- Email: [email protected]
S103 OUTCOME OF MICRODISSECTION TESTICULAR SPERM EXTRACTION IN PATIENTS WITH NONMUSAIC KLINEFELTER SYNDROME
Poster Session 7 ANDROLOGY II Saturday, 15 October, 09.40-11.20, Poster session room 1
S99
Does the presence of antisperm antibodies of leuccocytes in semen influnces intrauterine insemination
Djordjevic D.1, Lalic N.1, Vukovic I.1, Dragicevic S.1, Tulic I.2, Micic S.1 1 Clinical Center of Serbia, Dept. of Urology, Belgrade, Serbia, 2Clinical Center of Serbia, Dept. of Gynecology and Obstetrics, Belgrade, Serbia Introduction & Objectives: During the sperm preparation for Intrauterine Insemination (IUI), characteristics such as Anti-Sperm Antibodies (ASA) and presence of leukoccytes are noted. ASA means immuological factor and may be related to leukoccytes presence, which is suspected contributing factor to male infertility. We hypothesized that the presence of ASA and leukoccytes would decrease likelihood of pregnancy. Material & Methods: This study was retrosperctive, review of IUI's performed 2005-2009 (n=132) microscopic examination of semen sample before and after preparation for IUI was performed. Antisperm antibodies were done by MAR-test and leukoccytes were dected by peroxidase-test. Results: Analysis performed on 189 IUI cycles involving 132 women (mean agr 31) immunologic problem was detected in 19 procedures (9.94%) overall, the presence of ASA positive or leukoccytes over 1mil/Ml was not associated with pregnancy in 19% versus negative ASA and lower than 1 mil/Ml in 14.3%.When stratified by sperm preparation method, the effect was greater in the "wash" method group than the density gradient group. Conclusions: Immunologic factor and leukoccytes have generally been a factor for poorer prognosis in IUI cycle. But the presence of ASA and high leukoccytes number in seminal plasma, during the preparation ejaaculate for IUI does not decrease the chance of pregnancy. Further investigation in a higher number of patients will evaluate these findings.
S100
Microdissection-sperm retrieval-TESE-optimal approach for patient with non-obstructive azoospermia
Kuzmanoski M.1, Dimitrov G.2, Hadzi-Lega M.2, Stojkovska S.2, Sotirovska V.2, Aidin B.2, Suslevski D.2, Matevski V.2, Petanovski Z.2 1 PGH Remedika, Dept. of Surgery, Skopje, Macedonia, 2PGH Remedika, Dept. of IVF, Skopje, Macedonia Introduction & Objectives: Evaluation of results of treatment of the first patients treated with microtese due to non-obstructive asoospermia. Material & Methods: From January to May 2011, 20 patients were undergone on testicular biopsy-microtese, by using operative microscope and microsurgical equipment. We analyzed-ultrasound of the testicles, semen analysis, hormonal status-FSH, LH,prolactin and testisterone-preoperatively and postoperatively, including-histological examination of the testicles and results of sperm retrieval. Results: Preoperatively-average testicular length-32,5 (22-43) mm, average homonal levels- FSH-7,9 (5,7-24) U/L, LH-6,1 (3,4-9,3) U/L, testosterone-643 (234-975) ng/dL, prolactin-347 (270-390) mlU/L. Postoperatively-sperm retrieval rate was- 80% (sperm found in 16 patients), histology-maturation arrest in 12, Sertoly Cell Only Sy-5,chronic orchitis in 3 patients, no diferences in testicular dimensions and hormonal status. Testicular tissue removed- 20-50mg, average sperm cincentration-0,0381milions/ml and 2%progressive motility. Conclusions: Microdisection-sperm retrieval, minimizes tissue removing, allows superior sperm retrieval rate, with no differences in hormonal status postoperatively.
S101
Trichomonas vaginalis as a rare cause of male factor infertility in a hospital at East Anatolia
Özdemir E.1, Keleştemur N.2, Kaplan M.2 1 Fırat University, Dept. of Urology, Elazığ, Turkey, 2Fırat University, Dept. of Parasitology, Elazığ, Turkey Introduction & Objectives: Trichomonas vaginalis was known as an important cause of sexually transmitted infection in developing countries. The prevalence and spectrum of Trichomonasis, in men is less characterized. Material & Methods: We analyzed the presence of T. vaginalis in 80 infertile males using wet mount microscopy, Giemsa staining, culture and PCR methods. Results: We found 2.5% positivity for T. vaginalis by using PCR method. Wet mount microscopy was ineffective. Giemsa staining and culture tests were positive only in one patient. Both of our PCR positive patients were symptomatic. Conclusions: Our findings suggest that T. vaginalis should be considered for the ethiology of the male factor infertility, though it is rare in developed countries.
