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Background: 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).Materials and Methods: 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.Results: 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.Conclusion: 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.

Background: This study aimed to evaluate the predicting factors affecting sperm retrieval. We prospectively assessed the relationship between sonographic and microdissection testicular sperm extraction (mTESE) findings in Klinefelter syndrome (KS). Materials and Methods: In this prospective study, 44 azoospermic men with 47, XXY karyotypes participated in this study. In order to evaluate the amount of blood supply in different parts of testicular tissue, a doppler ultra-sonographic was performed. Also, for the detection of sperm in this group mTESE technique was performed. Results: The age average of positive mTESE and negative mTESE groups was 29.4 and 33.6 years, respectively. By comparing 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. Follicle-stimulating hormone (FSH) levels in men with negative mTESE (P=0.03) and testosterone levels in men with positive mTESE significantly increased (P=0.017). The overall rate of testis vascularity was significantly higher in the positive mTESE group than in the negative mTESE group. The clinical pregnancy rate in positive mTESE men was 9% per cycle, 16.6% per embryos were transferred (ET), and 12.5% per cycle. Conclusion: Totally, our observation indicated that there is not a significant relationship between sonographic and mTESE results in KS patients. However, more investigations with bigger sample Size can be useful to validate our results. [ABSTRACT FROM AUTHOR]

Azoospermia is present in 15% of infertile cases and it is a major concern due to inability to produce sperm. Most of IVF (in-vitro fertilization) clinics abroad has been using sperm donation via sperm bank facilities as a solution for infertile couple to have their own offspring. In Islam, it is forbidden to use sample from male other than their spouse. It is according to maqasid syari'ah to ensure the heredity of the human being. Based on the latest technology, one approach of stem cell differentiation process had been established to produce mature cells from primitive or immature cells (stem cells). This technology is in line with the concept of maqasid syari'ah since we are using the cells from one person. We try to adopt this technology to study the potential of testicular cells from non-obstructive azoospermic (NOA) patient to undergo in vitro spermatogenesis. Samples were cultured in modified human embryonic stem cells (HESC) media with specific growth factors; basic fibroblast growth factor (bFGF) and leukemia inhibitory factor (LIF). Protein expressions were analyzed by immunofluorescent staining on day 49 and 90 of culture. Results show spermatogonial stem cell-like cells (SSC-like cells) colonies formed after 14 to 21 days, the cells were expanding successfully and were stable for 49 days duration. Then SSCs differentiated into later stage of spermatogenesis on day 90. Four specifics SSCs protein markers were identified on day 49; ITGA1, ITGB1, CD9 and GFRA1 whereas SCP3 and TP1 proteins were expressed on day 90. This in vitro spermatogenesis suggests a possible approach for future for Muslim NOA patients in order to have their own children. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the safety and efficacy of percutaneous epididymal and testicular sperm aspiration as a diagnostic technique to confirm sperm production and as a therapeutic technique to harvest sperms for use in the intracytoplasmic sperm injection and the indications for performing testicular biopsy in azoospermic infertile males. Thirty married patients were included in this prospective study from February 2011 to December 2012 seen in Basrah General Hospital. Their age ranged from 20 to 40 years. All patients underwent full medical examination with laboratory tests which included seminal fluid analysis, serum leutinising hormone (LH), follicular stimulating hormone (FSH), testosterone, and prolactin in addition to color Doppler ultrasonography of the scrotum. Patients with history of undescended testes, varicocele, & testicular pathology were excluded from this study. All patients showed normal physical examination with normal secondary sexual characters. The external genitalia were normal with normal sizes of their testes. The percutaneous epididymal and testicular sperm aspirations were positive in 12 out of 30 patients (40%). The rest had negative aspirations (60%). The testicular biopsy which performed in the patients with negative aspiration showed normal germinal epithelium with mature spermatozoa in only 5 patients out of 18 (28%) while the rest 13 patients had spermatogenic arrest (72%). In conclusion, percutaneous epididymal and testicular sperm aspiration has been found helpful as a diagnostic technique for patients with non-reconstructable azoospermia. It is a minimally invasive sperm retrieval technique and appears to be an effective alternative to microsurgical epididymal sperm aspiration, which is more invasive and costly. It is less invasive than testicular biopsy and preferably performed as a first step procedure in an attempt to obtain sperms for both diagnostic and therapeutic purposes.

