilateral procedure to recovery sperm production. Method: We analized the sperm results of 25 NOA patients who undergone to a bilateral varicocelectomy procedure. Results: From a total of 25 patients, three (12%) recovered sperm count four months after procedure. One year after the procedure, five (20%) patients recovered sperm production. Conclusion: Patients with varicocele disease and azoospermia, without genetic changes or obstruction of the spermatic tract, should undergo surgical procedure to recover sperm.


Author(s):  
Akshay Tayawade ◽  
Akash More

Introduction: Approximately about 15%-20% of couples are affected by infertility. By the means of diagnosis and treatment both the partners male and female must be evaluated simultaneously, since male contributes as a factor for infertility in 40-60%. The primary step to diagnose male’s infertility in any case scenario is qualitative semen analysis. Urological evaluation and physical examination of male should be carried out as there are many factors which can affect semen quality. Widely, in assisted reproductive technology (ART) treatment, couples diagnosed with grievous male infertility (Non-Obstructive Azoospermia/OATz syndrome) as well as female patient deprived of male partners eager to have pregnancy are recommended to opt cryo-preserved donor spermatozoa. Main symptoms and important clinical findings: Qualitative semen analysis showed poor motility (94%-96% Immotility) and morphology (98% abnormality). The main diagnoses, therapeutic interventions, and outcomes: The couple was diagnosed with male factor infertility (Asthenoteratozoospermia), the couple was counselled and suggested for treatment of Intracytoplasmic Sperm Insemination with self-oocytes and donor sperms and Freeze all strategy for embryo transfer. Wife conceived in first treatment cycle. Conclusion: Frozen embryo transfer of 03 Grade A day 4 morula was done in March 2020, and patient conceived in 1st cycle. Later in November 2020 couple was blessed with a baby girl.


2021 ◽  
Author(s):  
Berhe Tesfai ◽  
Fitsum Kibreab ◽  
Hailemichael Gebremariam ◽  
Liwam Abraham

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.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ewa Janiszewska ◽  
Izabela Kokot ◽  
Iwona Gilowska ◽  
Ricardo Faundez ◽  
Ewa Maria Kratz

AbstractIn the seminal plasma (n = 118) and serum (n = 90) clusterin (CLU) the fucosylation and the expression of selected fucosyltransferases (FUTs) were analyzed. Samples from infertile men were divided into groups based on the results of the standard semen analysis: normozoospermic (N), teratozoospermic (T), asthenoteratozoospermic (AT) and oligoasthenoteratozoospermic (OAT). The CLU fucosylation was analyzed using lectin-ELISAs with biotinylated lectins specific to α1,3-, α1,2-linked antennary fucose, and α1,6-linked core fucose (LTA, UEA, and LCA, respectively). The concentrations of FUT3 and FUT4, reflecting the expression of Le oligosaccharide structures, were measured using ELISA tests. The differences in serum CLU and FUT4 concentrations, and in the expression of core fucose and antennary fucose α1,2-linked in CLU glycans between the N group and other groups examined suggest that the disturbances in sperm count, motility, and morphology are not the only cause of male infertility. Lack of similarities between levels of examined parameters in blood serum and seminal plasma may suggest the differences in mechanisms leading to glycoproteins glycosylation. It confirmed the observed differences in concentrations of seminal plasma CLU, FUT3, and FUT4 between the OAT group and N, T, AT groups, indicating that decreased sperm count may be related to these parameters expression. The serum CLU concentrations and expression of core fucose and fucose α1,2-linked in CLU, seem to be good markers differentiating normozoospermic men from those with abnormal sperm parameters, which was not observed for seminal plasma.


Biota ◽  
2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Kerin Victoria Sipahutar ◽  
Yudhi Nugraha ◽  
Cut Fauziah

Obesity caused by a high-fat diet leads to an altered reproductive hormonal profile, including impaired semen quality. Antioxidants can overcome these conditions. One of the well-known sources of antioxidants is in the rambutan fruit peel extract. This research aimed to figure the effect of rambutan fruit peel extract towards total sperm count in Wistar rats induced with high-fat feed. The study design used post-test only control group,  subjects were 30 male Wistar rats divided into five groups: Group I (Positive Control) was given high-fat feed, Group II (Treatment Control Group) was given 15mg/kg BW rambutan fruit peel extract, whereas group III, IV, V (Treatment Group) were given an extract of rambutan skin with a dosage of 15, 30, and 60 mg/kg BW, respectively. Treatment was administered for 81 days. This study showed that rambutan fruit peel extract with doses of 15, 30, and 60 mg/kg BW has significantly increased total sperm count in Wistar rats induced with high-fat feed. The outcome using Kruskal Wallis shows a result of p-value 0,010 (CI 95%). Antioxidant compounds found in rambutan fruit peel extract significantly increase total sperm count in Wistar rats induced with high-fat feed, with the highest efficacy on the dose of 15mg/kg BW.   Keywords: Fruit Peel Rambutan Extract; ; ; 


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