Forty-six XX disorder of sex development is an uncommon medical condition observed at times during the evaluation of a man＇s fertility. The following is a case series and literature review of phenotypically normal me...Forty-six XX disorder of sex development is an uncommon medical condition observed at times during the evaluation of a man＇s fertility. The following is a case series and literature review of phenotypically normal men diagnosed with this karyotype. Our goal is to comprehend the patients＇ clinical presentation as well as their laboratory results aiming to explore options available for their management. A formal literature review through PubMed and MEDLINE databases was performed using ＂46 XX man＂ as a word search. A total of 55 patients, including those conveyed in this article were diagnosed with a 46 XX karyotype during their fertility evaluation. The patients＇ mean age _＋ s.d. was 34 ＋ 10 years and their mean height ＋ s.d. was 166 ＋ 6.5 cm. Overall, they presented with hypergonadotropic hypogonadism. Sexual dysfunction, reduced hair distribution, and gynecomastia were reported in 20% （4120）, 25.8% （8/31）, and 42% （13131） of the patients, respectively. The SRYgene was detected in 36 （83.7%） and was absent in the remaining seven （16.3%） patients. We found that a multidisciplinary approach to management is preferred in 46 XX patients. Screening for remnants of the mullerian ducts and for malignant transformation in dysgenetic gonads is imperative. Hypogonadism should be addressed, while fertility options are in vitro fertilization with donor sperm or adoption.展开更多
According to the World Health Organization(WHO),oxidative stress(OS)is a significant contributor to male infertility.SeminalOS can be measured by a number of assays,all of which are either costly or time sensitive and...According to the World Health Organization(WHO),oxidative stress(OS)is a significant contributor to male infertility.SeminalOS can be measured by a number of assays,all of which are either costly or time sensitive and/or require large semen volume andcomplex instrumentation.One less expensive alternative is to quantify the oxidation-reduction potential(ORP)with the MiOXSYS.In this international multi-center study,we assessed whether ORP levels measured by the MiOXSYS could distinguish semensamples that fall within the 2010 WHO normal reference values from those that do not.Semen samples were collected from 2092patients in 9 countries;ORP was normalized to sperm concentration(mV/10^6 sperm/ml).Only those samples with a concentration>1×10^6 sperm ml1 were in eluded.The results showed that 199 samples fell within the WHO no rmal refere nee range while theremaining 1893 samples did not meet one or more of the criteria.ORP was negatively correlated with all semen parameters(P <0.01)except volume.The area under the curve for ORP was 0.765.The ORP cut-off value(1.34 mV/10^6 sperm/ml)was able todifferentiate specimens with abnormal semen parameters with 98.1%sensitivity,40.6%specificity,94.7%positive predictivevalue(PPV)and 66.6%negative predictive value(NPV).When used as an adjunct to traditional semen analysis,ORP levels mayhelp identify altered functional status of spermatozoa caused by OS in cases of idiopathic male infertility and in male partners ofcouples sufferi ng recurre nt pregna ncy loss,and thereby directi ng these men to relevant medical therapies and lifestyle modificati ons.展开更多
Semen analysis(SA)remains the cornerstone of male infertility evaluation and should ideally be performed by an accredited andrology laboratory or in vitro fertilization(IVF)clinics based on the standards defined by th...Semen analysis(SA)remains the cornerstone of male infertility evaluation and should ideally be performed by an accredited andrology laboratory or in vitro fertilization(IVF)clinics based on the standards defined by the World Health Organization(WHO)for the Examination and Processing of Human Semen and in accordance with the International Organization for Standardization’s Basic Semen Examination on Specification and Test Methods.展开更多
