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Background/aim: This study evaluated the treatment procedures for chemotherapy (CT)-induced persistent azoospermia and their outcomes from a different perspective. Materials and methods: In 63 patients (mean age: 30.16 ± 4.91 years) who had undergone CT 11 ± 5 years earlier, the semen volume, gonadotropins level, FSH level, genetics, micro-testicular sperm extraction (m-TESE) result, sperm DNA fragmentation index (SDFI), semen reactive oxidative stress (ROS) rate, duration of embryonic development, and pregnancy and baby take-home rates were examined. The correlations between the ROS rates and the SDFIs, m-TESE results, sperm motility, pathology scores, time-lapses, and baby take-home rates were evaluated. Results: The semen volumes were 3.5 ± 1.1/ml. The FSH level following CT was 17.87 ± 5.80 mIU/ml. A sperm rate of 34.9% was found from the m-TESE result. The mean SDFI and ROS rate were 4 (<15-30>) and 1.29 ± 0.51, respectively. The time-lapse was calculated as 5h. Pregnancy and live birth were achieved at 20.63% and 12.7%, respectively. In the patients with a low ROS (=1.42) and SDFI (=15), the m-TESE success rate was high, the FSH value was low, the pathological score and fertilization rate were elevated, the embryonic cleavage period was normal, and the pregnancy and baby take-home rates were high. Conclusion: The sperms may be detected using m-TESE in patients who develop persistent azoospermia associated with CT due to different oncological diagnoses. Our study revealed that a low FSH value and normal ejaculatory ROS rates are positive predictive factors of sperm detection before m-TESE. The motility of the sperms detected after m-TESE and normal SDFI rates were found to be positive predictive criteria of high fertilization, good embryonic cleavage, pregnancy, and live birth. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the genetic outcomes of obstructive/non-obstructive azoospermic Turkish men. Material and Method: Patients underwent anamnesis, examination, hormonal values, semen analysis, blood karyotype analysis, Y chromosome microdeletions, cystic fibrosis transmembrane conductance regulator gene mutation, scrotal color doppler, micro testicular sperm extraction. Results: The semens were 2.2±1.5/ml, pellet (-) and azoospermic. Grade I-III reflux (-), varicoceles, atrophic testicles and phenotypic stigmas were observed. FSH, total testosterone, prolactine were measured as 24.6±14.4 mIU/L, 9.83±7.35 ng/ml and 10.37±3,45 ng/mL, respectively. The genetic diagnostic rate was 34.4%. Chromosomal structural and numerical abnormalities were 4.08 % and 19.92 %, respectively, while the structural and numerical abnormality rate was 1.12%. Karyotype 46, XY was detected at a rate of 65.5 % followed by 47, XXY as the second most frequent karyotype at 17.9 %. Moreover, karyotype 46, XX/SRY (+) was detected at a rate of 1.4%, karyotype 45, XO/SRY (+) was identified at a rate of 1.4% in males and karyotype 47, XYY was detected at a rate of 0.3 %. Structural chromosomal abnormality 9qh (+) with inversion appeared at a rate of 2.5%. Chromosomal Y chromosome microdeletion was detected as 7%. Absence of vas deference was observed as 4.48%. Heterozygous mutation carriage of CFTR was detected at a rate of 0.84% within the whole series. Conclusion: While genetic diagnoses prevailed at high rate and with a different range of diversity among etiological factors in NOA/OA Turkish men, it was also noted that chromosomal numerical abnormalities and structural as well as structural/numerical abnormalities gained a major ground in etiology. [ABSTRACT FROM AUTHOR]

Due to their efficient osteoclastic inhibitor effect in bone metabolism and antiangiogenic activity, bisphosphonates are widely used in many cancer diseases particularly in prostate cancers with bone metastasis, lung cancer, breast cancer and multiple myeloma, as well as in systemic diseases such as osteoporosis, osteopenia, Paget disease and osteogenesis imperfect for the last 13 years. Prostate cancer is a common cancer in males and it is the leading cause of bone metastasis. Mandibular metastasis is rarely encountered during the course of prostate cancer. Mandibular osteonecrosis as well has begun to be observed along with the availability of more efficient and stronger formulations developed following the use of bisphosphonates. Zolendronic acid, which has been used also by our patient, has widely come into practice as a 3rd generation bisphosphonate. Because of prostate cancer and widespread bone metastases, our patient has been receiving zolendronic acid with maximum androgen blockage for 4 years. Tomography of the patient, who has undergone intensive treatment because of submandibular abscess, demonstrated extensive osteonecrosis in the fovea sublingual region of the mandible corpus. In large series, although, mandibular osteonecrosis was widely seen due to bisphosphonate use for the metastases of lung and breast cancers, this rate was between 9.6% and 11% for prostate cancer within the series. Although our patient had no mandibular metastasis before, mandibular necrosis was observed due to long-term bisphosphonate use. We are going to present our patient who had this rare complication with his clinical picture. [ABSTRACT FROM AUTHOR]