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1.
J Urol ; 203(1): 48-56, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31042452

RESUMO

PURPOSE: We evaluated the impact of varicocele grade on the response to varicocelectomy or spermatic vein embolization. MATERIALS AND METHODS: We systematically reviewed the published English language literature to identify studies on changes in semen quality and pregnancy outcomes after varicocele treatment, stratified by varicocele grade. Descriptive statistics and continuous random effects models were used to study the impact of varicocele grade and the surgical approach on the response to treatment. Result heterogeneity among studies was analyzed using the I2 statistic. Quality assessment of nonrandomized studies was done with the Newcastle-Ottawa Scale. Publication bias was analyzed using funnel plots and the Egger test. RESULTS: We identified 20 studies describing the outcome of varicocele treatment stratified by varicocele grade in a total of 2,001 infertile men with varicocele. A microsurgical approach (inguinal, subinguinal and/or Palomo) was used in 11 of the 20 studies (55%). Varicocele treatment was associated with improvements in sperm concentration and overall motility in patients with all grades of varicocele. Semen quality improvements were directly related to varicocele grade. The mean sperm concentration improvement in men with grades 1, 2, 2-3 and 3 varicoceles were 5.5, 8.9, 12.7 and 16.0 million sperm per ml, respectively. The mean improvement in the percent of overall motility in men with grades 1, 2, 2-3 and 3 varicoceles was 9.6%, 10.6%, 10.8% and 17.7%, respectively. Pregnancy outcomes were assessed but could not be analyzed systematically due to the lack of adequate published data. CONCLUSIONS: Mean improvements in the sperm concentration and the percent of overall motility after treatment of grade 1 varicocele were statistically significant but small in magnitude. In contrast, mean improvements in the sperm concentration and the percent of overall motility after treatment of grade 2-3 varicoceles were greater and highly likely to be clinically significant. Incorporating varicocele grade into shared decision making discussions with affected couples may improve the ability to select patients who are the best candidates for treatment.


Assuntos
Varicocele/cirurgia , Adulto , Feminino , Humanos , Infertilidade Masculina/etiologia , Masculino , Microcirurgia , Gravidez , Taxa de Gravidez , Análise do Sêmen , Varicocele/complicações
2.
Urologiia ; (5): 94-97, 2019 Dec.
Artigo em Russo | MEDLINE | ID: mdl-31808639

RESUMO

INTRODUCTION: Feasibility of prophylactic varicocelectomy in adolescents is under discussion, which determines the importance of studying the frequency of paternity among men who were actively monitored. AIM: to evaluate a paternity rate in a group of adult men who have not undergone varicocelectomy in childhood or adolescence. MATERIALS AND METHODS: The paternity rate was evaluated using a questionnaire-based survey carried out in 2018 among men who were actively monitored for unilateral varicocele with ipsilateral testicular hypotrophy during adolescence in 1999-2004. A total of 202 questionnaires were sent out checking whether the recipients were willing to have children. Median age at the time of the varicocele diagnosis was 15 years [Q1; Q3] (13-17). At the time of diagnosis, varicocele of grade III was found in 114 (93.4%) boys, and in 8 (6.6%) children, varicocele of grade II was seen. RESULTS: A total of 142 respondents were enrolled. Median age of the participants was 31 (29; 34). 20 men were excluded from the survey, due to prophylactic varicocelectomy (n=8, 5.6%), other reproductive diseases (n=4, 2.8%), previous radiotherapy or chemotherapy (n=2, 1.4%) and reproductive pathologies in the spouses (n=6, 4.2%). 16 (13.1%) participants were not planning to have children. Among the remaining, 9 respondents (6.6%) had no children. Varicocelectomy was carried out in 17 (16.3%) patients due to infertility, and 14 (82.3%) subsequently became fathers. 83 (78.3%) patients had one or more children as a result of spontaneous pregnancy. Paternity frequency in the surveyed group was 91.5%. CONCLUSION: Our results demonstrate high paternity frequency among men with asymptomatic left-sided varicocele accompanied by ipsilateral testicular hypotrophy during childhood and adolescence who were actively monitored without surgical treatment.


