scholarly journals Infertility: Practical Clinical Issues for Routine Investigation of the Male Partner

2020 ◽  
Vol 9 (6) ◽  
pp. 1644 ◽  
Author(s):  
Alberto Ferlin ◽  
Carlo Foresta
Keyword(s):  
Risk Factors ◽  
Semen Analysis ◽  
Male Partner ◽  
Transrectal Ultrasound ◽  
Infertile Couple ◽  
Clinical Approach ◽  
Partner Influence ◽  
Scrotal Ultrasound ◽  
Testicular Histology ◽  
Male Factors

About one-fifth of couples has fertility problems in Western countries. Male factors are present in about half of them, either alone or in combination with female causes. Therefore, both partners should be evaluated simultaneously. The fertility status and/or specific conditions of each partner influence the clinical and treatment approach. This article summarizes in a practical way when, how, and why the male partner of an infertile couple should be investigated. The available evidence and international guidelines were used, interpreting, discussing, and expanding them from personal decades-long experience in this field. The aim is to delineate the most appropriate clinical approach for the male partner of infertile couples, considering traditional and emerging technologies and laboratory analyses in the context of their clinical significance. Components of the initial evaluation in men without known risk factors for infertility should include at minimum medical history, physical examination, and semen analysis. Semen microbiological examination, endocrine assessment, scrotal ultrasound, and transrectal ultrasound are suggested in most men and are mandatory when specific risk factors for male infertility are known to be present or when the initial screening demonstrated abnormalities. Full examination, including genetic tests, testicular histology, or additional tests on sperm, is clinically oriented and/or suggested after the results of initial investigations.

scholarly journals Risk Factors Analysis for Abnormal Semen Characteristics in Sub-Fertile Male

2019 ◽  
Vol 31 (1) ◽  
pp. 31-35
Author(s):  
Afroza Akhter ◽  
Liza Chowdury ◽  
Mahbuba Akhter ◽  
Samira Haque
Keyword(s):  
Risk Factors ◽  
Sperm Count ◽  
Semen Analysis ◽  
Male Partner ◽  
Semen Parameters ◽  
Military Hospital ◽  
Surgical Trauma ◽  
Heavy Smoking ◽  
Sperm Abnormality ◽  
The Mean

Introduction: This study aimed to identify the risk factors for abnormal semen parameters in male partner of sub-fertile couples. Materials & Methods: This was a prospective study of 100 diagnosed infertile & sub-fertile couples in the age group between 23-58 yrs old male were from 1st March 2013 to 28th Feb 2014 treated in Dhaka Combined Military Hospital (CMH). On the basis of sperm count the cases were grouped as follows. normozoospermia, oligozoospermia & azoospermia. Semen analysis was done in all the cases, The results were described with arithmetic mean and standard deviation. Male partners with normal semen parameters was undertaken among the sub-fertile couples attending the General Outpatient Department (GOPD) of CMH Dhaka. The history was taken from selected individual and it includes personal, socio-economics, occupational, medical, surgical history and drug intake to find out risk factors for abnormal semen parameters. Results: In Normozoospermia mean and SD of sperm count, sperm abnormally, sperm motillity were 65.98±5.05, 24.44±1.57 and 45.5±2.94 respectively. In 0ligozoospermia the mean and SD of sperm count, sperm abnormality, sperm mtility were 7.74±1.23, 41.1±3.78, 14.54±2.77 respectively. In azoospermia the mean and SD of sperm count, sperm abnormality, sperm motility were absent. Conclusion: Here data statistically showed person with normozoospermia having good sperm morphology & motility than oligozoospermia and azoospermic subjects thereby causing male infertility which was responsible for hindrance in achieving pregnancy clinically. Using tight undergarment or working in hot atmosphere depresses spermatogenesis. Mumps orchitis permanently damage spermatogenesis. Bacterial or viral infection depresses the sperm count. Diabetes, malnutrition, heavy smoking reduces spermatogenesis. β-blocker, antihypertensive were likely to hinder spermatogenesis. The efferent ducts might be obstructed by infection like tubercular, gonococcal or by surgical trauma. Medicine Today 2019 Vol.31(1): 31-35

scholarly journals Comparison of Sperm Functional Parameters after Cryopreservation of Human Sperm in Three Different Media

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Sindhuja N. S. ◽  
Manjula G. ◽  
Sanjeeva Reddy N.
Keyword(s):  
Semen Quality ◽  
Semen Analysis ◽  
Male Partner ◽  
Egg Yolk ◽  
Infertility Treatment ◽  
Infertile Couple ◽  
Soy Lecithin ◽  
Semen Cryopreservation ◽  
Functional Parameters ◽  
Commercial Media

