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The aim of the study was to detect the incidence and types of genital and renal duct anomalies associated with congenital absent vas deferens (CAVD). In 200 males with CAVD, the demographic characteristics, physical examination findings were evaluated. Scrotal ultrasonography and transrectal ultrasonography (TRUS) were used as the diagnostic methods for evaluating unilateral or bilateral CAVD with associated abnormalities or agenesis of the testes, epididymes, seminal vesicles and prostate. Abdominal ultrasound was performed to detect any associated renal anomalies. There were a total of 111 CBAVD and 89 CUAVD males. Eight cases (8.98%) of CUAVD were associated with contralateral cryptorchidism. In most cases there were agenesis in the epididymal body and tail and seminal vesicles. Different types of renal anomalies (32.50%) especially renal agenesis were observed mainly in cases of left CUAVD and were predominately on the left hand side. An important implication of our study is the importance of requesting ultrasound of males with CAVD to discover any associated anomalies especially renal agenesis that may be ignored by many physicians.

Tribulus terrestris is an annual herb of the Zygophyllaceae family and is commonly known as Gokshur, Gokharu, or puncturevine. Flavonoids, alkaloids, saponins, lignin, amides, and glycosides are the main active phytoconstituents of this plant. Infertility is defined by the failure to conceive a child after one year or more of regular unprotected sexual intercourse. Infertility affects society at large and has a negative impact on the social and emotional aspects of the patient. This in-depth review presents several studies that evaluate the role of Tribulus terrestris in a chronological order to help us better understand the exact mechanism by which this herbal medicine acts in male infertility. In conclusion, the exact role of Tribulus terrestris in male infertility is still controversial and needs future double-blind placebo-controlled studies that deploy larger cohorts.

We evaluated the role of Tribulus terrestris in males with unexplained infertility and its effect on serum testosterone and semen parameters. Thirty randomized male patients presenting to Andrology outpatient clinic complaining of idiopathic infertility were selected. They were given Tribulus terrestris (750 mg) in three divided doses for three months. The effect of Tribulus terrestris on serum testosterone (total and free) and luteinizing hormone (LH), as well as its impact on semen parameters in those patients, was studied. No statistically significant difference was observed in the levels of testosterone (total and free) and LH and semen parameters (sperm concentration or motility, or abnormal forms) before and after the treatment. In addition, no statistically significant correlations were observed between testosterone (free and total) and LH and semen parameters before and after the treatment. Tribulus terrestris was ineffective in the treatment of idiopathic infertility.