Assuntos
Infertilidade Masculina/etiologia , Paternidade , Testículo/patologia , Varicocele/complicações , Adulto , Feminino , Humanos , Masculino , Gravidez , Varicocele/patologia
3.
Endocrinology ; 160(11): 2719-2736, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31513269

RESUMO

The increasing occurrence of obesity has become a significant public health concern. Individuals with obesity have higher prevalence of heart disease, stroke, osteoarthritis, diabetes, and reproductive disorders. Reproductive problems include menstrual irregularities, pregnancy complications, and infertility due to anovulation, in women, and lower testosterone and diminished sperm count, in men. In particular, women with obesity have reduced levels of both gonadotropin hormones, and, in obese men, lower testosterone is accompanied by diminished LH. Taken together, these findings indicate central dysregulation of the hypothalamic-pituitary-gonadal axis, specifically at the level of the GnRH neuron function, which is the final brain output for the regulation of reproduction. Obesity is a state of hyperinsulinemia, hyperlipidemia, hyperleptinemia, and chronic inflammation. Herein, we review recent advances in our understanding of how these metabolic and immune changes affect hypothalamic function and regulation of GnRH neurons. In the latter part, we focus on neuroinflammation as a major consequence of obesity and discuss findings that reveal that GnRH neurons are uniquely positioned to respond to inflammatory changes.


Assuntos
Infertilidade Feminina/etiologia , Infertilidade Masculina/etiologia , Obesidade/complicações , Animais , Feminino , Humanos , Hipotálamo/metabolismo , Infertilidade Feminina/metabolismo , Infertilidade Masculina/metabolismo , Inflamação/etiologia , Masculino , Sistemas Neurossecretores/metabolismo , Obesidade/metabolismo , Reprodução
4.
Medicine (Baltimore) ; 98(32): e16677, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393367

RESUMO

BACKGROUND: Male infertility has become a worldwide public health problem. However, the effect of low body mass index (BMI) is still controversial. METHODS: Relevant articles in Pubmed, Embase, Web of science, and Wanfang database published until September 2017 were searched without language restriction. We performed a meta-analysis about low BMI and semen parameters containing total sperm count, concentration, semen volume, and sperm motility (overall and progressive), including 709 men with low BMI and 14,622 men with normal BMI. RESULTS: Thirteen studies were included in this meta-analysis and a total of 15,331 individuals were accumulated. We pooled data from these articles and found standardized weighted mean differences in semen parameters (total sperm count and semen volume) showed significant difference between low BMI and normal BMI. CONCLUSIONS: This systematic review with meta-analysis has confirmed that there was a relationship between low BMI and semen quality, which suggesting low BMI may be a harmful factor of male infertility. Yet lacking of the raw data may influence the accuracy of the results. Further researches are needed to identify the role of underweight in male sterility.


Assuntos
Contagem de Espermatozoides/estatística & dados numéricos , Motilidade Espermática/fisiologia , Magreza/fisiopatologia , Índice de Massa Corporal , Estudos de Casos e Controles , Humanos , Infertilidade Masculina/etiologia , Masculino , Fatores de Risco , Magreza/complicações
6.
Medicine (Baltimore) ; 98(31): e16543, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374016

RESUMO

BACKGROUND: Number of studies have been performed to investigate the relationship between the CYP1A1 rs4646903 polymorphism and male infertility risk, but the sample size was small and the results were conflicting. A meta-analysis was performed to assess these associations. METHODS: A systematic search was conducted to identify all relevant studies from Medline, Web of science, Embase, China biology medical literature database (CBM), China National Knowledge Infrastructure (CNKI), WanFang and Weipu (VIP) databases up to June 30, 2018. The odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of associations. All of the statistical analyses were conducted using Revman 5.3 and Stata 14.0. RESULTS: Ten studies involved 3028 cases and 3258 controls. Overall, significant association was observed between the CYP1A1 rs4646903 polymorphism and male infertility (C vs T: OR = 1.42, 95%CI = 1.14-1.76; CC vs TT: OR = 2.13, 95%CI = 1.36-3.34; CC vs CT+TT: OR = 1.96, 95%CI = 1.30-2.95; CC+CT vs TT: OR = 1.51, 95%CI = 1.16-1.97). In subgroup analysis by ethnic group, a statistically significant association was observed in Asians (C vs T: OR = 1.59, 95%CI = 1.22-2.08), but not in Non-Asians (C vs T: OR = 1.01, 95%CI = 0.79-1.30). Additionally, none of the individual studies significantly affected the association between CYP1A1 rs4646903 polymorphism and male infertility, according to sensitivity analysis. CONCLUSION: Our meta-analysis supports that the CYP1A1 rs4646903 polymorphism might contribute to individual susceptibility to male infertility in Asians.