S102
Semen quality and hormonal levels in infertile patients with varicocele
Pakevic N.1, Durutovic O.2, Vuksanovic A.2, Milojevic B.2, Lalic N.2, Micic S.2 1 Medical Center of Valjevo, Dept. of Urology, Valjevo, Serbia, 2Clinical Center of Serbia, Dept. of Urology, Belgrade, Serbia Introduction & Objectives: Infertility and varicocele is common fenomenon. Correlation sperm count and motility and varicocele existed in different grade. Hormonal levels explain pituitary-gonadal axis and suggest possible failure in spermatogenesis. Material & Methods: Aim of thisstudy was to evaluate the semen quality and the serum leves of Follicle Stimulating Hormone (FSH) and Testosterone (T) in infertile men with and without varicocele. We analysed 265 infertile men at andrology investigation. The study was retro-prospective one. All men were evaluated by history, physical examination, semen analysis, smen culture, serum FSH and T determination. Results: We observed 76 (28.6%) men with varicocele compared to 189 (71.4%) without varicocele. A significant lower percentage of motile spermatozoa (21.2317,88 vs 25.16-15.67,p<0.001) and lower sperm number (13.22-11,34 vs 17.4416.54, p<0.001) were observed in men with varicocele compared to men without varicocele. No significant difference were detected in sperm vitality between two gropus. Serum FSH (1o.12-7.34 vs 8.91-12,55,p<0.001) levels were significantly higher in men with varicocele tnah in those without varicocele. Serum testosterone levels were similar in these gropus. Conclusions: These findings suggest thar the presence of clinical varicocele rule out fertility in men affecting with hypothalamic pituitary-gonadal axis.
S103
Outcome of microdissection testicular sperm extraction in patients with nonmusaic klinefelter syndrome
Sagighi Gilani M.A.1, Sabbaghian M.1, Hosseini S.J.1, Farrahi F.1, Dadkhah F.1, Modarresi T.1, Khalili G.R.2 1 Royan Institute for Reproductive Biomedicine, Dept. of Andrology, Reproductive Biomedicine Research Center, Tehran, Iran, 2Royan Institute for Reproductive Biomedicine, Dept. of Epidemiology and Reproductive Health, Reproductive Biomedicine Research Center, Tehran, Iran Introduction & Objectives: Klinefelter Syndrome (KS) occurs in 1:500 to 1:1000 of male newborns and is the commonest chromosomal cause of non-obstructive azoospermia. Several reports have described successful pregnancy outcome in these patients using advanced assisted reproductive techniques such as microdissection testicular sperm extraction (MD-TESE) with Intracytoplasmic sperm injection (ICSI). Materials & Methods: We retrospectively evaluated the MD-TESE performance in 117 patients with classic KS referred to Royan Institute between 2009 and 2011. The patients were divided into two groups according to MD-TESE outcome. Several factors including patient age, level of Follicle-stimulating hormone (FSH), Luteinizing hormone (LH) and Testosterone were compared between the two groups. The mean male age of KS patients with successful sperm retrieval of spermatozoa was significantly younger when compared with those with unsuccessful retrieval of spermatozoa (30.2±4.1 versus 34.5±5.9, p<0.02). Results: Comparison of clinical factors between two groups showed that the level of testosterone was significantly higher in patients with successful sperm retrieval (3.39±2.97 versus 2.05±1.26, p<0.001). Also, in logistic regression with Backward method after adjusting on LH and FSH, age and testosterone were significantly different between two groups. Intracytoplasmic sperm injection with cryopreserved sperm was performed for 17 out of 35 patients and resulted in 3 clinical pregnancies. Conclusions: In conclusion, this is the largest study of sperm recovery and ICSI outcome in men with KS and shows that MD-TESE/ICSI is a successful intervention for the majority of men with klinefelter syndrome.
S104
Serum concentration on nitric oxide in patients with varicocele
Hiros M., Selimovic M., Spahovic H., Sadovic S. Clinical Center Sarajevo, Dept. of Urology, Sarajevo, Bosnia and Herzegovina Introduction & Objectives: It has been shown that NO pathway could have a key role in the progression of varicocele.The aim of this study was to determine serum concentration of NO in spermatic vein of patients with varicocele compared with peripheral blood samples of patients. Also we evaluated findings of spermatograms. Material & Methods: We have analysed the production of NO in 25 pts with varicocele. The diagnosis of varicocele was made on the basis of clinical examinations, CD and founding of spermatogram at the Urology Clinic University of Sarajevo clinical center. No levels in samples were determined by evaluation of its stable degradation products, nitrate and nitrite. NO concentration in serum was determined by classic colorimetric Griess reaction. Blood samples were taken for internal vein and peripheral vein.
