Azoospermia fnac
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The presentation is about male factor infertility. Absence of sperms, also known as Azoospermia. The treatments of an Azoospermia had changed a lot in the last 25 years starting in 1995 when the first successful case of non-obstructive Azooxpermia was published in the journal of human reproduction. This lecture elaborates on the various methods that are used for obtaining sperm from the testis and also explains the current progress happening in this field of stem cells in the management of males. Infertility,
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The document discusses testicular biopsy and interpretation. It provides details on:
- The structure and layers of the normal testis
- The cells present within the seminiferous tubules including Sertoli cells, spermatogonia, and spermatocytes
- Indications for testicular biopsy including male infertility and controversial role in testicular cancer
- Techniques for testicular biopsy including open surgical and percutaneous methods
- Patterns seen in infertile males such as maturation arrest, Sertoli cell only syndrome, and hypospermatogenesis
Testicular biopsy
This document provides an overview of testicular biopsy, including:
1) The indications for testicular biopsy include evaluating infertility, distinguishing obstructive from non-obstructive causes of azoospermia, and identifying malignant germ cells.
2) The common methods are open incisional biopsy and percutaneous biopsy, with open biopsy being optimal.
3) Interpretation of biopsies in infertility involves qualitative, semi-quantitative, and quantitative analysis to assess patterns of damage and prognosis. Abnormal patterns include maturation arrest, hypospermatogenesis, and Sertoli cell-only syndrome.
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1. Prenatal screening and diagnostic techniques allow for the detection of fetal chromosomal abnormalities and genetic disorders. Techniques include first and second trimester screening, cell-free DNA screening, chorionic villus sampling, amniocentesis, and cordocentesis.
2. First trimester screening incorporates factors like maternal age, nuchal translucency, and biochemical markers. Second trimester screening analyzes maternal serum markers. Cell-free DNA screening analyzes fetal DNA in maternal blood. Invasive techniques like CVS and amniocentesis allow for karyotyping.
3. Genetic counseling is recommended to discuss family histories, risk factors, screening results
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2) While PGD has clear benefits when used appropriately, the effectiveness of routine PGS is questionable as it may reduce pregnancy rates. Techniques like day 3 biopsy have limitations due to mosaicism.
3) Extensive counseling is important given technical limitations and risks of erroneous results. Not all genetic issues can be detected and treatment has biological limits. Caution is needed against unnecessary "indication creep".
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This document discusses azoospermia, which is defined as the absence of sperm in a man's ejaculate. It covers the causes, classification, evaluation, and management of azoospermia. The main points are:
1) Azoospermia can be obstructive, caused by blockages, or non-obstructive, caused by testicular failure to produce sperm. Evaluation involves semen analysis, hormone testing, ultrasound, and sometimes genetic testing.
2) Management depends on the cause. For obstructive cases, surgery may correct blockages, while for non-obstructive cases, procedures like TESA may retrieve sperm for use in IVF/ICSI. Pretest
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This document discusses using cell-free fetal DNA in maternal blood to non-invasively screen for fetal chromosomal abnormalities like trisomy 21, 18, and 13. Current methods require invasive tests on fetal tissue that carry risks of miscarriage. The document outlines how cell-free fetal DNA can be detected in maternal plasma using PCR and sequencing. It notes the percentage of fetal DNA needed for accurate detection and limitations like confirmation with diagnostic testing.
Micro-TESE as the latest option for the worst azoospermia scenarios
This document summarizes information from a presentation on azoospermia and microsurgical testicular sperm extraction (Micro-TESE). It defines obstructive and non-obstructive azoospermia and compares conventional sperm retrieval techniques to Micro-TESE. Micro-TESE has higher sperm retrieval rates compared to conventional TESE, especially for men with non-obstructive azoospermia. It allows identification and preservation of the few seminiferous tubules that may contain sperm, minimizing damage to the testis.
Cell free fetal dna testing for prenatal diagnosis
Cell-free fetal DNA was first discovered in maternal plasma in 1997 and can now be used for non-invasive prenatal diagnosis and testing through methods like massively parallel next-generation sequencing. Current applications of cell-free fetal DNA analysis include determining fetal sex, blood group, and screening for fetal aneuploidies and single-gene disorders. While performance is high, factors like fetal fraction and placental mosaicism can influence test accuracy and result in false positives or negatives in some cases. As the technology advances, the uses of non-invasive prenatal testing through analysis of cell-free fetal DNA continue to expand.
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Cytogenetic abnormalities
1. Cytogenetics is the study of chromosomes and abnormalities involving changes in number or structure. Key milestones included the discovery and counting of chromosomes and development of techniques like karyotyping.
