Treatment of male infertility.

Male factor infertility is a general term that describes a situation in which the inability to conceive is associated with an alteration identified in the male partner. This dysfunction may be associated with low sperm concentration (oligozoospermia), poor sperm motility (asthenozoospermia) or abnormal sperm morphology (teratozoospermia); however, generally, a disturbance of all these variables, oligoasthenoteratozoospermia, is mostly frequent in male subfertility. For many andrological disorders, it is not possible to find a reasonable cause and various uncontrolled treatments have been applied to infertile men, often just on an empirical basis. More recently, after the explosive development of modern assisted reproduction techniques (ARTs), feasible with a single spermatozoon [intracytoplasmic sperm injection (ICSI)], the treatment of male infertility has received new meaning and andrologists are no longer expected to achieve a quantitative increase in sperm number but are instead asked to improve the fertility potential of the single sperm cell in order to achieve better results in both in vitro fertilization and ICSI. Additional prospective studies are needed to better understand the possible role of therapy in ART candidate patients.

Sperm tail agenesis in a case of consanguinity.

OBJECTIVE: To report a case of 100% teratozoospermia in a patient whose family history presented a high degree of consanguinity. DESIGN: Case report. SETTING: University-based andrology clinic. PATIENT(S): A 27-year-old man undergoing infertility evaluation. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Serum hormone analysis, standard (World Health Organization) semen quality evaluation, sperm ultrastructure, lymphocytic karyotype, and polymerase chain reaction screening for Y chromosome microdeletions in peripheral blood. RESULT(S): One hundred percent teratozoospermia characterized by shape alterations of the heads and tail agenesis on standard morphology evaluation, which was confirmed using electron microscopy. CONCLUSION(S): A case of familial infertility in a consanguineous patient characterized by morphological abnormalities of spermatozoa such as tail agenesis, chromatin subcondensation, and residual cytoplasmic droplets.

Ultrasound features of medullary thyroid carcinoma correlate with cancer aggressiveness: a retrospective multicenter study.

BACKGROUND: Poor prognosis of medullary thyroid cancer (MTC) with suspicious ultrasound (US) features has been reported. The aim of the study was to investigate the association between preoperative US presentation and aggressiveness features of MTC. Also, US features of MTC were compared with those previously reported. METHODS: Study group comprised 134 MTC from nine different centers. Based on US presentation the nodules were stratified in "at risk for malignancy" (m-MTC) or "probably benign" (b-MTC) lesions. RESULTS: Eighty nine (66.4%) m-MTC and 45 (33.6%) b-MTC were found. Metastatic lymph nodes (p = 0.0001) and extrathyroid invasiveness (p < 0.0001) were more frequent in m-MTC. There was statistically significant correlation (p = 0.0002) between advanced TNM stage and m-MTC with an Odds Ratio 5.5 (95% CI 2.1-14.4). Mean postsurgical calcitonin values were 224 ± 64 pg/ml in m-MTC and 51 ± 21 in b-MTC (p = 0.003). CONCLUSIONS: This study showed that sonographically suspicious MTC is frequently associated with features of aggressiveness, suggesting that careful preoperative US of MTC patients may better plan their surgical approach.