Assuntos
Citocromo P-450 CYP1A1/genética , Infertilidade Masculina/etiologia , Infertilidade Masculina/genética , Predisposição Genética para Doença , Humanos , Masculino , Razão de Chances
7.
J Clin Pathol ; 72(9): 579-587, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31296604

RESUMO

Subfertility affects one in seven couples and is defined as the inability to conceive after 1 year of regular unprotected intercourse. This article describes the initial clinical evaluation and investigation to guide diagnosis and management. The primary assessment of subfertility is to establish the presence of ovulation, normal uterine cavity and patent fallopian tubes in women, and normal semen parameters in men. Ovulation is supported by a history of regular menstrual cycles (21-35 days) and confirmed by a serum progesterone >30 nmol/L during the luteal phase of the menstrual cycle. Common causes of anovulation include polycystic ovary syndrome (PCOS), hypothalamic amenorrhoea (HA) and premature ovarian insufficiency (POI). Tubal patency is assessed by hysterosalpingography, hystero-contrast sonography, or more invasively by laparoscopy and dye test. The presence of clinical or biochemical hyperandrogenism, serum gonadotrophins (luteinising hormone/follicle stimulating hormone) / oestradiol, pelvic ultrasound to assess ovarian morphology / antral follicle count, can help establish the cause of anovulation. Ovulation can be restored in women with PCOS using letrozole (an aromatase inhibitor), clomifene citrate (an oestrogen antagonist) or exogenous gonadotrophin administration. If available, pulsatile gonadotrophin releasing hormone therapy is the preferred option for restoring ovulation in HA. Spermatogenesis can be induced in men with hypogonadotrophic hypogonadism with exogenous gonadotrophins. Unexplained subfertility can be treated with in vitro fertilisation after 2 years of trying to conceive. Involuntary childlessness is associated with significant psychological morbidity; hence, expert assessment and prompt treatment are necessary to support such couples.


Assuntos
Fertilidade , Infertilidade Feminina/terapia , Infertilidade Masculina/terapia , Técnicas de Reprodução Assistida , Feminino , Humanos , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/etiologia , Infertilidade Feminina/fisiopatologia , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/etiologia , Infertilidade Masculina/fisiopatologia , Masculino , Ovulação , Valor Preditivo dos Testes , Gravidez , Fatores de Risco , Espermatogênese , Tempo para Engravidar , Resultado do Tratamento
8.
Lakartidningen ; 1162019 Jul 19.
Artigo em Sueco | MEDLINE | ID: mdl-31334817

RESUMO

The most severe form of male infertility is non obstructive azoospermia (NOA), where spermatogenesis is impaired or absent. If testicular sperm can be retrieved, men with NOA can become biological fathers with IVF/ ICSI. In Sweden, testicular sperm aspiration (TESA) is the most common method used to retrieve sperm but is only successful in up to 34% of procedures. In 2013, our fertility center introduced MD-TESE, where an operating microscope is used to target the biopsies. We have performed more than 134 MD-TESE procedures, mainly in cases where TESA sperm recovery failed previously. Sperm sufficient for ICSI were recovered in 52 % and in these cases 75 % resulted in embryo transfer, resulting in a 34 % ongoing pregnancy rate/deliveries per transfer. Results are encouraging and hopefully more Swedish IVF centers will introduce this technique.