2. Cytogenetic analysis involves culturing cells, arresting cell division, staining and analyzing chromosomes to identify abnormalities. It is used to diagnose conditions like Down syndrome, Edwards syndrome, Patau syndrome, Turner syndrome, and Klinefelter syndrome which are caused by gains or losses of whole chromosomes.
3. Chromosomal abnormalities can be numerical, involving extra or missing chromosomes, or structural with changes like translocations, deletions, or duplications. These abnormalities are associated with developmental delays, birth defects,
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Non-invasive prenatal testing (NIPT) uses a blood test to screen for chromosome abnormalities like Down syndrome early in pregnancy. Some women use positive results to terminate pregnancies or prepare for a child with disabilities, while critics argue it degrades the value of disabled children. Most women (over 90%) terminate if prenatal testing shows Down syndrome. As genetic testing becomes more widespread and affordable, it raises debates around abortion, disability rights, and eugenics.
Interpretation of testicular biopsy
The document discusses testicular biopsy and interpretation. It provides details on:
- The structure and layers of the normal testis
- The cells present within the seminiferous tubules including Sertoli cells, spermatogonia, and spermatocytes
- Indications for testicular biopsy including male infertility and controversial role in testicular cancer
- Techniques for testicular biopsy including open surgical and percutaneous methods
- Patterns seen in infertile males such as maturation arrest, Sertoli cell only syndrome, and hypospermatogenesis
Testicular biopsy
This document provides an overview of testicular biopsy, including:
1) The indications for testicular biopsy include evaluating infertility, distinguishing obstructive from non-obstructive causes of azoospermia, and identifying malignant germ cells.
2) The common methods are open incisional biopsy and percutaneous biopsy, with open biopsy being optimal.
3) Interpretation of biopsies in infertility involves qualitative, semi-quantitative, and quantitative analysis to assess patterns of damage and prognosis. Abnormal patterns include maturation arrest, hypospermatogenesis, and Sertoli cell-only syndrome.
Prenatal diagnosis
1. Prenatal screening and diagnostic techniques allow for the detection of fetal chromosomal abnormalities and genetic disorders. Techniques include first and second trimester screening, cell-free DNA screening, chorionic villus sampling, amniocentesis, and cordocentesis.
2. First trimester screening incorporates factors like maternal age, nuchal translucency, and biochemical markers. Second trimester screening analyzes maternal serum markers. Cell-free DNA screening analyzes fetal DNA in maternal blood. Invasive techniques like CVS and amniocentesis allow for karyotyping.
3. Genetic counseling is recommended to discuss family histories, risk factors, screening results
SPERM SELECTION IN ICSI
ICSI as it is presently performed is far from an ideal solution because the selection of sperm is based on the judgement of an embryologist, who is looking for the most normal appearing sperm available.
Anti mullerian hormone
Serum anti-Mullerian hormone (AMH) levels were measured in 14080 human samples over 6 months using an ELISA method. AMH levels declined with increasing age and varied individually. AMH strongly correlates with antral follicle count and predicts ovarian response to fertility treatments. AMH assessment is valuable for evaluating ovarian reserve, infertility, polycystic ovary syndrome, and menopausal status. While age impacts ovarian reserve, AMH is a better marker as levels decline earlier than other indicators.
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This document provides an overview of preimplantation genetic testing (PGT). It discusses the history and development of PGT, important terms, current techniques used like embryo biopsy and genetic analysis, indications for PGT including PGD and PGS, challenges and risks of PGT, and the future of the field. The techniques section describes the process of embryo biopsy and different genetic analysis methods like PCR, FISH, and microarrays.
PGD and PGS in India - the good, bad and ugly
1) PGD and PGS are genetic testing techniques used prior to embryo transfer in IVF treatment. PGD screens for known genetic disorders while PGS screens for chromosome abnormalities.
2) While PGD has clear benefits when used appropriately, the effectiveness of routine PGS is questionable as it may reduce pregnancy rates. Techniques like day 3 biopsy have limitations due to mosaicism.
3) Extensive counseling is important given technical limitations and risks of erroneous results. Not all genetic issues can be detected and treatment has biological limits. Caution is needed against unnecessary "indication creep".
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Clinical evaluation of an infertile male,necessary investigations,endocrines and role of ultrasonography and genetic screening
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PGD combines IVF with genetic testing of embryos before implantation. It aims to identify genetic defects or chromosomal abnormalities to select healthier embryos. There are two main types of testing - PCR for single gene disorders and FISH/CGH for aneuploidies. While PGD can reduce risks of genetic diseases and miscarriages, it has limitations as not all abnormalities can be detected and the procedure carries a small risk of embryo damage. As techniques advance to test all chromosomes, PGD may help avoid more conditions but remains an expensive and specialized procedure currently only available at certain IVF clinics in India.
