Comparison of Open Sub-Inguinal and Microscopic Sub-Inguinal Varicocelectomy for Improvement of Sperm Parameters

2021 ◽  
Vol 15 (10) ◽  
pp. 2882-2885
Author(s):  
Saleem Shahzad ◽  
Muhammad Waqar Shahid ◽  
Muhammad Azeem Mughal ◽  
Ismat Ullah ◽  
Attiq-ur- Rehman Khan
Keyword(s):  
Male Infertility ◽  
Sperm Count ◽  
Semen Analysis ◽  
Semen Parameters ◽  
Surgical Methods ◽  
Group A ◽  
Treatment Objective ◽  
Randomized Controlled Trail ◽  
Group B ◽  
Keywords Male Infertility

Background: Varicoceles along with oligospermia as well as with asthenozoospermia lead to the male infertility. It can weaken the spermatogenesis via many different pathophysiological mechanisms. Many surgical and non-surgical methods are available for its treatment. Objective: To compare microscopic versus open sub-inguinal varicocelectomy in males with varicocele with oligospermia and asthenozoospermia. Study Design: Randomized controlled trail Place and Duration of Study: Department of Urology, Lahore General Hospital, Lahore from 1st May to 30th November 2017. Methodology: One hundred and fifty males with varicocele were recruited and divided in two equal groups. Group A patients underwent microsurgical sub-inguinal varicocelectomy and Group B patients underwent conventional/open sub-inguinal varicocelectomy. Semen analysis was done before surgery and after four months of surgery and 50% improvement in semen parameters were noted. Results: The mean age was 31.69±5.49 years. In group A and group-B ≥50% improvement was observed in 36 (48%) and 21 (28%) respectively. The improvement was significantly higher in group A than group B (p>0.012). Conclusion: The improvement in sperm count and motility was significantly higher in patients treated with microsurgical sub-inguinal varicocelectomy when treated with conventional/open sub-inguinal varicocelectomy. Keywords: Male infertility, Varicocele, Varicocelectomy, Seminal parameters, Microsurgical sub-inguinal, Conventional/open sub-inguinal

scholarly journals Utility of shear wave ultrasound elastography in evaluation of testicular stiffness in patients with varicocele

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ahmed Tohamy Ahmed
Keyword(s):  
Shear Wave ◽  
Sperm Count ◽  
Semen Analysis ◽  
Ultrasound Elastography ◽  
Imaging Method ◽  
Healthy Controls ◽  
Stiffness Evaluation ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background Testicular varicocele is the most frequent cause of male infertility. The study aimed at evaluation of testicular stiffness in patients with varicocele measured by shear wave ultrasound elastography (SWE) in correlation to patient semen analysis (total sperm count) and varicocele grade. This case–control study involved 50 patients (40 patients with bilateral testicular varicocele and 10 patients with unilateral Lt. testicular varicocele of different grades) and 25 healthy controls. All participants underwent physical examination, semen analysis (patient group subdivided in two groups: group A; normospermic and group B; oligospermic), scrotal grey scale and Doppler ultrasound, and shear wave ultrasound elastography with measurement of mean testicular stiffness. Evaluation of testicular stiffness and correlation to varicocele grade and semen analysis (total sperm count) were done. Results The mean testicular stiffness value measured by SWE in patients with testicular varicocele was greater than that of healthy controls (7.46 ± 1.64 kPa vs. 3.84 ± 0.62 kPa, P < 0.001). The mean testicular stiffness value in group B exceeded that of group A (8.57 ± 1.53 kPa vs. 6.34 ± 1.76 kPa, P = 0.001). A moderate positive correlation was found between mean testicular stiffness value and the varicocele grade (P = 0.01) which was more evident in group B than in group A (P = 0.01). Conclusions Testicular ultrasound SWE is a quantitative noninvasive imaging method which helps in the assessment of testicular parenchymal changes due to varicocele. Higher testicular stiffness values were found in testes of patients with varicocele, more in oligospermic patients than the testes of healthy controls. Testicular stiffness is moderately correlated to varicocele grade.

scholarly journals Comparative study between the outcome of Laparoscopic Palomo and open inguinal Varicocelectomy

2015 ◽  
Vol 22 (2) ◽  
pp. 156-162
Author(s):  
Uttam Karmaker ◽  
SM Mahbub Alam ◽  
Md Shafiqul Alam Chowdhury ◽  
Mohammed Mizanur Rahman ◽  
Md Nazmul Islam ◽  
...  
Keyword(s):  
Semen Quality ◽  
Sperm Count ◽  
Semen Analysis ◽  
Testicular Atrophy ◽  
P Value ◽  
College Hospital ◽  
Medical College ◽  
Quasi Experimental ◽  
Group A ◽  
Group B