Oxidative stress(OS)is detri me ntal to sperm fun ctio ns,and the oxidation reductio n pote ntial(ORP)is a good measure of OS as it considers the balance betwee n oxidants and reducta nts.Total motile sperm count(TMSC...Oxidative stress(OS)is detri me ntal to sperm fun ctio ns,and the oxidation reductio n pote ntial(ORP)is a good measure of OS as it considers the balance betwee n oxidants and reducta nts.Total motile sperm count(TMSC)is viewed as the single most im porta nt semen analysis parameter that can predict male infertility severity,and its correlation with ORP has never been undertaken.The objectives of this study were to assess the correlation between ORP and TMSC,to identify the ORP cutoff value based on the TMSC result,and to compare this cutoff value with previously reported ORP cutoff values in literature.One thousand one hundred and sixty-eight infertile patients and 100 fertile controls were enrolled.Demographic and semen data of the participants were retrieved and analyzed.Wilcox on's rank-sum test compared variables betwee n infertile men and fertile controls;Spearman's correlation assessed the static ORP(sORP)-TMSC relationship for the whole sample and among each group individually.Using a 20×10^6TMSC threshold,receiver operator characteristic(ROC)analysis determined the sORP cutoff associated with the highest predictive values.TMSC was significantly negatively correlated with sORP across all participants(r=0.86,P<0.001),among infertile patients(r=0.729,P<0.001),and among fertile controls(r=0.53,P<0.001).A 20-million TMSC threshold determined an sORP cutoff value of 2.34 mV/106sperm/ml to be associated with 82.9%sensitivity,82.8%specificity,91.5%positive predictive value(PPV),68.5%negative predictive value(NPV),and 82.9%overall accuracy.Compared with previously reported cutoff values in searched literature,the 2.34 mV/10^6sperm/ml cutoff value identified in our study yielded the highest overall diagnostic accuracy in the evaluation of in fertile men.展开更多
Background:Tubular ectasia of rete testis(TERT)is a benign condition due to dilatation of the rete testis as a consequence of multiple etiologies,including postinfectious,trauma,prior inguinal or scrotal surgeries,mec...Background:Tubular ectasia of rete testis(TERT)is a benign condition due to dilatation of the rete testis as a consequence of multiple etiologies,including postinfectious,trauma,prior inguinal or scrotal surgeries,mechanical compression of extratesticular excretory ducts,and congenital malformation.TERT is a rare and underreported condition in the medical literature.Its association with infertility is lacking in the literature.Case Presentation:We present a rare case of primary infertility and obstructive azoospermia associated with TERT.We performed extensive literature regarding the possible etiologies,associations,clinical diagnosis,and different management options of this entity.Our patient is a 33-year-old man presented with primary infertility.He was found to have obstructive azoospermia.During scrotal exploration,the diagnosis of intratesticular obstruction due to TERT was made.The couple was advised to undergo intracytoplasmic sperm injection using testicular sperms.This is the third report of TERT associated with azoospermia.Conclusion:TERT is usually asymptomatic but can occasionally be associated with pain or abnormal semen analysis,but further studies are required to confirm its effect on fertility.Fortunately,it has a benign course and typically does not require surgical intervention.It is vital to differentiate it from neoplastic conditions.展开更多
Background:Obstructive azoospermia(OA)is a prevalent cause of male infertility in Qatar and globally,with vasectomy reversal(VV)and vasoepididymostomy(VE)being the primary surgical treatments.While microsurgical techn...Background:Obstructive azoospermia(OA)is a prevalent cause of male infertility in Qatar and globally,with vasectomy reversal(VV)and vasoepididymostomy(VE)being the primary surgical treatments.While microsurgical techniques have advanced,data from the Middle East remain limited,influenced by the region's distinct demographic and cultural factors.This study aimed to evaluate the outcomes of microsurgical VV and VE performed for OA in a tertiary center in the Middle East,with a focus on success rates,influencing factors,and the unique regional characteristics of OA.Methods:A retrospective cohort study analyzed 105 patients with OA undergoing VV or VE over a period of 10 years.Data on demographics,clinical variables,surgical findings,and postoperative