Assuntos
Azoospermia/cirurgia , Microdissecção/métodos , Recuperação Espermática , Testículo/cirurgia , Azoospermia/etiologia , Feminino , Humanos , Infertilidade Masculina/etiologia , Infertilidade Masculina/cirurgia , Masculino , Gravidez , Injeções de Esperma Intracitoplásmicas , Resultado do Tratamento
9.
Arch Ital Urol Androl ; 91(2)2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266282

RESUMO

OBJECTIVE: This exploratory retrospective study aimed to compare the level of Sperm DNA Fragmentation (SDF) and investigate its association with bulk semen parameters, for the first time in Bulgarian patients with varicocele, using a distinct methodology. MATERIAL AND METHODS: Standard semen analysis was performed according to the 2010 criteria of the European Society of Human Reproduction and Embryology - Nordic Association for Andrology (ESHRE-NAFA-2010) and DNA fragmentation was assessed using the Halosperm® kit. The total sample included 28 males: the control group consisted of men with normal genital examination and unknown fertility (n = 10), group one consisted of men with varicocele, normozoospermia and DNA fragmentation > 15% (n = 9) and group two consisted of men with varicocele, abnormal sperm parameters and DNA fragmentation > 15% (n = 9). RESULTS: DNA fragmentation was found to be higher in patients with abnormal sperm parameters (43.78 ± 30.78) compared to the normozoospermic group (21.22 ± 3.93) (p = 0.008). In normozoospermic patients, no statistically significant correlations were observed between SDF and bulk semen parameters. In patients with abnormal sperm parameters, DNA fragmentation exhibited significant very strong negative association with motility (a+b), vitality and typical morphology (p < 0.001). CONCLUSIONS: DNA integrity assays could be used for a better evaluation and management of male infertility, particularly in normozoospermic varicocele patients.


Assuntos
Fragmentação do DNA , Sêmen/metabolismo , Espermatozoides/metabolismo , Varicocele/complicações , Adulto , Bulgária , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/etiologia , Masculino , Estudos Retrospectivos , Análise do Sêmen , Motilidade Espermática , Espermatozoides/patologia , Adulto Jovem
10.
Genes (Basel) ; 10(7)2019 07 11.
Artigo em Inglês | MEDLINE | ID: mdl-31336797

RESUMO

Up to 30% of men with normal semen parameters suffer from infertility and the reason for this is unknown. Altered expression of sperm proteins may be a major cause of infertility in these men. Proteomic profiling was performed on pooled semen samples from eight normozoospermic fertile men and nine normozoospermic infertile men using LC-MS/MS. Furthermore, key differentially expressed proteins (DEPs) related to the fertilization process were selected for validation using Western blotting. A total of 1139 and 1095 proteins were identified in normozoospermic fertile and infertile men, respectively. Of these, 162 proteins were identified as DEPs. The canonical pathway related to free radical scavenging was enriched with upregulated DEPs in normozoospermic infertile men. The proteins associated with reproductive system development and function, and the ubiquitination pathway were underexpressed in normozoospermic infertile men. Western blot analysis revealed the overexpression of annexin A2 (ANXA2) (2.03 fold change; P = 0.0243), and underexpression of sperm surface protein Sp17 (SPA17) (0.37 fold change; P = 0.0205) and serine protease inhibitor (SERPINA5) (0.32 fold change; P = 0.0073) in men with unexplained male infertility (UMI). The global proteomic profile of normozoospermic infertile men is different from that of normozoospermic fertile men. Our data suggests that SPA17, ANXA2, and SERPINA5 may potentially serve as non-invasive protein biomarkers associated with the fertilization process of the spermatozoa in UMI.


Assuntos
Anexina A2/metabolismo , Antígenos de Superfície/metabolismo , Biomarcadores/metabolismo , Proteínas de Transporte/metabolismo , Infertilidade Masculina/metabolismo , Inibidor da Proteína C/metabolismo , Western Blotting , Cromatografia Líquida , Humanos , Infertilidade Masculina/etiologia , Masculino , Proteoma , Análise do Sêmen , Espectrometria de Massas em Tandem
11.
Urol Clin North Am ; 46(3): 341-351, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31277729

RESUMO

The presence of cancer in the testis, as well as the therapies used to treat testis cancer, can impair fertility potential for affected men. Fertility preservation is an important aspect of survivorship care and should be offered to all patients before initiating treatment. The only established means of fertility preservation in men is cryopreservation of sperm. Methods for fertility preservation in prepubertal boys are still experimental. Physicians treating men with testicular cancer should be familiar with the available options. This article outlines testicular cancer and its treatment's effects on fertility, fertility preservation options, and barriers to accessing this specialized care.