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

scholarly journals Interventional study to find out effect of human chorionic gonadotropin and antioxidants on idiopathic male infertility

2017 ◽  
Vol 6 (2) ◽  
pp. 496
Author(s):  
Namrata V. Padvi ◽  
Pooja P. Singh ◽  
Kishore M. Nadkarni ◽  
Prabhakar M. Singh
Keyword(s):  
Male Infertility ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Medical Management ◽  
Sperm Count ◽  
Semen Analysis ◽  
Semen Parameters ◽  
P Value ◽  
Idiopathic Male Infertility ◽  
Significant Difference

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.

scholarly journals Semen Parameters Are Seriously Affected in Acephalic Spermatozoa Syndrome

2021 ◽  
Author(s):  
Li-juan Ying ◽  
Qing-ting Liu ◽  
Lin Yu ◽  
Tingting Yang ◽  
Ying-bi Wu ◽  
...  
Keyword(s):  
Case Control Study ◽  
Semen Quality ◽  
Sperm Quality ◽  
Semen Analysis ◽  
Semen Parameters ◽  
Control Group ◽  
Semen Volume ◽  
Group A ◽  
Group B ◽  
Control Study

Abstract Objective: To evaluate the effect of acephalic spermatozoa syndrome on sperm quality in semen with different proportions of headless sperm.Design: Case control study.Setting: Andrology Laboratory.Patient(s): A total of 391 patients with headless sperm and 400 prenatal examination patients with no headless sperm who underwent semen analysis at the andrology laboratory.Intervention(s): None.Main Outcome Measure(s): The correlation of the proportion of headless sperm in semen with semen parameters.Result(s): All semen parameters except the semen volume were negatively (P<0.05) correlated with the proportion of headless sperm in the semen. The semen samples were divided into three groups based on the proportion of headless sperm (PHS) as follows: 0<PHS≤10% (n=249, group A), 10<PHS≤20% (n=71, group B) and PHS>20% (n=71, group C). Nearly all semen parameters were significantly lower in group B and group C than in the control group (P<0.05). However, in group A, only the vitality and motility parameters were lower than those of the control group.Conclusion(s): Semen samples containing headless sperm tend to have lower semen parameters than samples without headless sperm. Increases in the proportion of headless sperm in semen samples are associated with decreases in semen quality.

scholarly journals Combined Tamoxifen and L-Carnitine Therapies for the Treatment of Idiopathic Male Infertility Attending Intracytoplasmic Sperm Injection: A Randomized Controlled Trial

2015 ◽  
Vol 6 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Milat Haje ◽  
Kameel Naoom
Keyword(s):  
Randomized Controlled Trial ◽  
Male Infertility ◽  
Intracytoplasmic Sperm Injection ◽  
Sperm Count ◽  
Controlled Trial ◽  
Idiopathic Male Infertility ◽  
Randomized Controlled ◽  
Group A ◽  
Icsi Outcomes ◽  
Group B

ABSTRACT Aim The aim of the present study is to evaluate the fertility outcomes of intracytoplasmic sperm injection (ICSI) as well as sperm count, motility and morphology in couples with infertile male partners exhibiting idiopathic oligoasthenozoospermia (OA) and treated with tamoxifen citrate and/or L-carnitine. Materials and methods In this randomized controlled trail, couples with female cause of infertility were excluded. Only couples with male cause of infertility with idiopathic OA were admitted to this study and randomly assigned into four different groups of treatments as follow: Group A (n = 45) received an anti-estrogen compound (tamoxifen 20 mg/day), group B (n = 20) received L-carnitine (1000 mg/day), group C (n = 34) received tamoxifen 20 mg/day plus L-carnitine 1000 mg/day, whereas group D (n = 29) received placebo. Treatments were continued for 3 to 6 months. Results Treatment groups of A, B, and C showed an overall improvement in the tested parameters of sperm when compared to the control group that showed an overall reduction in those parameters after termination of the treatment. In this context, sperm count increased from 7.58 ± 2.93 × 106/ml before treatment to 10.81 ± 1.84 × 106/ml after treatment in group A (p = 0.016). Similarly, sperm count increased from 5.32 ± 2.09 × 106/ml to 8.92 ± 2.29 × 106/ml in group C (p = 0.01). Patients from group C did not only have an improved total motility of sperm from 8.03 ± 1.59% to 13.78 ± 3.85% (p = 0.045) but also an improved sperm normal morphology from 0.88 ± 0.45% to 1.99 ± 0.71% (p = 0.026). Patients from group A or C exhibited an improved ICSI outcomes when compared to those in patients from group B or D (48.9 or 48.3 vs 16.6 or 20, respectively, p = 0.46). Conclusion It is concluded that administration of tamoxifen and L-carnitine can improve both sperm parameters of fertility and ICSI outcomes. Combined tamoxifen and L-carnitine treatments result in maximum therapeutic effect in men with idiopathic OA. How to cite this article Haje M, Naoom K. Combined Tamoxifen and L-Carnitine Therapies for the Treatment of Idiopathic Male Infertility Attending Intracytoplasmic Sperm Injection: A Randomized Controlled Trial. Int J Infertil Fetal Med 2015;6(1):20-24.