outcomes were assessed.Success was defined as sperm presence in semen within 3–6 months post-surgery.Results:The overall success rate for VV was 85.7%,with similar rates across bilateral and unilateral procedures.VE success was 50%,with bilateral intussusception technique yielding superior outcomes(71.9%).Factors predicting success included shorter obstructive interval for VV and bilateral reconstruction for VE.Conclusion:Microsurgical VV remains a reliable first-line treatment for OA,achieving high success rates consistent with international benchmarks.VE presents greater variability in outcomes,highlighting the complexity of managing epididymal obstruction and the importance of advanced surgical techniques like intussusception.The distinct etiological patterns observed in the Middle East emphasize the need for tailored approaches to diagnosis,surgical planning,and patient counseling.展开更多
文摘Forty-six XX disorder of sex development is an uncommon medical condition observed at times during the evaluation of a man＇s fertility. The following is a case series and literature review of phenotypically normal men diagnosed with this karyotype. Our goal is to comprehend the patients＇ clinical presentation as well as their laboratory results aiming to explore options available for their management. A formal literature review through PubMed and MEDLINE databases was performed using ＂46 XX man＂ as a word search. A total of 55 patients, including those conveyed in this article were diagnosed with a 46 XX karyotype during their fertility evaluation. The patients＇ mean age _＋ s.d. was 34 ＋ 10 years and their mean height ＋ s.d. was 166 ＋ 6.5 cm. Overall, they presented with hypergonadotropic hypogonadism. Sexual dysfunction, reduced hair distribution, and gynecomastia were reported in 20% （4120）, 25.8% （8/31）, and 42% （13131） of the patients, respectively. The SRYgene was detected in 36 （83.7%） and was absent in the remaining seven （16.3%） patients. We found that a multidisciplinary approach to management is preferred in 46 XX patients. Screening for remnants of the mullerian ducts and for malignant transformation in dysgenetic gonads is imperative. Hypogonadism should be addressed, while fertility options are in vitro fertilization with donor sperm or adoption.
文摘According to the World Health Organization(WHO),oxidative stress(OS)is a significant contributor to male infertility.SeminalOS can be measured by a number of assays,all of which are either costly or time sensitive and/or require large semen volume andcomplex instrumentation.One less expensive alternative is to quantify the oxidation-reduction potential(ORP)with the MiOXSYS.In this international multi-center study,we assessed whether ORP levels measured by the MiOXSYS could distinguish semensamples that fall within the 2010 WHO normal reference values from those that do not.Semen samples were collected from 2092patients in 9 countries;ORP was normalized to sperm concentration(mV/10^6 sperm/ml).Only those samples with a concentration>1×10^6 sperm ml1 were in eluded.The results showed that 199 samples fell within the WHO no rmal refere nee range while theremaining 1893 samples did not meet one or more of the criteria.ORP was negatively correlated with all semen parameters(P <0.01)except volume.The area under the curve for ORP was 0.765.The ORP cut-off value(1.34 mV/10^6 sperm/ml)was able todifferentiate specimens with abnormal semen parameters with 98.1%sensitivity,40.6%specificity,94.7%positive predictivevalue(PPV)and 66.6%negative predictive value(NPV).When used as an adjunct to traditional semen analysis,ORP levels mayhelp identify altered functional status of spermatozoa caused by OS in cases of idiopathic male infertility and in male partners ofcouples sufferi ng recurre nt pregna ncy loss,and thereby directi ng these men to relevant medical therapies and lifestyle modificati ons.
文摘Semen analysis(SA)remains the cornerstone of male infertility evaluation and should ideally be performed by an accredited andrology laboratory or in vitro fertilization(IVF)clinics based on the standards defined by the World Health Organization(WHO)for the Examination and Processing of Human Semen and in accordance with the International Organization for Standardization’s Basic Semen Examination on Specification and Test Methods.
