Treatment of Poor Sperm Quality and Erectile Dysfunction With Oral Pentoxifylline: A Systematic Review

Background: Pentoxifylline (PTX) is a member of methylxanthine chemicals and a type of non-selective phosphodiesterase-5 inhibitors, which has been used in male infertility treatment to improve sperm quality and erectile dysfunction (ED) treatment. Mutually tight associations existed between ED and male infertility. Using PTX might kill two birds with one stone by improving sperm quality and erectile function in infertile men with ED.Methods: PubMed, Cochrane Library, EMBASE, and Web of Science were searched by October 2021. Based on available evidence from observational studies and randomized-controlled trials (RCTs), we conducted a systematic review to summarize the efficacy and safety of PTX in treating ED and male infertility. The protocol of the article was registered and updated in PROSPERO (CRD42021291396).Results: From 202 records, eight studies (7 RCTs) evaluating the role of PTX in ED and three studies (2 RCTs) assessing the efficacy of PTX in male infertility were included in the systematic review. Three studies (100.00%) and two studies (100.00%) reported the beneficial role of PTX in improving sperm progressive motility and normal sperm morphology rate, respectively. In contrast, only one study (33.33%) indicated the favorable role of PTX in enhancing sperm concentration. As for ED, three (60.00%) studies supported the treatment role of PTX alone in ED, and two studies (66.67%) favored the combination use of PTX and selective PDE5Is compared with selective PDE5Is alone. Safety analysis showed that PTX was a well-tolerated drug in ED and male infertility treatment.Conclusion: Given the association between ED and male infertility and satisfying findings from available evidence, PTX administration for the simultaneous treatment of poor sperm quality and mild ED in infertile men will highly enhance the treatment compliance. However, the finding should be treated carefully until validated by further studies.

A Homeopathic Treatment İn a Female Patient with İnfertility

There is a physiological balance between our systems in our body. When this physiological balance is disturbed, diseases ocur. Infertility; It is defined as not having a pregnancy despite the couples having regular sexual intercourse. Homeopathy, a natural remedy that has been used widely all over the world for 200 years system. It has been recognized by the World Health Organization (WHO) as the second largest treatment method used worldwide. Although it is the most popular form of treatment in India and South America, it is also used by over 30 million people in Europe and millions of other people around the world. A female patient 33 years old who applied to Getat Polk for infertility had also divorsed from her first marriage for 8 years due to infertility. She continued her infertility treatment during her marriage. Tsh 1.93Uıu/ml, t3 3,05 pg/ml,t4 0.76ng/dl. Glukose 82mg/ml, d vitamine 8ng/ml, b12 270pg/ml, total cholesterol 176mg/ml, creatinine 0.63mg/dl tg 77 mg/dl fe 38ug/dl AST 19 U/L E stradiole 46ug/l LH 12,42IU/L Ferritine 8.51 ug/l hemoglobine 11.8g/dl .After a detailed anamnesis, the patient was started on Hyos c30 2*1, Ignatia c30 2*1, and folliculunum c200 2*1 (1st and 14th days of menstruation) in December 2020. The patient was 7 weeks pregnant in september 2021.β-Hcg 15000Mıu/ml Fe 171 ug/dl. Hormonal balance in women is very sensitive and easily effected, either by endogen or exogen disturbances. Pressure and suppression induced by dominant forces on an individual such as dominant parents, husband, harassment at work or religions dominance can be a cause to create a so called Folliculinum state, as well as results from immune system suffering after long lasting and profound infection, which is suppressed by medication.

