Speciality
Spotlight

 




 


Oncology


 

 






Infertility

    

  • JF Jr Donovan, M DiBause, AET Sparks, et al [ Univ of lowa City]

    Comparison of Microscopic Epididymal Sperm Aspiration and Intracytoplasmic Sperm Injection / In-vitro fertilization With repeat Microscopic Reconstruction Following Vasectomy : Is second Attempt Vas Reversal Worth the Effort ?

    Hum Reprod 13: 387-393, 1998

        


    Conclusion – The effect of ICSI on the treatment of infertility in men with congenital absence of the vas deferens is profound. As efficacy rates increase and costs decline, the use of epididymal or testicular sperm retrieval may become the treatment of choice in men with obstructive azospermia.However, microsurgical reconstruction is currently the most appropriate approach for obstruction of the excurrent duct system, even in men who have failed previous vasovasostomy

        

  • Madgar I, A Hourvitz, J Levron et al [ Tel Aviv Univ, Isreal; assuta Med Ctr, Tel Aviv, Israel]

    Outcome of In vitro fertilization and Intracytoplasmic Injection of Epididymal and Testicular Sperm Extracted from Patients with Obstructive and Nonobstructive Azoospermia

    Fertil Steril 69: 1080-1084, 1998

       


    Methods – 63 patients [103 cycles] with obstructive azoospermia underwent epididymal or testicular sperm retrieval [group 1], and 60 [75 cycles] with nonobstructive azoospermia underwent testicular sperm retrieval combined with in vitro fertilization treatment [group 2].

      


    Findings – Fertilization rates were 48.4% 41.5% in groups 1 & 2 respectively, a nonsignificant difference.

       


    The clinical pregnancy rates per embryo transfer cycle were 24% in group 1 and 17.7% in group 2. Oocyte fertilization rates with fresh and frozen thawed spermatozoa were 23.6% and 14.3% respectively and did not differ significantly between groups.

         

  • Rucker GB, Mielnik A, King P, et al [ New York Hosp-Cornell Med Ctr; Polulation Council New York]

    Preoperative Screening for Genetic Abnormalities in Men With Nonobstructive Azoospermia Before Testicular Sperm Extraction 

    J Urol 160: 2068-2971, 1998

        


    Results – There were 33 of 190 men [17%] with genetic abnormalities.

         


    21% had 9% had Y chromosomal partial deletion. Before testicular sperm extraction, genetic counseling was conducted in 32 men.

        


    In 21% of couples in which the man had a genetic abnormality, knowledge of the specific genetic detect resulted in a change of clinical
    management
    12 men with non obstructive azoospermia who are candidates for testicular sperm extraction with intracytoplasmic sperm injection, preoperative genetic screening is important.

          

  • Bettocchi C, Parkinson MC, Ralph DJ, et al [Univ of Bari, Italy; Univ College London]

    Clinical Aspects Associated with Sertoli-Cell-Only Histology

    Br J Urol 82: 534-537, 1998

        


    Conclusions– sertoli cell only syndrome presents with varying phenotypes with or without Y-chromosomal microdeletions. 

        


    The likelyhood of sperm recovery with testicular sperm extraction in SCO is about 30%.

        


    It is advisable to perform concurrent testicular sperm extraction with cryopresevation at the time of diagnostic tests biopsy to identify those men in whom in vitro fertilization/intractoplasmic sperm injection may be feasible.

         

  • Zavos PM, Correa JR, Karagounis CS, et al [ Andrology Inst of Lexington, Ky; Univ of Salonika, Greece; Univ of Kentucky, Lexington]

    An Electron Microscope Study of the Axonemal Ultrastructure in Human Spermatozoa from Male Smokers and Nonsmokers

    Fertil steril 69: 430-434, 1998

          


    Conclusions – Compared with nonsmokers, smokers had changes in the number and arrangement of axonemal microtubules. The incidence of axonemal abnormalities was greater in spermatozoa from smokers than from
    nomsmokers.

         

  • Zavos PM, Correa JR, Antypas S, et al [ Andrology Inst of Lexington, Ky; Children’s Hosp “Ayia Sofia” , Athens, Greece, Greek-American Andrology Inst of Athens, Greece]

    Effects of Seminal Plasma from Cigarette Smokers on Sperm Viability and Longevity

    Fertil Steril 69: 425-429, 1998

         

    Findings – The quality of spermatozoa from non smokers was higher than that from smokers. The seminal plasma from the 2 groups had clear effect on the respective sperm quality. Beneficial for non-smokers and detrimental for non-smokers.

        


    Exposing spermatozoa from non-smokers to seminal plasma of smokers significantly decreased sperm viability.