Semen cryopreservation is an integral part of infertility treatment in the current day scenario. Recovery of an optimal number of functionally intact spermatozoa from thawed samples has always been the main objective of semen cryopreservation technology. The aim of this study was to compare of Commercial freezing media with Glycerol egg yolk citrate and Soy lecithin media for the cryopreservation of human spermatozoa. This prospective observational study was done at the department of reproductive medicine and surgery, Sri Ramachandra University during the period of August 2015 to January 2016. Male partner of the infertile couple visiting OPD for infertility treatment with normal semen quality (Normozoospermic) were included in the study. Each semen sample was divided into three aliquots and frozen with Commercial media, Glycerol Egg Yolk Citrate (GEYC) media and soy lecithin media. Semen analysis and sperm function tests before freezing and after thawing namely Acrosome reaction, Capacitation and Mitochondrial potential was compared between the groups. There was a significant decline in motility, vitality and functional parameters of the sperms compared to fresh and frozen thawed in all the groups. However, among the frozen thawed groups, the commercial media and GEYC media were comparable in motility and viability parameters;GEYC media was superior to Commercial media in functional sperm parameter maintenance.

scholarly journals Clinical Spectrum of Infertile Couple: a Retrospective Study at Teaching Hospital

2020 ◽  
Vol 3 (2) ◽  
pp. 375-378
Author(s):  
Hima Rijal ◽  
Suvana Maskey
Keyword(s):  
Semen Analysis ◽  
Male Partner ◽  
Cross Sectional Study ◽  
Clinical Spectrum ◽  
Infertile Couple ◽  
Male Factor ◽  
Cross Sectional ◽  
Chewing Tobacco ◽  
One Year ◽  
Unilateral Block

Introduction: Infertility has been rising steeply as the prime health issue among women around the world these days. This study aims to investigate the causes, hormonal profi le, and clinical spectrum of infertility.Materials and Methods: This is a descriptive cross-sectional study conducted throughout a one year duration in an infertility clinic. The couples meeting the inclusion criteria were included and a pre-formed proforma was used to collect the data regarding history, examination, and investigations.Results: A total of 118 infertile couples were analyzed. The mean age of the females was 28.3±4.5 years. There were 72.1 %cases of primary infertility and 27.9 %of secondary infertility. Regarding obesity status,35.5% were overweight and 15.2 % were obese. Thirty-one (26.2%) males were smokers, 41 (34.7%) used to consume alcohol, and 14 (11.8%) had a habit of chewing tobacco. Among the different fi ndings of semen analysis, 21.1% asthenozoospermia, 9.3% oligoasthenozospermia,7.6% oligospermia, 1.6% azoospermia. Female factor accounted for 45.3%, the malefactor for 28% and in 19.3% the defi nite factor was not determined. The ovulatory disorder was diagnosed in 38.6% of females and hysterosalpingography (HSG) revealed that around 10% had a unilateral block and 1.7% had a bilateral block.Conclusions: Infertility is becoming a global issue affecting a signifi cant number of young couples. About forty-six percent were female aging more than thirty years. The female factor for infertility was more common than the male factor among which ovulatory disorder was the commonest one. Asthenozoospermiawas the commonest abnormal fi nding on semen analysis in a male partner.

scholarly journals Semen Analysis and Insight into Male Infertility

2021 ◽  
Vol 9 (A) ◽  
pp. 252-256
Author(s):  
Batool Mutar Mahdi
Keyword(s):  
Retrospective Study ◽  
Male Infertility ◽  
Semen Analysis ◽  
Male Partner ◽  
Sperm Concentration ◽  
World Health ◽  
Semen Parameters ◽  
Infertile Couple ◽  
Male Reproductive Function ◽  
The World

Objectives: Semen analysis is the cornerstone for the valuation of the male partner in the infertile couples. This test has been standardized throughout the world through the World Health Organization (WHO) since the1970s by producing, editing, updating, and disseminating a semen analysis manual and guidelines. A retrospective study to give an insight about  male infertility. Methods: This retrospective study assessed the semen findings of 1000 men evaluated at the  Department of Urology, Al-Kindy Teaching Hospital in Baghdad-Iraq  between January 2016 and May 2019. Semen analysis were done for them. Results: According to WHO standard for semen normality, 1000 samples that were analyzed, normospermia was shown in 835 (83.5%)males (95% CI=0.811-0.857) and 12% had oligospermia and the rest 4.5% was azospermia. The normospermic samples had significantly higher levels regarding the following parameters: count per ml (51.30±1.24) (P= 0.001), volume(3.34±2.31)(P=0.0001), pus cell (8.04±1.02)(P=0.0001), motility (22.81±5.8)(P=0.0001), abnormal motility (22.81±5.8)(P=0.0001) and  normal (V)(P=0.0001)or abnormal morphology (25.86 ±12.4)(P=0.0002) when compared with oligospermia. Conclusions: Semen analysis is the keystone of infertile couple. Semen parameters like sperm concentration, motility and morphology, are indicators for male reproductive function. Sperm concentration is declining and there is a significant association between sperm concentration and sperm parameters.

