RESUMEN
OBJECTIVE: Despite higher sperm DNA fragmentation may affect intracytoplasmic sperm injection (ICSI) outcomes, sperm selection protocols do not evaluate this parameter. Therefore, sperm's head birefringence has been suggested as an adjuvant of seminal processing to select viable sperm for couples with severe male factor. Considering men with normal seminal parameters may also curse with DNA fragmentation, the aim of this study was to evaluate the impact of sperm selection by birefringence on ICSI outcomes in couples with different infertility factors compared to those submitted to conventional sperm selection. METHODS: In this case-control study, medical records from 181 couples who underwent ICSI from January 2018 to August 2020 (107 from the Conventional and 74 from the Birefringence group) were included in the study. Clinical characteristics and ICSI outcomes were compared between the groups using Student's t test or Chi-square test (p<0.05) and a multivariate logistic regression model was applied regarding clinical pregnancy. RESULTS: Despite the Birefringence group showed higher female age (p=0.01), lower seminal sperm concentration (p<0.01) and higher sperm DNA fragmentation (p<0.01), those patients cursed with both higher cleavage rate (p=0.04), clinical pregnancy rate per transfer (p=0.03) and clinical pregnancy rate per initiated cycle (p=0.02). The logistic regression showed a positive group effect on clinical pregnancy. CONCLUSIONS: The findings suggest a positive clinical impact of this cheap and easily reproducible adjuvant technique on ICSI outcomes in couples with different infertility factors. If confirmed by further methodologically appropriate studies, the sperm's head birefringence could be considered to improve the reproductive chances of those patients.
Asunto(s)
Infertilidad Masculina , Inyecciones de Esperma Intracitoplasmáticas , Embarazo , Humanos , Masculino , Femenino , Inyecciones de Esperma Intracitoplasmáticas/métodos , Estudios de Casos y Controles , Birrefringencia , Semen , Espermatozoides , Infertilidad Masculina/terapia , Infertilidad Masculina/genéticaRESUMEN
Este relato de caso trata de uma paciente com hipotireoidismo, que apresentou tumor ovariano raro, de tecido tireoidiano, denominado Struma ovarii. Em análise da literatura, somente 5% dos casos associa-se a hipertireoidismo, não havendo relatos de associação a hipotireoidismo. Foram demonstradas imagens de ultrassonografia, laparoscopia e histologia do tumor, e realizadas comparações clínicas com as características previamente descritas sobre esse tipo de tumor
This case report is about a patient with hypothyroidism who presented a rare ovarian tumor containing thyroid tissue, known as struma ovarii. According to the literature, only 5% of the cases are associated with hyperthyroidism and there are no reports of an association with hypothyroidism. Ultrasound, laparoscopic and histological images of the tumor were compared with the characteristics of this type of tumor described in the literature