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The document discusses the Sperm Chromatin Dispersion Test, which is used to assess DNA fragmentation in sperm. It works by using an acid treatment to denature fragmented sperm DNA, then removing nuclear proteins to allow dispersed DNA loops to form halos around nucleoids. For sperm with fragmented DNA, little to no halo is observed. Treatments discussed to address DNA fragmentation include antibiotics, antioxidants, lifestyle changes like quitting smoking, and medical procedures. The test is shown to be useful for diagnosing infertility issues and evaluating treatment effectiveness.
NIPT, Dr. Sharda Jain, Life Care centre
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This document discusses azoospermia, which is defined as the absence of sperm in a man's ejaculate. It covers the causes, classification, evaluation, and management of azoospermia. The main points are:
1) Azoospermia can be obstructive, caused by blockages, or non-obstructive, caused by testicular failure to produce sperm. Evaluation involves semen analysis, hormone testing, ultrasound, and sometimes genetic testing.
2) Management depends on the cause. For obstructive cases, surgery may correct blockages, while for non-obstructive cases, procedures like TESA may retrieve sperm for use in IVF/ICSI. Pretest
Fetal DNA in maternal serum
This document discusses using cell-free fetal DNA in maternal blood to non-invasively screen for fetal chromosomal abnormalities like trisomy 21, 18, and 13. Current methods require invasive tests on fetal tissue that carry risks of miscarriage. The document outlines how cell-free fetal DNA can be detected in maternal plasma using PCR and sequencing. It notes the percentage of fetal DNA needed for accurate detection and limitations like confirmation with diagnostic testing.
Micro-TESE as the latest option for the worst azoospermia scenarios
This document summarizes information from a presentation on azoospermia and microsurgical testicular sperm extraction (Micro-TESE). It defines obstructive and non-obstructive azoospermia and compares conventional sperm retrieval techniques to Micro-TESE. Micro-TESE has higher sperm retrieval rates compared to conventional TESE, especially for men with non-obstructive azoospermia. It allows identification and preservation of the few seminiferous tubules that may contain sperm, minimizing damage to the testis.
Cell free fetal dna testing for prenatal diagnosis
Cell-free fetal DNA was first discovered in maternal plasma in 1997 and can now be used for non-invasive prenatal diagnosis and testing through methods like massively parallel next-generation sequencing. Current applications of cell-free fetal DNA analysis include determining fetal sex, blood group, and screening for fetal aneuploidies and single-gene disorders. While performance is high, factors like fetal fraction and placental mosaicism can influence test accuracy and result in false positives or negatives in some cases. As the technology advances, the uses of non-invasive prenatal testing through analysis of cell-free fetal DNA continue to expand.
Alcian blue stain
Experiment No - 3 aims to perform an Alcian blue stain to identify acid mucopolysaccharides in a fungal sample such as Cryptococcus neoformans. The Alcian blue stain uses a blue dye that binds to acid mucopolysaccharides, allowing identification of fungi containing these substances under a microscope. The process involves staining tissue sections with Alcian blue solution followed by rinsing in distilled water and dehydration using concentrated alcohol solutions to preserve the stained sample.
Cytogenetic abnormalities
1. Cytogenetics is the study of chromosomes and abnormalities involving changes in number or structure. Key milestones included the discovery and counting of chromosomes and development of techniques like karyotyping.
2. Cytogenetic analysis involves culturing cells, arresting cell division, staining and analyzing chromosomes to identify abnormalities. It is used to diagnose conditions like Down syndrome, Edwards syndrome, Patau syndrome, Turner syndrome, and Klinefelter syndrome which are caused by gains or losses of whole chromosomes.
3. Chromosomal abnormalities can be numerical, involving extra or missing chromosomes, or structural with changes like translocations, deletions, or duplications. These abnormalities are associated with developmental delays, birth defects,
Hormonal cytology
This document summarizes the hormonal effects on vaginal cytology and the interpretation of vaginal smear samples. It describes how hormones influence the cells seen in smears throughout a woman's life. Estrogen causes maturation of superficial cells while progesterone increases intermediate cells. The maturation index is used to assess the ratio of cell types. Smears change over the menstrual cycle and with life events like pregnancy and menopause due to varying hormone levels. Precise collection and interpreting samples in the context of a patient's history is important for evaluation.
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2. Normal parameters include a sperm count of 15 million/ml or more, motility grades of 40% or more, and normal morphology of 4% or more according to WHO standards.