scholarly journals Effects of aqueous leaf extract of Corchorus olitorius on sperm count and sperm motility of adult wistar rats

2021 ◽  
Vol 6 (2) ◽  
pp. 01-06
Author(s):  
Godwin Chinedu Uloneme
Keyword(s):  
Body Weight ◽  
Sperm Motility ◽  
Wistar Rats ◽  
Leaf Extract ◽  
Sperm Count ◽  
Semen Analysis ◽  
Control Group ◽  
Corchorus Olitorius ◽  
Group A ◽  
Group B

Background: The plant, Corchorus olitorius is consumed by many tribes and cultures for both nutritional and therapeutic purposes. Purpose: The study was therefore designed to investigate, evaluate and unravel the possible effects of the plant extract on the sperm count and sperm motility. Method: A total number of thirty two adult Wistar rats weighing between 180 and 200 g separated into four groups labeled A,B,C and D respectively were used for the study. Animals in group A which served as the control group were fed with the normal rat chow and water only. The group B rats were administered 100mg/kg body weight of aqueous extract of Corchorus olitorius; while those in group C were administered 500mg/kg body weight of the extract. The group D rats received 1000mg/kg body weight of the extract. For a period of four weeks, the different experimental animal groups received the respective aforementioned treatments once daily, around nine- o’clock in the morning through oral intubation. At the end of the 28 day treatment, the rats were sacrificed and the testes and accompanying epididymis harvested for investigations using standard laboratory standards. Results: Surprisingly, semen analysis showed that group B, C and D rats had an improved and increased sperm motility rate over group (A). Again, there was a pronounced significant increase in the average sperm count of the rats treated with varying doses of Corchorus olitorius leaf extract over that of the control group, a development that appeared to be dose dependent.

scholarly journals Impact of Leucocytospermia on Semen Parameters among Sudanese Sub-Fertile Men Port Sudan -2019

2021 ◽  
pp. 1-5
Author(s):  
Dalal Salih Abdel-aziz ◽  
◽  
Mohammed Ahmed Ibrahim Ahmed ◽  
Esam Eldin Osman Elghazali ◽  
Areeg Salih Abdel Aziz Ahmed ◽  
...  
Keyword(s):  
Male Infertility ◽  
Sperm Count ◽  
Semen Analysis ◽  
Semen Parameters ◽  
Cross Sectional ◽  
Normal Morphology ◽  
Long Time ◽  
Microbial Etiology ◽  
Infertility Patients ◽  
The Impact

Background: For a long time, bacterial infection of the male genital tract was thought to be one of the leading causes of male infertility. Various clinical studies have identified Leucocytospermia as a proxy marker for these infections, although other causes of inflammation may also play a role. Objective: The study was conducted at the Dermatology Teaching Hospital in Port Sudan with the aim of determining the impact of leucocytospermia on semen parameters and defining the microbial etiology among infertile males. Methods: Between September 2019 and February 2020, a descriptive, cross-sectional, hospital-based investigation was applied. After meeting the study requirements, 140 patients were randomly selected; patient information was collected via a closed-ended questionnaire after patients provided their authorization. Results: A total of 140 male infertility patients were evaluated. The mean age of respondents was 43.5 + 2.6 years old, 61.4% of the patients had infertility for 1-5 years, 55.7% of the patients had secondary infertility, 32.1% of the patients demonstrated leucocytospermia on their semen analysis. Semen analysis results showed that 37.8 of the leucospermic patients’ sperm count was <15 X 106. In 73.3% of the patients, the motile sperms were < 40%, and normal morphology was less than 4% in 46.7% of the patients. The analysis showed mixed infection by both gram positive and negative bacteria are common (42.2%). Conclusion: According to the findings, there is an association between leucocytospermia and male infertility.

