فهرست مطالب hesamoddin sajadi

This study aimed to evaluate the predicting factors affecting sperm retrieval. We prospectively assessedthe relationship between sonographic and microdissection testicular sperm extraction (mTESE) findings in Klinefeltersyndrome (KS).

In this prospective study, 44 azoospermic men with 47, XXY karyotypes participated in thisstudy. In order to evaluate the amount of blood supply in different parts of testicular tissue, a doppler ultra-sonographicwas performed. Also, for the detection of sperm in this group mTESE technique was performed.

The age average of positive mTESE and negative mTESE groups was 29.4 and 33.6 years, respectively. Bycomparing the testicle volume (based on the data obtained from the clinical examinations conducted by the urologist)it was determined that there is no significant difference between mTESE positive and negative groups. Folliclestimulatinghormone (FSH) levels in men with negative mTESE (P=0.03) and testosterone levels in men with positivemTESE significantly increased (P=0.017). The overall rate of testis vascularity was significantly higher in the positivemTESE group than in the negative mTESE group. The clinical pregnancy rate in positive mTESE men was 9% percycle, 16.6% per embryos were transferred (ET), and 12.5% per cycle.

Totally, our observation indicated that there is not a significant relationship between sonographic and mTESEresults in KS patients. However, more investigations with bigger sample Size can be useful to validate our results.

We aim to determine the prevalence of renal anomalies in patients with congenital vas deferens agenesisreferred for infertility assessment. This cross-sectional study was carried out on eligible infertile men from 2016 to 2019.Infertile men who were suspected of obstructive azoospermia were referred to the Ultrasound ward and they wereexamined by abdominal ultrasound for detecting the genital and kidney anomalies. An informed consent form wasfilled out by patients. Data was entered into SPSS software 21. Patients were divided into two groups in termsof congenital bilateral absence of vas deferens (CBAVD) or congenital unilateral absence of the vas deferens(CUAVD). Using the Chi-square test kidney anomalies between groups were compared. The P<0.05 was consideredsignificant. The mean age of participants was 33.05 ± 6.35. The frequency of CBAVD was 66 and the frequency of leftside VD and right side VD were 23 and 21, respectively. The percentage of other comorbidities was calculated. Outof 110 cases, 12 (11%) men had coexistence of vas deferens and kidney agenesis. Other studies are in agreement withour findings. Although the percentage of CBAVD and CUAVD were 9.1% and 1.8% respectively, the difference wasnot significant (P=0.07). Considering the fact that kidney agenesis is a remarkable congenital anomaly that coexists with themajority of vas deferens agenesis cases and could not be detected by routine laboratory tests or transrectal ultrasoundexamination, it should be ruled out with transabdominal ultrasound examination after detection of vas deferensagenesis.

In the process of human reproduction, spermatogenesis is one of the most important stages,which is controled by special genes on Y chromosome. Previous studies show that some infertile men havemicrodeletions on Y chromosome, which cause the reduction of sperm count. Three prominent spermatogene-sis loci have been identified on the Y chromosome and entitled “azoospermia factors” (AZFa, b, and c). Hereby,this review article aimed to investigate the content of the Y chromosome microdeletions and their importancein male fertility.

Data and information were collected on English-language articles from PubMedand MEDLINE databases. For Persian articles, Persian-language databases, including SID Scientific Database,IranMedex Medical Articles Database, IranDoc (Iran Scientific Information and Documents Research Institute),Magiran Publication Information, and MedLib were investigated. More than 50 articles on Y chromosome mi-crodeletions and infertility published during 2000-2020 were studied.

Previous studies implicated thatY chromosome microdeletions in AZFa, AZFb, and AZFc regions are accompanied by defect in spermatogenesis,leading to oligo / azoospermia. Patients with AZFa and AZFb microdeletions present secretory azoospermia anddo not have sperm in their seminiferous tubules. Complete AZFc deletion involves region b2/b4, which con-tains a total of 12 genes. Incomplete deletion of AZFc includes b1/b3, b2/b3 and gr/gr. The most common ofwhich are gr/gr. In men with gr/gr deletion, sperm count and motility were lower than control group.Conclu-sion:Y chromosomal microdeletions emerged as the most frequent structural chromosome anomaly associatedwith the quantitative reduction of sperm. The development of assisted reproductive techniques (ART) like intra-cytoplasmic sperm injection (ICSI) and testicular sperm extraction (TESE) helps to bypass the natural barriersof fertilization.

Background: Assessing the net-results of microsurgical varicocelectomy in infertile men with non-obstructive azoosper- mic (NOA) and clinical varicocele in five years at Royan Institute. Materials and Methods: This is a descriptive retrospective cohort study. A backward-looking review of patients treated for NOA and varicocele from march 2011 to march 2016 was performed. In addition, MDTESE results of 57 patients with NOA and clinical varicocele, with 537 NOA patients without varicocele were compared. Results: Of 57 patients who underwent varicocelectomy, eight patients (14%) had sperm on sperm analysis post-opera- tively. One of the eight patients was single, and one of them had spontaneous pregnancy (1/7) 14%, and one had a child by microinjection (1/7) 14%. Out of these 8 patients, 6 had hypospermatogenesis pathology. Of 38 patients who under- went MDTESE, 14 patients (36%) had sperm on their testis tissues, but one of them had no egg fertilization. Therefore, the fertilization rate was (92%). Of the remaining 13 patients, 3 had live child birth (3/13) 23%. Sperm retrieval rate (SRR) in NOA men without clinical varicocele was lower from those who had varicocele and NOA (22 vs. 36%). Also live birth rate in NOA men with varicocelectomy was higher than NOA men without varicocele (23 vs. 11%). Conclusion: Microsurgical varicocelectomy in NOA men may have positive effects on post-operative sperm in ejacu- late and natural or assisted pregnancies, but it seems that the effect is more significant on MDTESE results and follow- ing successful microinjection. Meanwhile, SRR and live birth rate was higher in our patients compare to NOA men without clinical varicocele.

Bilateral vassal agenesis (CBAVD) is a rare cause of male infertility. Also one of the
nonobstructive cause of azoospermia and infertility in men is microdeletion in long arm of Y chromosome.
In this case report we have reported a rare case of CBAVD, LT renal agenesis and AZFc
microdeletion. Patient Information: 28 years old man, who was farmer with history of 6 years of infertility presented to our andrology
clinic in Royan institute. In physical examination there was not any palpable vas deferens bilaterally,
also The semen analysis was azoospermia. In sonographic evaluation, LT kidney wasn’t seen in
its anatomic location. The patient candidate for diagnostic PESA and bilateral PESA were negative.
After that, the patient candidate for bilateral TESE and fascinatingly TESE was negative too. After
genetic evaluation microdeletion was detected in AZFc subregion of Y chromosome. In men with obstructive azoospermia mostly testicular spermatogenesis is normal but this is not
the rule because seldom spermatogenic dysfunction maybe present like our patient. We emphasize
about the importance of consideration of obstructive and nonobstructive azoospermia together in
a patient for urologists.