scholarly journals Study of Semen Analysis Patterns in Male Partner of Infertile Couple Attending Tertiary Level Hospital of Nepal

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Surendra Koju ◽  
Suman Raj Tamrakar ◽  
Ramita Shankhadev
Keyword(s):  
Semen Analysis ◽  
Male Partner ◽  
World Health ◽  
Semen Parameters ◽  
Infertile Couple ◽  
Laboratory Manual ◽  
Holistic Management ◽  
Set Up ◽  
Health Organization ◽  
Level Hospital

Aims: The aim of this study is to analyze the pattern of semen abnormality in male partner of infertile couple in Nepal. Methods: A retrospective study of semen sample of male partner of infertile couple analyzed in Department of pathology, Dhulikhel Hospital from January 2014 to December 2018. All semen samples were processed and analyzed according to methods and standards outlined by World Health Organization laboratory manual for the examination and processing of human semen 2010. Results: A total of 520 semen samples were analyzed. Our study shows 221 (44%) abnormal for different semen parameters and asthenozoospermia (39.3%) is the most common abnormality followed by azoospermia (28.8 %), Oligoasthenozoospermia (17.9 %), Oligozoospermia (8.7 %), Oligoasthenoteratozoospermia (3.5 %) and teratozoospermia (1.8 %). Conclusions: Abnormal semen parameters remain significant causes in overall infertility in our set up with asthenozoospermia and azoospermia were common abnormalities in male partner. Semen analysis is an inevitable tool for evaluation of infertility in male partner. Further study is required to find out the possible etiologies of male infertility for holistic management of infertility.

Incidence of Recurrent Venous Ulcer in Patients Treated at an Outpatient Clinic: Historical Cohort

2022 ◽  
pp. 153473462110659
Author(s):  
Michele Neves Brajão Rocha ◽  
Carol Viviana Serna Gonzalez ◽  
Eline Lima Borges ◽  
Vera Lúcia Conceição de Gouveia Santos ◽  
Soraia Assad Nasbine Rabeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Outpatient Clinic ◽  
Onset Time ◽  
Venous Ulcer ◽  
High Recurrence Rate ◽  
Ulcer Recurrence ◽  
Clinical Approach ◽  
Historical Cohort ◽  
Venous Ulcers

The recurrence of venous ulcers is the wound reopening after a period of completed epithelisation of a previous ulcer due to exposure to causal factors and lack of prevention. Venous ulcers have a high recurrence rate that may increase through the years. Epidemiological evidence on its incidence and risk factors is scarce due to the lack of patient follow-up in outpatient clinics and adherence to treatment after healing. The objective was to analyze the incidence of venous ulcers recurrency in outpatients and the risk factors for its occurrence. It is an observational historical cohort with retrospective data collection, performed through electronic medical records. Setting: private health insurance outpatient clinic. The participants were adult patients with healed venous ulcers. Incidence of venous ulcer recurrence was calculated within individuals with healed ulcers from 2014 and 2018 with a follow-up of at least one year. Bivariate analysis and logistic regression were used to explore risk factors considering demographic, clinical, and wound-related variables. As a result, sixty-five (65) of the 134 patients with healed venous ulcers had a recurrence, leading to an incidence of 48.5%, with a mean onset time of 230.1 (SD 267) days. Patients with recurrent venous ulcers were primarily women (39/48.1%), with a mean age of 64 (SD 15.5) years, 57 (50.8%) had some comorbidity, with systemic arterial hypertension as the most frequent (47/51%). Obesity (15/88.2%) increased the risk of venous ulcers recurrence by 8.7 (OR 95% CI 2.1-60.8; P = .009) times. In conclusion, venous ulcers recurrence incidence was 48.5%, with obesity as a risk factor. This study demonstrates that the clinical approach of people with venous ulcers should not finish when the wound is healed. For ulcer recurrence prevention interventions addressing systemic factors, besides topical management of the wound, are essential.

scholarly journals Sonographic features of the testicular adrenal rests tumors in patients with congenital adrenal hyperplasia: a single-center experience and literature review