Assuntos
Preservação da Fertilidade/métodos , Infertilidade Masculina/etiologia , Neoplasias Testiculares/complicações , Neoplasias Testiculares/terapia , Fatores Etários , Criopreservação , Humanos , Masculino
12.
Fertil Steril ; 111(6): 1033-1035, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31155112

RESUMO

This issue's of Views and Reviews considers the origins of lifetime health established around the time of conception in some prevalent conditions related to infertility. Reviews will look at the effects of advanced paternal and maternal age, the influence of the severe sperm factor, and the impact of some endocrinopathies commonly seen in infertile couples, especially women, like polycystic ovary syndrome, under- and overweight, diabetes, and thyroid disorders. The aim of this Views and Reviews section is to summarize current evidence on the consequences of these conditions on postnatal health to encourage research in this field and the need to develop strategies and preventative measures to reduce or prevent unfavorable outcomes in future generations.


Assuntos
Saúde da Criança , Filho de Pais Incapacitados , Fertilidade , Infertilidade Feminina/etiologia , Infertilidade Masculina/etiologia , Adolescente , Criança , Pré-Escolar , Suscetibilidade a Doenças , Feminino , Nível de Saúde , Humanos , Lactente , Recém-Nascido , Infertilidade Feminina/fisiopatologia , Infertilidade Feminina/terapia , Infertilidade Masculina/fisiopatologia , Infertilidade Masculina/terapia , Masculino , Idade Materna , Saúde Materna , Idade Paterna , Técnicas de Reprodução Assistida , Medição de Risco , Fatores de Risco , Resultado do Tratamento
13.
Int J Mol Med ; 44(2): 375-389, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31173155

RESUMO

Telomere length (TL) has long been associated with aging, as telomeres serve as protective caps of chromosomes, and are thus deeply involved in the preservation of genome integrity and are vital to cellular functions. Traditionally, a strong link connects aging and infertility in both sexes, with an earlier onset in females. Over the past decade, telomeres have attracted increasing attention due to the role they play in fertility. In this review, we investigated the potential positive or negative association between relative TL and different factors of female and male infertility. A systematic search of the PubMed database was conducted. Out of the 206 studies identified, 45 were reviewed as they fulfilled the criteria of validity and relevance. Following an analysis and a comparison of the study outcomes, several clear trends were observed. The majority of female infertility factors were associated with a shorter TL, with the exception of endometriosis, premature ovarian failure and clear cell carcinoma that were associated with a longer TL and polycystic ovary syndrome (PCOS), which revealed conflicting results among several studies, leading to ambiguous conclusions. Male infertility factors were associated with a shorter TL. Although this review can provide an outline of general trends in the association of TL with infertility factors, further epidemiological and original research studies are required to focus on investigating the basis of these varying lengths of telomeres.


Assuntos
Infertilidade Feminina/genética , Infertilidade Masculina/genética , Encurtamento do Telômero , Envelhecimento , Feminino , Humanos , Infertilidade Feminina/etiologia , Infertilidade Feminina/patologia , Infertilidade Masculina/etiologia , Infertilidade Masculina/patologia , Masculino , Telômero/genética
14.
Int J Mol Sci ; 20(12)2019 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-31248186

RESUMO

Sperm motility is the most important parameter involved in the fertilization process and it is strictly required for reproductive success. Although sperm movements are essential for the physiologic fertilization process, the data, deriving from studies focused on the research of altered cell pathways involved in asthenozoospermia, offer only limited information about the molecular mechanism underlying sperm motility. The aim of this study was to identify proteins involved in human sperm motility deficiency by using label-free mass-spectrometry liquid chromatography (LC-MS/MS). For this purpose, we selected sperm samples with three different classes of progressive motility: low, medium (asthenozoospermic samples) and high (normozoospermic samples). We found that several differential expressed proteins in asthenozoospermic samples were related to energetic metabolism, suggesting an interesting link between bioenergetics pathways and the regulation of sperm motility, necessary for the flagellum movement. Therefore, our results provide strong evidence that mass spectrometry-based proteomics represents an integrated approach to detect novel biochemical markers of sperm motility and quality with diagnostic relevance for male infertility and unravel the molecular etiology of idiopathic cases.