Eur Urol Suppl 22011;10(9):599
S99
Does the presence of antisperm antibodies of leuccocytes in semen influnces intrauterine insemination
Djordjevic D.1, Lalic N.1, Vukovic I.1, Dragicevic S.1, Tulic I.2, Micic S.1 1 Clinical Center of Serbia, Dept. of Urology, Belgrade, Serbia, 2Clinical Center of Serbia, Dept. of Gynecology and Obstetrics, Belgrade, Serbia Introduction & Objectives: During the sperm preparation for Intrauterine Insemination (IUI), characteristics such as Anti-Sperm Antibodies (ASA) and presence of leukoccytes are noted. ASA means immuological factor and may be related to leukoccytes presence, which is suspected contributing factor to male infertility. We hypothesized that the presence of ASA and leukoccytes would decrease likelihood of pregnancy. Material & Methods: This study was retrosperctive, review of IUI's performed 2005-2009 (n=132) microscopic examination of semen sample before and after preparation for IUI was performed. Antisperm antibodies were done by MAR-test and leukoccytes were dected by peroxidase-test. Results: Analysis performed on 189 IUI cycles involving 132 women (mean agr 31) immunologic problem was detected in 19 procedures (9.94%) overall, the presence of ASA positive or leukoccytes over 1mil/Ml was not associated with pregnancy in 19% versus negative ASA and lower than 1 mil/Ml in 14.3%.When stratified by sperm preparation method, the effect was greater in the "wash" method group than the density gradient group. Conclusions: Immunologic factor and leukoccytes have generally been a factor for poorer prognosis in IUI cycle. But the presence of ASA and high leukoccytes number in seminal plasma, during the preparation ejaaculate for IUI does not decrease the chance of pregnancy. Further investigation in a higher number of patients will evaluate these findings.
S100
Microdissection-sperm retrieval-TESE-optimal approach for patient with non-obstructive azoospermia
Kuzmanoski M.1, Dimitrov G.2, Hadzi-Lega M.2, Stojkovska S.2, Sotirovska V.2, Aidin B.2, Suslevski D.2, Matevski V.2, Petanovski Z.2 1 PGH Remedika, Dept. of Surgery, Skopje, Macedonia, 2PGH Remedika, Dept. of IVF, Skopje, Macedonia Introduction & Objectives: Evaluation of results of treatment of the first patients treated with microtese due to non-obstructive asoospermia. Material & Methods: From January to May 2011, 20 patients were undergone on testicular biopsy-microtese, by using operative microscope and microsurgical equipment. We analyzed-ultrasound of the testicles, semen analysis, hormonal status-FSH, LH,prolactin and testisterone-preoperatively and postoperatively, including-histological examination of the testicles and results of sperm retrieval. Results: Preoperatively-average testicular length-32,5 (22-43) mm, average homonal levels- FSH-7,9 (5,7-24) U/L, LH-6,1 (3,4-9,3) U/L, testosterone-643 (234-975) ng/dL, prolactin-347 (270-390) mlU/L. Postoperatively-sperm retrieval rate was- 80% (sperm found in 16 patients), histology-maturation arrest in 12, Sertoly Cell Only Sy-5,chronic orchitis in 3 patients, no diferences in testicular dimensions and hormonal status. Testicular tissue removed- 20-50mg, average sperm cincentration-0,0381milions/ml and 2%progressive motility. Conclusions: Microdisection-sperm retrieval, minimizes tissue removing, allows superior sperm retrieval rate, with no differences in hormonal status postoperatively.
S101
Trichomonas vaginalis as a rare cause of male factor infertility in a hospital at East Anatolia
Özdemir E.1, Keleştemur N.2, Kaplan M.2 1 Fırat University, Dept. of Urology, Elazığ, Turkey, 2Fırat University, Dept. of Parasitology, Elazığ, Turkey Introduction & Objectives: Trichomonas vaginalis was known as an important cause of sexually transmitted infection in developing countries. The prevalence and spectrum of Trichomonasis, in men is less characterized. Material & Methods: We analyzed the presence of T. vaginalis in 80 infertile males using wet mount microscopy, Giemsa staining, culture and PCR methods. Results: We found 2.5% positivity for T. vaginalis by using PCR method. Wet mount microscopy was ineffective. Giemsa staining and culture tests were positive only in one patient. Both of our PCR positive patients were symptomatic. Conclusions: Our findings suggest that T. vaginalis should be considered for the ethiology of the male factor infertility, though it is rare in developed countries.
