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

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

Sperm Profile of Infertile Men in the Western Region of Algeria: About 320 Cases

Objective : The aim of this study is to describe the sperm profile and eventually determine the main spermatic disturbances at the origin of male infertility in western Algeria. Methods: We conducted a cross-sectional study in 320 infertile male patients consulting at the Medically Assisted Procreation Unit (MAP) of Oran, in Western Algeria, in the end of exploring the results of their semen analyses and semen culture. Results: The results of semen analysis revealed that the main spermatic disruption in our study was asthenospermia because at the first hour after emission, 93% of our patients had less mobility than normal. Oligospermia was present in 37% of cases and azoospermia in 14% of cases. That is, a concentration of sperm below normal in 51% of cases. Results of the analysis of the sperm’s morphological characteristics revealed that only 16% of our patients had teratospermia. The semen culture revealed that the main pathogen found in our patients is Staphylococci in nearly 70% of cases. Conclusion: Our study revealed alterations in both quantitative and qualitative semen of patients. This was mainly asthenospermia in 93% of cases followed by oligospermia. Keywords: Male infertility, Semen analysis, Semen culture, Western Algeria.

The frequency of terminal deletions sY160 among men with microdeletions of AZFc region Y-chromosome

Aim. Determine the frequency of absence marker terminal deletions sY160 among men with microdeletions of AZFc region Y-chromosome. Methods. DNA from probands blood samples was isolated using a modified salting out method. Microdeletions of Y chromosome AZF region were analyzed using two multiplex PCR. The molecular-genetic study of terminal deletions (absence of sY160) was carried out using allele-specific PCR and analysed by electrophoresis in a 2 % agarose gel. Results. Among infertile men (1500 individuals), Y chromosome microdeletions were detected in 7% males: microdeletions of AZFa subregion in 1 %, AZFb subregion – 3 %, AZF(b+c) subregions – 15 %, AZFc subregion – 67 %. The presence of heterochromatin marker sY160 was confirmed in 39 cases (84.8 %) and absence of sY160 in 7 men (15.2 %). Absence of sY160 was detected in 2 men with AZFc microdeletion and in 5 men with AZFb+AZFc microdeletions. It is important to point out that terminal AZFc deletion was confirmed in 83.3 % of cases of AZFb+c microdeletions and only in 5.1 % of isolated AZFc microdeletions. Conclusions. Thus, among 15.2 % man with different AZF microdeletions of Y-chromosome the heterochromatin marker of terminal deletion sY160 was absents. The implementation of testing of marker of terminal deletion – sY160 may help to determine if the deletion corresponds to the b2/b4 pattern and to avoid biopsy in man which most likely not benefit from the surgical procedure. Keywords: male infertility, spermatogenesis, Y chromosome, AZF region, terminal deletions.