文摘Oxidative stress(OS)is detri me ntal to sperm fun ctio ns,and the oxidation reductio n pote ntial(ORP)is a good measure of OS as it considers the balance betwee n oxidants and reducta nts.Total motile sperm count(TMSC)is viewed as the single most im porta nt semen analysis parameter that can predict male infertility severity,and its correlation with ORP has never been undertaken.The objectives of this study were to assess the correlation between ORP and TMSC,to identify the ORP cutoff value based on the TMSC result,and to compare this cutoff value with previously reported ORP cutoff values in literature.One thousand one hundred and sixty-eight infertile patients and 100 fertile controls were enrolled.Demographic and semen data of the participants were retrieved and analyzed.Wilcox on's rank-sum test compared variables betwee n infertile men and fertile controls;Spearman's correlation assessed the static ORP(sORP)-TMSC relationship for the whole sample and among each group individually.Using a 20×10^6TMSC threshold,receiver operator characteristic(ROC)analysis determined the sORP cutoff associated with the highest predictive values.TMSC was significantly negatively correlated with sORP across all participants(r=0.86,P<0.001),among infertile patients(r=0.729,P<0.001),and among fertile controls(r=0.53,P<0.001).A 20-million TMSC threshold determined an sORP cutoff value of 2.34 mV/106sperm/ml to be associated with 82.9%sensitivity,82.8%specificity,91.5%positive predictive value(PPV),68.5%negative predictive value(NPV),and 82.9%overall accuracy.Compared with previously reported cutoff values in searched literature,the 2.34 mV/10^6sperm/ml cutoff value identified in our study yielded the highest overall diagnostic accuracy in the evaluation of in fertile men.
文摘Background:Tubular ectasia of rete testis(TERT)is a benign condition due to dilatation of the rete testis as a consequence of multiple etiologies,including postinfectious,trauma,prior inguinal or scrotal surgeries,mechanical compression of extratesticular excretory ducts,and congenital malformation.TERT is a rare and underreported condition in the medical literature.Its association with infertility is lacking in the literature.Case Presentation:We present a rare case of primary infertility and obstructive azoospermia associated with TERT.We performed extensive literature regarding the possible etiologies,associations,clinical diagnosis,and different management options of this entity.Our patient is a 33-year-old man presented with primary infertility.He was found to have obstructive azoospermia.During scrotal exploration,the diagnosis of intratesticular obstruction due to TERT was made.The couple was advised to undergo intracytoplasmic sperm injection using testicular sperms.This is the third report of TERT associated with azoospermia.Conclusion:TERT is usually asymptomatic but can occasionally be associated with pain or abnormal semen analysis,but further studies are required to confirm its effect on fertility.Fortunately,it has a benign course and typically does not require surgical intervention.It is vital to differentiate it from neoplastic conditions.
文摘Background:Obstructive azoospermia(OA)is a prevalent cause of male infertility in Qatar and globally,with vasectomy reversal(VV)and vasoepididymostomy(VE)being the primary surgical treatments.While microsurgical techniques have advanced,data from the Middle East remain limited,influenced by the region's distinct demographic and cultural factors.This study aimed to evaluate the outcomes of microsurgical VV and VE performed for OA in a tertiary center in the Middle East,with a focus on success rates,influencing factors,and the unique regional characteristics of OA.Methods:A retrospective cohort study analyzed 105 patients with OA undergoing VV or VE over a period of 10 years.Data on demographics,clinical variables,surgical findings,and postoperative outcomes were assessed.Success was defined as sperm presence in semen within 3–6 months post-surgery.Results:The overall success rate for VV was 85.7%,with similar rates across bilateral and unilateral procedures.VE success was 50%,with bilateral intussusception technique yielding superior outcomes(71.9%).Factors predicting success included shorter obstructive interval for VV and bilateral reconstruction for VE.Conclusion:Microsurgical VV remains a reliable first-line treatment for OA,achieving high success rates consistent with international benchmarks.VE presents greater variability in outcomes,highlighting the complexity of managing epididymal obstruction and the importance of advanced surgical techniques like intussusception.The distinct etiological patterns observed in the Middle East emphasize the need for tailored approaches to diagnosis,surgical planning,and patient counseling.