S102
Semen quality and hormonal levels in infertile patients with varicocele
Pakevic N.1, Durutovic O.2, Vuksanovic A.2, Milojevic B.2, Lalic N.2, Micic S.2 1 Medical Center of Valjevo, Dept. of Urology, Valjevo, Serbia, 2Clinical Center of Serbia, Dept. of Urology, Belgrade, Serbia Introduction & Objectives: Infertility and varicocele is common fenomenon. Correlation sperm count and motility and varicocele existed in different grade. Hormonal levels explain pituitary-gonadal axis and suggest possible failure in spermatogenesis. Material & Methods: Aim of thisstudy was to evaluate the semen quality and the serum leves of Follicle Stimulating Hormone (FSH) and Testosterone (T) in infertile men with and without varicocele. We analysed 265 infertile men at andrology investigation. The study was retro-prospective one. All men were evaluated by history, physical examination, semen analysis, smen culture, serum FSH and T determination. Results: We observed 76 (28.6%) men with varicocele compared to 189 (71.4%) without varicocele. A significant lower percentage of motile spermatozoa (21.2317,88 vs 25.16-15.67,p<0.001) and lower sperm number (13.22-11,34 vs 17.4416.54, p<0.001) were observed in men with varicocele compared to men without varicocele. No significant difference were detected in sperm vitality between two gropus. Serum FSH (1o.12-7.34 vs 8.91-12,55,p<0.001) levels were significantly higher in men with varicocele tnah in those without varicocele. Serum testosterone levels were similar in these gropus. Conclusions: These findings suggest thar the presence of clinical varicocele rule out fertility in men affecting with hypothalamic pituitary-gonadal axis.
S103
Outcome of microdissection testicular sperm extraction in patients with nonmusaic klinefelter syndrome
Sagighi Gilani M.A.1, Sabbaghian M.1, Hosseini S.J.1, Farrahi F.1, Dadkhah F.1, Modarresi T.1, Khalili G.R.2 1 Royan Institute for Reproductive Biomedicine, Dept. of Andrology, Reproductive Biomedicine Research Center, Tehran, Iran, 2Royan Institute for Reproductive Biomedicine, Dept. of Epidemiology and Reproductive Health, Reproductive Biomedicine Research Center, Tehran, Iran Introduction & Objectives: Klinefelter Syndrome (KS) occurs in 1:500 to 1:1000 of male newborns and is the commonest chromosomal cause of non-obstructive azoospermia. Several reports have described successful pregnancy outcome in these patients using advanced assisted reproductive techniques such as microdissection testicular sperm extraction (MD-TESE) with Intracytoplasmic sperm injection (ICSI). Materials & Methods: We retrospectively evaluated the MD-TESE performance in 117 patients with classic KS referred to Royan Institute between 2009 and 2011. The patients were divided into two groups according to MD-TESE outcome. Several factors including patient age, level of Follicle-stimulating hormone (FSH), Luteinizing hormone (LH) and Testosterone were compared between the two groups. The mean male age of KS patients with successful sperm retrieval of spermatozoa was significantly younger when compared with those with unsuccessful retrieval of spermatozoa (30.2±4.1 versus 34.5±5.9, p<0.02). Results: Comparison of clinical factors between two groups showed that the level of testosterone was significantly higher in patients with successful sperm retrieval (3.39±2.97 versus 2.05±1.26, p<0.001). Also, in logistic regression with Backward method after adjusting on LH and FSH, age and testosterone were significantly different between two groups. Intracytoplasmic sperm injection with cryopreserved sperm was performed for 17 out of 35 patients and resulted in 3 clinical pregnancies. Conclusions: In conclusion, this is the largest study of sperm recovery and ICSI outcome in men with KS and shows that MD-TESE/ICSI is a successful intervention for the majority of men with klinefelter syndrome.
S104
Serum concentration on nitric oxide in patients with varicocele
Hiros M., Selimovic M., Spahovic H., Sadovic S. Clinical Center Sarajevo, Dept. of Urology, Sarajevo, Bosnia and Herzegovina Introduction & Objectives: It has been shown that NO pathway could have a key role in the progression of varicocele.The aim of this study was to determine serum concentration of NO in spermatic vein of patients with varicocele compared with peripheral blood samples of patients. Also we evaluated findings of spermatograms. Material & Methods: We have analysed the production of NO in 25 pts with varicocele. The diagnosis of varicocele was made on the basis of clinical examinations, CD and founding of spermatogram at the Urology Clinic University of Sarajevo clinical center. No levels in samples were determined by evaluation of its stable degradation products, nitrate and nitrite. NO concentration in serum was determined by classic colorimetric Griess reaction. Blood samples were taken for internal vein and peripheral vein.
Eur Urol Suppl 22011;10(9):599