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.

scholarly journals Is there a place for nutritional supplements in the treatment of idiopathic male infertility?

2014 ◽  
Vol 86 (3) ◽  
pp. 164 ◽  
Author(s):  
Davide Arcaniolo ◽  
Vincenzo Favilla ◽  
Daniele Tiscione ◽  
Francesca Pisano ◽  
Giorgio Bozzini ◽  
...  
Keyword(s):  
Male Infertility ◽  
Sperm Count ◽  
Nutritional Supplements ◽  
Semen Parameters ◽  
Male Factor ◽  
Treatment Regimens ◽  
Idiopathic Male Infertility ◽  
Infertile Men ◽  
Wide Variability

Objective: Infertility affects 15% of couples in fertile age. Male factor is a cause of infertility in almost half of cases, mainly due to oligoasthenoteratozoospermia (OAT). The purpose of this study is to review the effects of nutritional supplements as medical treatment for idiopathic male infertility. Material and methods: A Pub Med and Medline review of the published studies utilizing nutritional supplements for the treatment of male infertility has been performed. Results: Clinical trials on Vitamin E, Vitamin A, Vitamin C. Arginine, Carnitine, N-Acetyl-Carnitine, Glutathione, Coenzyme Q10, Selenium and Zinc were reviewed. Although there is a wide variability in selected population, dose regimen and final outcomes, nutritional supplements both alone and in combination seems to be able to improve semen parameters (sperm count, sperm motility and morphology) and pregnancy rate in infertile men. Conclusions: There are rising evidences from published randomized trials and systematic review suggesting that nutritional supplementation may improve semen parameters and the likelihood of pregnancy in men affected by OAT. This improvement, however, is not consistent and there is a wide variation in the treatment regimens used. Well designed and adequately powered RCTs are needed to better clarify the role of nutritional supplements as treatment for male infertility.

scholarly journals SEMEN pH;

2012 ◽  
Vol 19 (02) ◽  
pp. 234-241
Author(s):  
HENRY. A. MWAKYOMA ◽  
ERICK. P. MAGOROSA
Keyword(s):  
Hormonal Regulation ◽  
Seminal Fluid ◽  
Sperm Count ◽  
Semen Analysis ◽  
Staining Technique ◽  
Semen Parameters ◽  
Morphological Examination ◽  
Pathology Laboratory ◽  
Cross Sectional ◽  
The World

Background: Male infertility is a frequent reproductive health problem in the world. It is usually related to abnormal spermproduction or function and these abnormalities can occur anywhere in the production of sperm including hormonal regulation, storage andtransport of sperm. Various factors are known to be responsible for seminal fluid abnormalities. Usually the first step in evaluating for maleinfertility is semen analysis. Setting: The study was conducted at Muhimbili National Hospital mainly in the department of Pathology laboratory,cytology unit. Study design: The study was a hospital based cross-sectional type. Objective: To determine semen pH in patients presenting withinfertility complains and relate how pH of seminal fluid and other semen parameters influence each other. Material and methods: Beforesemen collection, patients were instructed to abstain from sexual intercourse for a minimum of 48 hours to 7 days and collect semen bymasturbation and transport it to the laboratory through shirt pocket. Semen was to reach the laboratory for examination in not more than onehour from time of collection. Semen was examined macroscopically for volume, colour, viscosity and pH by using a pH meter (Consort C830)followed by microscopic examination which included motility of spermatozoa and sperm count by using Neuber counting chamber. The smearwas made on glass slides, fixed in 95% ethyl alcohol for 30 minutes then stained by using Papanicolaou’s staining technique and then analyzedmicroscopically for morphological examination. Results: In the analysis of the influence of semen parameters on semen pH, there wasdecrease in seminal fluid pH with age whereby as age increased the pH of seminal fluid decreased.. The general trend observed was that thepH of seminal fluid tended to decrease with an increase in the days of abstinence. pH tended to decrease with an increase of seminal fluidvolume. The pH of seminal fluid also increased with an increase in viscosity (Hyperviscosity >Hypoviscosity). The pH of seminal fluid in patientswith less than 50% forward progressive movement of spermatozoa was higher when compared to those with more than 50% forwardprogressive movement. pH had an influence on the motility of spermatozoa. Conclusions and recommendation: pH and other parameterstended to have an influence each other during seminal analysis in our study. There is a variation of pH in different parts of the World according tothe studies done. It is recommended that pH should be included during seminal analysis because our study has shown that it affects most of theseminal fluid parameters in and contribute to the problem of infertility.

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