        


    Exposing spermatozoa from smokers to seminal plasma of non smoker significantly improved sperm viability.


           

  • GJ Matthews, ED Mattews, M Goldstein [New York Hosp-cornell Med Ctr]

    Induction of Spermatogenesis and Achievement of Azoospermia and Severe Oilgoasthenospermia

    Fertil Steril 70: 71-75; 1998 

       

    After vaicocele repair, 55% of the 22 men with azoospermia and 69% of the 51 men with no motile sperm before surgery had motile sperm in their ejaculate. The mean total number of motile sperm per ejaculate rose from 0.08 x 106 before varicocelectomy to 7.2 x 106 afterward.

     


    Conclusions – 31% of men with azoospermia or severe oligoasthenospermia should be considered for varicocele repair. In most men in this series, treatment resulted in induction or enhancement of spermatogenesis. Unassisted pregnancies after varicocele repair are, apparently, not possible when men have profound abnormalities of spermatogenesis.

       

  • R
    Munkelwitz, BR Gilbert, [ State Univ of New York at Stony Brook]

    Are Boxer Shorts Really Better ? A Critical Analysis of the Role of Underwear Type in Male Subfertility

    J Urol 160: 1329-1333, 1998

      


    Conclusion – The hyperthermic effect of brief style underwear has been exaggerated. 

      


    Underwear type does not affect scrotal temperature. It is unlikely that male fertility is affected by underwear type. 

      


    Available scientific evidence does not support routinely advising infertility patients to wear boxer shorts.


       

  • TM Jaffe, ED Kim, TH Hoekstra, et al [ Baylor College of Medicine, Houston] 

    Sperm Pellet Analysis : A Technique to Detect the Presence of sperm in Men Considered to Have Azoospermia by routine semen Analysis

    J Urol 159: 1548-1550, 1998

      


    Background – Sperm may be identified after centrifuging semen from men with azoospermia detected by routine semen analyses. These sperm may be used for intracytoplasmic sperm injection. 

      


    Conclusions – Motile and nonmotile sperm were detected in 18.6% of men with obstructive azoospermia and 22.8% with nonobstructive azoospermia.

      


    Multiple sperm pelleting should be performed, especially in those with testicular failure because IVF with intracytoplasmic sperm injection is now widely available.


        


 

 



 

 

Speciality Spotlight

 

 

Infertility
    

  • JF Jr Donovan, M DiBause, AET Sparks, et al [ Univ of lowa City]
    Comparison of Microscopic Epididymal Sperm Aspiration and Intracytoplasmic Sperm Injection / In-vitro fertilization With repeat Microscopic Reconstruction Following Vasectomy : Is second Attempt Vas Reversal Worth the Effort ?
    Hum Reprod 13: 387-393, 1998
        
    Conclusion – The effect of ICSI on the treatment of infertility in men with congenital absence of the vas deferens is profound. As efficacy rates increase and costs decline, the use of epididymal or testicular sperm retrieval may become the treatment of choice in men with obstructive azospermia.However, microsurgical reconstruction is currently the most appropriate approach for obstruction of the excurrent duct system, even in men who have failed previous vasovasostomy
        

  • Madgar I, A Hourvitz, J Levron et al [ Tel Aviv Univ, Isreal; assuta Med Ctr, Tel Aviv, Israel]
    Outcome of In vitro fertilization and Intracytoplasmic Injection of Epididymal and Testicular Sperm Extracted from Patients with Obstructive and Nonobstructive Azoospermia
    Fertil Steril 69: 1080-1084, 1998
       
    Methods – 63 patients [103 cycles] with obstructive azoospermia underwent epididymal or testicular sperm retrieval [group 1], and 60 [75 cycles] with nonobstructive azoospermia underwent testicular sperm retrieval combined with in vitro fertilization treatment [group 2].
      
    Findings – Fertilization rates were 48.4% 41.5% in groups 1 & 2 respectively, a nonsignificant difference.
       
    The clinical pregnancy rates per embryo transfer cycle were 24% in group 1 and 17.7% in group 2. Oocyte fertilization rates with fresh and frozen thawed spermatozoa were 23.6% and 14.3% respectively and did not differ significantly between groups.
         

  • Rucker GB, Mielnik A, King P, et al [ New York Hosp-Cornell Med Ctr; Polulation Council New York]
    Preoperative Screening for Genetic Abnormalities in Men With Nonobstructive Azoospermia Before Testicular Sperm Extraction 
    J Urol 160: 2068-2971, 1998
        
    Results – There were 33 of 190 men [17%] with genetic abnormalities.
         
    21% had 9% had Y chromosomal partial deletion. Before testicular sperm extraction, genetic counseling was conducted in 32 men.
        