Assuntos
Metabolismo Energético , Redes e Vias Metabólicas , Proteoma , Proteômica , Motilidade Espermática , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Humanos , Infertilidade Masculina/etiologia , Infertilidade Masculina/metabolismo , Masculino , Fosforilação Oxidativa , Proteômica/métodos , Espermatozoides/fisiologia , Transcriptoma
15.
Curr Urol Rep ; 20(8): 43, 2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-31203470

RESUMO

PURPOSE OF REVIEW: The classification of morphologically normal sperm has been progressively redefined. Concurrently, our understanding of the significance of sperm morphology in relation to male factor infertility has evolved. In this review, we will discuss the evolution of sperm morphology assessment and factors that contribute to its measurement variability. We will examine the impact of sperm morphology on natural pregnancy, IUI, IVF, and ICSI outcomes. RECENT FINDINGS: There is a lack of consensus on sperm morphology classification, technique, and inter-observer grading variability. Current evidence suggests sperm morphology has low predictive value for pregnancy success, for both natural and assisted reproduction. Additionally, the threshold for what is considered an adequate percentage of morphologically normal sperm has changed over time. These variables have called into question the relevance of this variable in predicting fertility outcomes. Our understanding of the impact of sperm morphology on reproductive outcomes continues to evolve and seems to play less of a role than initially thought.


Assuntos
Infertilidade Masculina/etiologia , Infertilidade Masculina/patologia , Técnicas de Reprodução Assistida , Análise do Sêmen/métodos , Espermatozoides/citologia , Espermatozoides/patologia , Contagem de Células , Feminino , Fertilidade/fisiologia , Humanos , Masculino , Gravidez , Resultado da Gravidez , Prognóstico , Reprodução/fisiologia
16.
Microb Pathog ; 134: 103602, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31226289

RESUMO

Little attention has been paid to the influence of asymptomatic colonizers of genital tract on female infertility. Albeit, a variety of uropathogens have been known to negatively alter sperm parameters in vitro, but their impact on female fertility outcome under in vivo conditions is not clearly established. Therefore, the present study was intended to investigate the effect of Pseudomonas aeruginosa on sperm parameters and to identify its role in female infertility. The strain of P. aeruginosa was found to reduce sperm motility, viability and sperm Mg++ATPase activity. It could also lead to premature acrosomal loss and induce morphological defect in spermatozoa. For fertility studies, female mice administered intravaginally with 104, 106, 108 cfu of P. aeruginosa for 10 consecutive days, were allowed to mate with proven breeder male on day 12. The results showed that group of mice receiving P. aeruginosa were rendered infertile whereas group receiving PBS showed abdominal distension, string of pearls and finally delivered pups at the end of gestation period. Further, no other clinical manifestation could be observed apparently, histologically or immunologically. Thus, it can be concluded that infertility in mice might be attributed to asymptomatic colonization of genital tract with sperm immobilizing P. aeruginosa.


Assuntos
Infertilidade/etiologia , Infertilidade/microbiologia , Infecções por Pseudomonas/complicações , Pseudomonas aeruginosa/crescimento & desenvolvimento , Vagina/microbiologia , Acrossomo/metabolismo , Administração Oral , Animais , Antibacterianos/farmacologia , ATPase de Ca(2+) e Mg(2+)/metabolismo , Sobrevivência Celular , Citocinas/análise , Modelos Animais de Doenças , Feminino , Humanos , Imobilização , Infertilidade Masculina/etiologia , Inflamação , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Testes de Sensibilidade Microbiana , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/microbiologia , Infecções por Pseudomonas/patologia , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/patogenicidade , Reprodução , Aglutinação Espermática , Motilidade Espermática , Espermatozoides/citologia , Vagina/patologia
18.
Hinyokika Kiyo ; 65(2): 55-59, 2019 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-31067844

RESUMO

A 41-year-old male with the chief complaint of infertility was referred to our hospital. He presented withmild erectile dysfunction and reduced shaving frequency. Semen analysis indicated a decreased semen volume in addition to a low sperm count and motility. Hormone evaluation revealed the following details : follicle stimulating hormone (FSH) 1.7 mIU/ml (range 2.0-8.3 mIU/ml), luteinizing hormone (LH) 0.9 mIU/ml (range 0.8-5.7 mIU/ml), testosterone 86.6 ng/dl (range 225.0-1,039 ng/dl), and prolactin (PRL) 242.0 ng/ml (range 3.6-12.8 ng/ml). Magnetic resonance imaging (MRI) of the patient's head showed empty sella turcica. He was diagnosed with acquired hypogonadotropic hypogonadism due to hyperprolactinemia. We suspected that the hyperprolactinemia was due to the pituitary lesion, although the possibility of coexisting pituitary microadenoma could not be discarded. Based on the diagnosis, cabergoline therapy was started. Four months after initiation of cabergoline therapy, the patient's hormone levels and semen parameters normalized, followed by improvement in his clinical symptoms. Furthermore, his wife spontaneously conceived.