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Li Ma ◽  
Yu Xia ◽  
Linlin Wang ◽  
Ruifeng Liu ◽  
Xuepei Huang ◽  
...  
Keyword(s):  
Literature Review ◽  
Congenital Adrenal Hyperplasia ◽  
Medical Center ◽  
Semen Analysis ◽  
Steroid Treatment ◽  
Adrenal Hyperplasia ◽  
Hydroxylase Deficiency ◽  
Scrotal Ultrasound ◽  
Testicular Lesions

Abstract Purpose Testicular adrenal rests tumor (TART) is a rare kind of benign tumor in the testis. It usually occurred secondary to congenital adrenal hyperplasia (CAH), a hormonal disorder caused by hydroxylase deficiency. As the first-line examination method, ultrasound provides crucial diagnostic information for TART, although misdiagnosis to malignancy is quite common because of its rare prevalence. We aimed to summarize the sonographic manifestations of TART to improve the diagnostic accuracy and specificity. Methods Eight CAH patients with TART identified by ultrasound in our medical center were retrospectively reviewed. Clinical and hormonal profile, semen analysis and treatment choices were collected. Sonographic examinations were performed at the first evaluation and interpreted by experienced radiologists individually. All patients received regular follow-up, and 5 patients undertook repeated scrotal ultrasound. A literature review of TART in CAH patients was conducted, with 123 patients from 23 articles since 1990 included. Results A total of 8 patients aged between 4 to 27 years old were enrolled. 7 of 8 (87.5%) patients exhibited bilateral testicular lesions. The sizes of the testicular lesions were between 0.18 ml to 5.68 ml, and all showed a clear boundary. 10/15 (66.7%) lesions were homogenously hypoechoic, 4/15 (26.7%) were heterogeneously iso-hypoechoic, and 1/15 (6.7%) were homogenously isoechoic. 10/15 (66.7%) lesions were hyper-vascular. The longitudinal follow-up of 5 patients showed testicular lesions changed in terms of size, echogenicity, and vascularity after steroid treatment. A potential correlation may exist between ACTH levels and tumor size (p = 0.066). From the literature review, 100/123 (81%) patients got bilateral lesions, and 95% of them were located near the mediastinum. 80/103 (78%) lesions exhibited a clear boundary, and predominant lesions (74%) were hypoechogenic. Vascularity was with great diversity. Seventy-nine lesions of 44 patients were followed-up by scrotal ultrasound, among which 29 (37%) remained unchanged, 29(37%) shrank, and 21(27%) disappeared. Conclusions Key sonographic characteristics of TART are: resembled lesions on both testes, located near the mediastinum, clear boundary, and changed in size or echogenicity after steroid treatment. These features can help radiologists to make an accurate diagnosis of TART.

scholarly journals Atherosclerotic Extension of Carotid Arteries: An Insertion in Clinical Practice

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
M. L. Furlanetto ◽  
E. F. B. Chagas ◽  
Payão SLM
Keyword(s):  
Risk Factors ◽  
Carotid Stenosis ◽  
Statistical Tests ◽  
Positive Association ◽  
Arterial Disease ◽  
Lower Limbs ◽  
Atherosclerotic Disease ◽  
Clinical Approach ◽  
Diffuse Disease ◽  
Coronary Territory

Introduction. Atherosclerotic disease is a diffuse disease that is strongly associated with age, risk factors, and variable progression. The anatomical prevalence of atheromas does not always follow, a sequence by sectors, and in many cases are concomitant. Objectives. This study is aimed at studying atherosclerosis in the arterial territories of the carotid and lower limbs, in order to correlate their extension as a form of primary prevention. Methods. Participating patients with the main risk factors for atherosclerotic disease were composed of two groups: one with chronic peripheral obstructive arterial disease (PAD) and another without PAD. After performing carotid ultrasound Doppler (USD) of all patients, the occasional prevalence of the disease was evaluated. We performed by statistical tests the correlation between the findings in these patients and the risk factors. Obtaining n from 226 patients, in which 116 patients are from the PAD group and 110 patients are from the group without PAD. Results. Our findings add up to 8.8% for lesions over 50% in patients with PAD, with 6.2% over 70% meeting the few published scientific findings. In this study, the correlation was evaluated between carotid stenosis and PAD, in which we observed a positive association. We observed in the studies that the prevalence of moderate and severe carotid stenosis was similar to patients with coronary artery disease (CAD). There are a number of nonclassical risk factors that we do not evaluate, but even studying the traditional ones, we find that they are less than 27% dependent. Conclusion. Therefore, our study proposes an improvement in the clinical approach of patients with PAD for both the carotid and coronary territory, not using only 2 factors traditional risk factors, for the extension study and to consider the PAD that has 10% dependence alone, as effect and projection of the carotid atherosclerotic plaque.

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