    In 21% of couples in which the man had a genetic abnormality, knowledge of the specific genetic detect resulted in a change of clinical management 12 men with non obstructive azoospermia who are candidates for testicular sperm extraction with intracytoplasmic sperm injection, preoperative genetic screening is important.
          

  • Bettocchi C, Parkinson MC, Ralph DJ, et al [Univ of Bari, Italy; Univ College London]
    Clinical Aspects Associated with Sertoli-Cell-Only Histology
    Br J Urol 82: 534-537, 1998
        
    Conclusions– sertoli cell only syndrome presents with varying phenotypes with or without Y-chromosomal microdeletions. 
        
    The likelyhood of sperm recovery with testicular sperm extraction in SCO is about 30%.
        
    It is advisable to perform concurrent testicular sperm extraction with cryopresevation at the time of diagnostic tests biopsy to identify those men in whom in vitro fertilization/intractoplasmic sperm injection may be feasible.
         

  • Zavos PM, Correa JR, Karagounis CS, et al [ Andrology Inst of Lexington, Ky; Univ of Salonika, Greece; Univ of Kentucky, Lexington]
    An Electron Microscope Study of the Axonemal Ultrastructure in Human Spermatozoa from Male Smokers and Nonsmokers
    Fertil steril 69: 430-434, 1998
          
    Conclusions – Compared with nonsmokers, smokers had changes in the number and arrangement of axonemal microtubules. The incidence of axonemal abnormalities was greater in spermatozoa from smokers than from nomsmokers.
         

  • Zavos PM, Correa JR, Antypas S, et al [ Andrology Inst of Lexington, Ky; Children’s Hosp “Ayia Sofia” , Athens, Greece, Greek-American Andrology Inst of Athens, Greece]
    Effects of Seminal Plasma from Cigarette Smokers on Sperm Viability and Longevity
    Fertil Steril 69: 425-429, 1998
         
    Findings – The quality of spermatozoa from non smokers was higher than that from smokers. The seminal plasma from the 2 groups had clear effect on the respective sperm quality. Beneficial for non-smokers and detrimental for non-smokers.
        
    Exposing spermatozoa from non-smokers to seminal plasma of smokers significantly decreased sperm viability.
        
    Exposing spermatozoa from smokers to seminal plasma of non smoker significantly improved sperm viability.

           

  • GJ Matthews, ED Mattews, M Goldstein [New York Hosp-cornell Med Ctr]
    Induction of Spermatogenesis and Achievement of Azoospermia and Severe Oilgoasthenospermia
    Fertil Steril 70: 71-75; 1998 
       
    After vaicocele repair, 55% of the 22 men with azoospermia and 69% of the 51 men with no motile sperm before surgery had motile sperm in their ejaculate. The mean total number of motile sperm per ejaculate rose from 0.08 x 106 before varicocelectomy to 7.2 x 106 afterward.
     
    Conclusions – 31% of men with azoospermia or severe oligoasthenospermia should be considered for varicocele repair. In most men in this series, treatment resulted in induction or enhancement of spermatogenesis. Unassisted pregnancies after varicocele repair are, apparently, not possible when men have profound abnormalities of spermatogenesis.
       

  • R Munkelwitz, BR Gilbert, [ State Univ of New York at Stony Brook]
    Are Boxer Shorts Really Better ? A Critical Analysis of the Role of Underwear Type in Male Subfertility
    J Urol 160: 1329-1333, 1998
      
    Conclusion – The hyperthermic effect of brief style underwear has been exaggerated. 
      
    Underwear type does not affect scrotal temperature. It is unlikely that male fertility is affected by underwear type. 
      
    Available scientific evidence does not support routinely advising infertility patients to wear boxer shorts.

       

  • TM Jaffe, ED Kim, TH Hoekstra, et al [ Baylor College of Medicine, Houston] 
    Sperm Pellet Analysis : A Technique to Detect the Presence of sperm in Men Considered to Have Azoospermia by routine semen Analysis
    J Urol 159: 1548-1550, 1998
      
    Background – Sperm may be identified after centrifuging semen from men with azoospermia detected by routine semen analyses. These sperm may be used for intracytoplasmic sperm injection. 
      
    Conclusions – Motile and nonmotile sperm were detected in 18.6% of men with obstructive azoospermia and 22.8% with nonobstructive azoospermia.
      
    Multiple sperm pelleting should be performed, especially in those with testicular failure because IVF with intracytoplasmic sperm injection is now widely available.

        

 

 

 

By |2022-07-20T16:42:24+00:00July 20, 2022|Uncategorized|Comments Off on Infertility

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