Assuntos
Síndrome da Sela Vazia , Hiperprolactinemia , Hipogonadismo , Infertilidade Masculina , Adulto , Síndrome da Sela Vazia/complicações , Humanos , Hiperprolactinemia/complicações , Infertilidade Masculina/etiologia , Hormônio Luteinizante , Masculino , Testosterona
19.
PLoS One ; 14(5): e0216802, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31086401

RESUMO

BACKGROUND: The sterile insect technique (SIT) requires mass-rearing of the target species, irradiation to induce sexual sterility and transportation from the mass-rearing facility to the target site. Those treatments require several steps that may affect the biological quality of sterile males. This study has been carried out to evaluate the relative impact of chilling, irradiation and transport on emergence rate, flight ability and survival of sterile male Glossina palpalis gambiensis. RESULTS: Chilling, irradiation and transport all affected the quality control parameters studied. The emergence rate was significantly reduced by long chilling periods and transport, i.e. from 92% at the source insectary in Burkina Faso to 78% upon arrival in Senegal. Flight ability was affected by all three parameters with 31% operational flies lost between the production facility and the destination site. Only survival under stress was not affected by any of the treatments. CONCLUSION: The chilling period and transport were the main factors that impacted significantly the quality of sterile male pupae. Therefore, in the operational programme, the delivery of sterile male pupae was divided over two shipments per week to reduce the chilling time and improve the quality of the sterile males. Quality of the male pupae may further be improved by reducing the transport time and vibrations during transport.


Assuntos
Controle Biológico de Vetores/métodos , Moscas Tsé-Tsé/fisiologia , Animais , Burkina Faso , Temperatura Baixa , Infertilidade Masculina/etiologia , Infertilidade Masculina/veterinária , Masculino , Pupa/fisiologia , Pupa/efeitos da radiação , Reprodução , Senegal , Transportes , Moscas Tsé-Tsé/efeitos da radiação
20.
J Nepal Health Res Counc ; 17(1): 85-89, 2019 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-31110383

RESUMO

BACKGROUND: Infertility is defined as a couple's inability to conceive after a period of twelve months of regular unprotected intercourse. Infertility globally affects approximately 10-15% of couples. This study was carried out to find out the determinants of infertility among infertile couples. METHODS: This is a retrospective review of records of 3231 infertile couples in the Department of Obstetrics and Gynecology, Dhulikhel Hospital from January 1, 2008 to June 30, 2018. A total of 3231 infertile couples were evaluated by reviewing their case history including demographic parameters and investigations performed. RESULTS: Mean age of female cases seeking infertility treatment was 26.85 (±4.78) years and that of male cases was 29.81±3.18 years. About three quarter (74.7%) of the cases was of primary type. Almost half of infertility cases (48.8%) were having only female factor. Of the female contributory factors, half of them (52.12%) had ovulatory cause. Male factors contributed 23.9% of cases and 22.7% cases had abnormality in semen analysis while 1.2% had other sexual dysfunction. Mixed type of infertility was seen in 26.6% and unexplained factors had contribution of 14.4%. CONCLUSIONS: Primary infertility cases are three times more common in Dhulikhel hospital.Ovulatory cause was the most common contributory factors among female infertile cases while abnormality in semen parameter was the commonest problem among male infertile cases. Thorough evaluation and repeated visits were required to find out the apparent determinants of infertility problem.


Assuntos
Infertilidade/etiologia , Adulto , Feminino , Humanos , Infertilidade/epidemiologia , Infertilidade Feminina/etiologia , Infertilidade Masculina/etiologia , Masculino , Nepal/epidemiologia , Estudos Retrospectivos , Análise do Sêmen , Fatores Sexuais , Disfunções Sexuais Fisiológicas/complicações
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