Comparative efficacy of various methods of infertility treatment in patients with external genital endometriosis

With the aim of comparative examination of efficacy of different drugs and methods of endoscopic surgery in treatment of infertile women with genital endometriosis 548 patients were examined. Distinct advantages of combined treatment were revealed: surgical destruction of endometrial foci at the first stage and administration of antigonadotrophic preparations at the second stage. Maximum frequency of impregnation after such therapy was observed during first 6-8 months. By 11-12 months the index decreased to its minimum. So, it is reasonable to give up passive supervision after 12 months

PERMA model vs. integrative-behavioral couple therapy for fertility problems: A randomized clinical trial protocol

Background: Psychological interventions may reduce fertility problems. Positive emotion, engagement, meaning, positive relationship and accomplishment (PERMA) is a cognitive intervention and integrative-behavioral couple therapy (IBCT) is a behavioral intervention. Appropriate mental interventions are important in infertility treatment. Objective: To investigate the effect of the PERMA model vs. IBCT in reducing the fertility problems of couples. Materials and Methods: The content of the interventions was developed and adjusted based on a literature review and the opinions of experts. In this three-arm parallel randomized clinical trial, 42 couples undergoing infertility treatment will be allocated randomly into three groups (n = 14 couples/each). Group 1 will receive the PERMA intervention, group 2 will receive the IBCT intervention, and group 3 as the control group will receive an infertility treatment training program intervention. The primary outcome will be the fertility problems, which will be measured by completing a fertility problem inventory at baseline, as well as in the 5th and 9th wk as a follow-up. Another primary outcome, satisfaction with the intervention, will also be assessed in the 5th and 9th wk. The secondry outcome will be a positive pregnancy test at wk 12. The interventions will be conducted through a combination of face-to-face and online via WhatsApp. Conclusion: This study will assess social, sexual, and parenthood concerns. A combination of online and face-to-face interventions will be appropriate given the COVID-19 pandemic. Couple’s counseling may provide better counseling outcomes for fertility problems in comparison with group counseling. This study will try to optimize resilience during infertility treatment through learning better relationship and problem-solving skills, and may have an indirect impact on pregnancy rate, burden of infertility, and costs of treatment due to increased effectiveness. Key words: Online, Face-to-face, Infertility, Integrative-behavioral couple therapy, PERMA model, RCT, Positive psychology, Protocol study, COVID-19.

Cure tactics of patients with infertility on suspicion to external genital endometriosis

The role of laparoscopy in diagnostics of the outside genital endometriosis at infertility is indicated on the base of 548 clinical observations. It was made an assessment concerning dependences on clinical appearing the outside genital endometriosis in respect of the grade of process extension. The article contains the algorithm of female patients with infertility treatment on suspicion to the outside genital endometriosis.

Male Subfertility; Challenges and advancement in the andrology clinic at Khyber Pakhtunkhwa, Pakistan

Objective: This study is aimed to discuss the challenges in dealing the infertile male and advances in the treatment of male infertility. Material and methods: The study included infertile male patients who presented to andrology outpatient as primary or secondary infertility between December 2018 and January 2021. The data detailed different aspects of challenges and advances in male infertility treatment. The data analysisone with SPSS. Results: Total 289 patients included, most of them (74%) presented as primary infertility and a quarter presented as secondary infertility. The mean delay in presentation was 6.8 years which were due to treatment from non-andrologist doctors of different specialities (53.9%), hakims (15.2%), quacks (13.8%), gynaecologists (10.3%) and some were reluctant to tell their problem (6.5%). The diagnosis was N.O.A (42.9%), unexplained infertility (24.2%), varicocele (22.8%), OA (6.2%), OAT syndrome (2.7%) and CABVD (1%). Different treatment option opted were vasography plus vasovasostomy or vasoepididmostomy (31.1%), ART (23.9%), MSV (22.8%) and medical treatment (22.1%). Vasography plus vasovasostomy or vasoepididmostomy and medical treatment were the available options provided. There was no ART facility and those who were counseled for referral either their unwillingness or cost resulted in a hurdle in their provision. Conclusion: There are still a number of challenges in treating infertile men. Recently provision of medical and microsurgical treatment at andrology clinic resulted in proper treatment of a large number of infertile men who previously received treatment from un- related facilities.