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Andrology
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Q11–16. Semen analysis<4% normal forms<32% motile sperms<15 million/mL39≥7.215>1.5
Semen Analysis
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Meaghanne K. Caraballo, Alyssa M. Giroski, Rakesh Sharma, Ashok Agarwal
Conducting a routine semen analysis is the first step of laboratory evaluation of semen analysis. It is comprised of both macroscopic and microscopic tests conducted using the recommendations set forth by WHO. In addition, advanced sperm tests comprised of ROS, TAC, SDF, and ORP can be included. These tests can provide additional information on the quality of the semen to the clinician in the management of male infertility.
Urology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Surgery cannot reverse the maturational failure of the undescended testis but it can reduce the impact from further thermal injury. Historical data have documented normal semen analysis in 60% of men with unilateral and 25% of those with bilateral undescended testis, although paternity is achieved by up to 90% and 65%, respectively. Since then, the recommended age for orchidepexy has steadily decreased. So far, improved sperm counts and mobility as well as a reduced malignancy risk have been reported. The risk of malignancy is estimated to be 2–3 times that of the normal population for boys who had an orchidopexy before puberty. Monthly testicular self-examination should commence at puberty.
Analysis of blocking antibodies and lymphocyte subsets in patients with recurrent reproductive failure
Published in Human Fertility, 2022
Jingbo Gao, Huimin Guo, Lei Zhu, Bo Yang, Jinli Zhang, Kai Xu, Chaoqun Hao
This was a retrospective analysis of RRF patients in our hospital’s Reproductive Centre from April 2015 to October 2019. All subjects were asked to sign an informed consent before the study. This study was approved by our Hospital’s Ethics Committee (Ref: IRB-KY-2017). The selection criteria were as follows: (i) ≥3 spontaneous abortions in RSA patients; (ii) ≥3 embryo transfers without pregnancy in RIF patients. In each case, the BA and lymphocyte subsets were detected. Exclusion criteria: (i) abnormal anatomical structure of uterus; (ii) luteal dysfunction; (iii) chromosome karyotype abnormality in the woman or her partner; (iv) abnormal semen analysis; (v) thyroid dysfunction; (vi) positive for hepatitis B, C, syphilis or HIV; (vii) positive for antinuclear antibody, anticardiolipin antibody or anti-DNA antibody; (viii) positive for antisperm antibody or antithyroid antibody. In total there were 411 patients with RSA and 309 patients with RIF meeting the inclusion criteria.
Is there a role for phosphodiesterase inhibitors in the treatment of male subfertility?
Published in Human Fertility, 2022
Abigail Sharpe, Harish Bhandari, David Miller
Infertility affects one in seven couples with the male partner contributing to at least 37% of all cases (Human Fertilisation & Embryology Authority, 2018). In up to 60% of infertile couples investigated, an abnormal semen analysis is found, which may be explained by genetic, endocrine, structural conditions and/or medication exposure. However, in 50% of these abnormal semen analyses, no clear reason for this (idiopathic) is apparent (Dohle et al., 2005; Poongothai et al., 2009). ICSI (Intracytoplasmic Sperm Injection) involves micro-manipulation of gametes during assisted reproductive technology (ART) treatment where a single spermatozoon is injected directly into the oocyte and is frequently offered to treat male factor infertility (National Institute for Health & Care Excellance, 2013; Palermo et al., 1992). Hence, men with low sperm counts or reduced sperm motility are now able to father a child biologically. However, ICSI bypasses the ‘natural selection’ process where sperm are required to swim across the female genital tract to fertilise the egg and the laboratory selection of sperm for ICSI does not currently include an assessment of how well the sperm functions or whether it is sufficiently viable to support pregnancy (Esteves et al., 2018).
The effect of micronutrient supplementation on spermatozoa DNA integrity in subfertile men and subsequent pregnancy rate
Published in Gynecological Endocrinology, 2021
Markus Lipovac, Verena Nairz, Judith Aschauer, Claus Riedl
Infertility is defined as failure to conceive after one year of regular and unprotected intercourse, and is defined as no pregnancy within six cycles. Up to 15% of couples suffer from primary or secondary infertility, a situation that may increase relationship break-up [1]. A 25–30% of subfertility/infertility cases are caused by male factors, which can be diagnosed through semen analysis [2]. Semen analysis provides an overview of its quality: motility, morphology, vitality, and sperm cell concentration. Causes of pathological semen analysis include hypogonadism, varicoceles, genital tract infections, or sperm cell autoantibodies. Despite this, in more than half of cases the underlying causes for a pathological semen analysis are unknown [3]. In fact, in nearly 15% of all couples with male factor subfertility/infertility, the standard semen analysis does not reveal abnormalities. Perhaps these cases are related to decreased sperm DNA integrity [4]. Current studies have shown that DNA integrity plays an important role during fertilization and early pregnancy. A direct correlation has been observed between decreased sperm DNA integrity and decreased pregnancy rates (natural and artificial) [5–8], and higher miscarriage rate [9]. DNA damage can be caused by intrinsic (i.e. pathological sperm cell maturation or oxidative stress) or extrinsic factors (i.e. varicoceles, infections, or advanced age) [10]. In 8% of males with decreased sperm DNA integrity, no abnormality can be found upon conventional sperm analysis [5].