Paraoxonase and arylesterase enzymes are corner stones of antioxidant defence. We aimed to compare azoospermic infertile men and normozoospermic individuals with respect to total antioxidant status ( TAS), total oxidant status ( TOS), oxidative stress index ( OSI), paraoxonase and arylesterase levels in the blood and seminal plasma. Two-hundred consecutive infertility patients and voluntarily participated were included. In the normozoospermic group, TAS, PON, arylesterase values were statistically significantly higher when compared with those in the azoospermic group, while lower TOS and OSI levels were observed in the blood and seminal plasma of azoospermic group. In the semen analyses of normozoospermic group, the correlation between semen volume, sperm concentration, sperm motility and morphology and TAS, TOS, OSI, PON and arylesterase values was examined. A negative correlation was determined between semen volume and OSI. Levels of serum oxidative parameters were higher in the azoospermic group relative to normozoospermic group, but antioxidant parameters were lower than those of the normozoospermic group. Oxidative stress performs an essential role in the aetiology of male infertility by negatively influencing sperm quality and function. Assessment of blood and seminal plasma oxidative profiles might be an important tool to better evaluation of sperm reproductive capacity and functional competence. [ABSTRACT FROM AUTHOR]

To study the genetic mutation, which could cause problems in spermatogenesis, we screened the point mutations of the FSH receptor gene (C566T) in idiopathic azoospermic men in Japan. We performed mutational analysis of the FSH receptor in 54 Japanese patients diagnosed for azoospermia with Sertoli cell-only (SCO) syndrome (n = 33), hypospermatogenesis (n = 11) and maturation arrest (n = 10). For mutation screening of the FSH receptor, polymerase chain reaction (PCR) amplification from genomic DNA with flanking intronic primers were used. On BsmI digestion, all patients demonstrated homozygous, normal exon 7 alleles with 51 and 27 bp fragments. The absence of any 78 bp fragments demonstrated that no heterozygous or homozygous mutant alleles were present in any patients. None of the 54 patients showed a C566T FSH receptor mutation. We could not confirm that the genomic mutation of the FSH receptor (C566T) is a common cause in Japanese azoospermic patients. [ABSTRACT FROM AUTHOR]

Introduction: Approximately half of infertility reasons are related to male factors among which genetic etiology is the main cause. Signaling molecules can regulate spermatogenesis during regulation of germ cells maturation. Tumor necrosis factor-a (TNF-α) is one of the prominent cytokines that supports signaling molecules and it can affect spermatogenesis. Materials and Methods: This case-control study includes 50 azoospermic men who referred to Yazd Research and Clinical Center for Infertility and 50 healthy controls. After sperm analysis, DNA was extracted and Restriction Fragment Length Polymorphic-Polymerase Chain Reaction (RFLP-PCR) was carried out for TNF alpha -308 polymorphism. Results: The frequencies of A allele and G allele were 58% and 42% in azoospermic group, and 34% and 67% among controls, respectively. Among azoospermic patients, 42% presented AA homozygous genotype, 32% AG heterozygous genotype, and 26% GG homozygous genotype. In the control group, 20% presented A A homozygous genotype, 28% AG heterozygous genotype, and 52% GG homozygous genotype. According to our findings, A allele (p=0.001, OR=2.681) and AA genotype (p=0.030, OR=2.89) have a positive association with spermatogenic failure in the cases. Conclusion: Our data suggest that the polymorphism might be associated with the risk of spematogenic failure in Iranian azoospermic and it can be used as an infertility marker for screening as well as further treatment. [ABSTRACT FROM AUTHOR]