The objective of this study was to investigate whether medical therapy can reduce sperm aneuploidy levels and irfiprove the results of intracytoplasmic sperm injection （ICSI） in patients with severe idiopathic oligo...The objective of this study was to investigate whether medical therapy can reduce sperm aneuploidy levels and irfiprove the results of intracytoplasmic sperm injection （ICSI） in patients with severe idiopathic oligoasthenoteratospermia （OAT）. Thirty-three infertile couples requiring ICSI because of severe idiopathic OAT after at least one unsuccessful ICSI cycle were considered. Semen parameters （concentration, motility and morphology）, the percentage of aneuploid sperm and the results of ICSI （the number of oocytes fertilized, embryos transferred, biochemical pregnancies, clinical pregnancies and live births） were compared before and after a 3-month course of treatment with L-carnitine 1 g given twice per day＋acetyI-L-carnitine 500 mg given twice per day＋one 30-mg cinnoxicam tablet every 4 days. Aneuploidy was assessed using fluorescent in situ hybridisation （FISH） performed on chromosomes X, Y, 13, 15, 16, 17, 18, 21 and 22. The results showed that 22 of the 33 patients had a reduced frequency of aneuploid sperm and improved sperm morphology after treatment （group 1）, and 11 showed no change （group 2）. The numbers of biochemical pregnancies, clinical pregnancies and live births were significantly higher in group I than in group 2. No significant difference was found between the groups regarding the numbers of oocytes fertilized and embryos transferred. The side effects were negligible. The numbers of ICSI pregnancies and live births in severe idiopathic OAT patients improved with a course of L-carnitine, acetyI-L-carnitine and cinnoxicam.展开更多
Aim： To evaluate the treatment outcome of antegrade internal spermatic vein sclerotherapy in men with non-obstructive azoospermia or severe oligoteratoasthenospermia （OTA） as a result of varicocele. Methods： Betwe...Aim： To evaluate the treatment outcome of antegrade internal spermatic vein sclerotherapy in men with non-obstructive azoospermia or severe oligoteratoasthenospermia （OTA） as a result of varicocele. Methods： Between September 1995 and January 2004, 47 patients （mean age 33.8 ± 6.3 years） underwent antegrade internal spermatic vein sclerotherapy for the treatment of varicocele with azoospermia （14 patients） or severe OTA （33 patients）. Testicular core biopsy was also performed in complete azoospermic patients who provided informed consent. The outcome was assessed in terms of improvement in semen parameters and conception rate. Results： Forty-two （89.4%） of 47 patients had bilateral varicocele. Serum follicle stimulating hormone （FSH） did not differ between patients with azoospermia and severe OTA. After the follow-up of 24.8 ± 9.2 months, significant improvement was noted in mean sperm concentration, motility and morphology in 35 patients （74.5%）. Comparison between groups during the follow-up revealed significantly higher values of sperm concentration, motility and normal morphology in the severe OTA group. Pregnancy was achieved in 14 cases （29.8%）. Testicular histopathology of the azoospermic patients with postoperative induction of spermatogenesis revealed maturation arrest at spermatid stage, Sertoli-cell-only （SCO） with focal spermatogenesis or hypospermatogenesis. None of the patients with pure SCO pattern or maturation arrest at spermatocyte stage achieved spermatogenesis after the treatment. Preoperative serum FSH levels didn＇t relate to treatment outcome. Conclusion： Antegrade internal spermatic vein sclerotherapy is an easy and effective treatment for symptomatic varicocele. It can significantly reverse testicular dysfunction and improve spermatogenesis in men with severe OTA, as well as induce sperm production in men with azoospermia, improving pregnancy rates in subfertile couples.展开更多
文摘The objective of this study was to investigate whether medical therapy can reduce sperm aneuploidy levels and irfiprove the results of intracytoplasmic sperm injection （ICSI） in patients with severe idiopathic oligoasthenoteratospermia （OAT）. Thirty-three infertile couples requiring ICSI because of severe idiopathic OAT after at least one unsuccessful ICSI cycle were considered. Semen parameters （concentration, motility and morphology）, the percentage of aneuploid sperm and the results of ICSI （the number of oocytes fertilized, embryos transferred, biochemical pregnancies, clinical pregnancies and live births） were compared before and after a 3-month course of treatment with L-carnitine 1 g given twice per day＋acetyI-L-carnitine 500 mg given twice per day＋one 30-mg cinnoxicam tablet every 4 days. Aneuploidy was assessed using fluorescent in situ hybridisation （FISH） performed on chromosomes X, Y, 13, 15, 16, 17, 18, 21 and 22. The results showed that 22 of the 33 patients had a reduced frequency of aneuploid sperm and improved sperm morphology after treatment （group 1）, and 11 showed no change （group 2）. The numbers of biochemical pregnancies, clinical pregnancies and live births were significantly higher in group I than in group 2. No significant difference was found between the groups regarding the numbers of oocytes fertilized and embryos transferred. The side effects were negligible. The numbers of ICSI pregnancies and live births in severe idiopathic OAT patients improved with a course of L-carnitine, acetyI-L-carnitine and cinnoxicam.
文摘Aim： To evaluate the treatment outcome of antegrade internal spermatic vein sclerotherapy in men with non-obstructive azoospermia or severe oligoteratoasthenospermia （OTA） as a result of varicocele. Methods： Between September 1995 and January 2004, 47 patients （mean age 33.8 ± 6.3 years） underwent antegrade internal spermatic vein sclerotherapy for the treatment of varicocele with azoospermia （14 patients） or severe OTA （33 patients）. Testicular core biopsy was also performed in complete azoospermic patients who provided informed consent. The outcome was assessed in terms of improvement in semen parameters and conception rate. Results： Forty-two （89.4%） of 47 patients had bilateral varicocele. Serum follicle stimulating hormone （FSH） did not differ between patients with azoospermia and severe OTA. After the follow-up of 24.8 ± 9.2 months, significant improvement was noted in mean sperm concentration, motility and morphology in 35 patients （74.5%）. Comparison between groups during the follow-up revealed significantly higher values of sperm concentration, motility and normal morphology in the severe OTA group. Pregnancy was achieved in 14 cases （29.8%）. Testicular histopathology of the azoospermic patients with postoperative induction of spermatogenesis revealed maturation arrest at spermatid stage, Sertoli-cell-only （SCO） with focal spermatogenesis or hypospermatogenesis. None of the patients with pure SCO pattern or maturation arrest at spermatocyte stage achieved spermatogenesis after the treatment. Preoperative serum FSH levels didn＇t relate to treatment outcome. Conclusion： Antegrade internal spermatic vein sclerotherapy is an easy and effective treatment for symptomatic varicocele. It can significantly reverse testicular dysfunction and improve spermatogenesis in men with severe OTA, as well as induce sperm production in men with azoospermia, improving pregnancy rates in subfertile couples.