3. Samples should be collected after 2-7 days of abstinence and delivered to the lab within 1 hour to examine volume, pH, viscosity, sperm count, motility, morphology, and presence of other cells. Abnormal results can indicate conditions like infection or abnormalities of the reproductive organs.
Review of glaucoma
Glaucoma is a group of eye diseases that damage the optic nerve and cause vision loss. It is often associated with an abnormally high pressure inside the eye. There are several types of glaucoma including primary open-angle glaucoma (POAG), angle-closure glaucoma (ACG), and secondary glaucoma due to other health conditions. Glaucoma is managed through medication, laser treatment, or surgery depending on the type and severity. The goal is to prevent further optic nerve damage and vision loss.
hemolytic anemias
This document discusses several types of enzyme deficiency anemia, including pyruvate kinase deficiency, glucose-6-phosphate dehydrogenase deficiency (G6PD), and microangiopathic hemolytic anemia (MAHA). Pyruvate kinase deficiency is an inherited metabolic disorder causing hemolytic anemia due to deficiencies in ATP and 2,3-BPG production. G6PD deficiency is an inherited disease that causes hemolytic anemia by inhibiting the ability to detoxify oxidizing agents. MAHA causes hemolysis due to destruction of red blood cells in small blood vessels from microthrombi formation.
Meghana - neoplastic lesions of lymph node - part 1
This document summarizes neoplastic lesions of lymph nodes, including Hodgkin lymphoma and non-Hodgkin lymphoma. It describes the classification, histopathology, cytology, and variants of several types of lymphoma such as Hodgkin lymphoma, follicular lymphoma, diffuse large B-cell lymphoma, and Burkitt lymphoma. References including textbooks and the WHO classification of tumors of hematopoietic and lymphoid tissue are provided.
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After close to 45 years of assisted reproduction and a glance back at what are major milestones had impacted the practice of assisted reproduction. The first is the birth of Louis brown in 1978. A decade and a half later, the advent of icsi, tese icsi, has changed the management of male factor infertility. A decade later, in the early 2000s, we had the vitrification initially of the embryos, latter oocyte, and reproductive tissue. Now maybe we are. on the threshold of another revolution, and this time into ivf laboratory where the closed door of embryo development has to be opened to the miracle of early human embryology development through time-lapse embryo monitoring. This presentation walks you through the development
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1) The document discusses using 3D ultrasound to evaluate the uterus in four dimensions, including the myometrial architecture, junctional zone, endometrial cavity, and endometrial architecture.
2) Abnormalities that can be identified include developmental abnormalities of the uterus, myometrial abnormalities like adenomyosis, endometrial abnormalities like polyps, and iatrogenic issues like C-section scars.
3) 3D ultrasound can provide detailed information on the uterine and placental vasculature that 2D ultrasound cannot, and help identify vascular abnormalities like AV malformations that can impact fertility.
Endometrial receptivity
Endometrial receptivity is the ability of the endometrium to successfully attach the blastocyst, to nourish it, and keep it alive. .
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Time-lapse follow-up of embryo development comprises undisturbed culture and the application of the visual information to support embryo evaluation
UTERUS AND INFERTILITY
THIS SLIDE SET SHOWS CURRENT STATUS OF IMAGING IN 2019 AND EXPECT MANY MORE IN NEXT 5 YEARS WITH ARTIFICIAL INTELLIGENCE
Lh in assisted reproduction by DR G A RAMARAJU
Luteinizing hormone (LH) in synergy with follicle stimulating hormone (FSH) stimulates normal follicular growth and ovulation. FSH is frequently used in assisted reproductive technology (ART). Recent studies have facilitated better understanding on the complementary role of the LH to FSH in regulation of the follicle; however, role of LH in stimulation of follicle, optimal dosage of LH in stimulation and its importance in advanced aged patients has been a topic of discussion among medical fraternity. Though the administration of exogenous LH with FSH is obligatory for controlled ovarian stimulation in patients with hypogonadotropic hypogonadism, there is still a paucity of information of its usage in other patient population.A Brief introduction of Lh polymorphism in ovarian stimulation
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1) Letrozole is an aromatase inhibitor that has been shown to be an effective ovulation induction drug for infertility treatment, with benefits over clomiphene citrate such as higher ovulation and pregnancy rates and lower risk of multiple pregnancies and ovarian hyperstimulation syndrome.
2) A landmark randomized controlled trial found letrozole resulted in higher live birth rates compared to clomiphene citrate for infertility treatment in women with polycystic ovary syndrome.
3) Guidelines recommend letrozole as a first-line treatment option for ovulation induction in infertility, similar to clomiphene citrate. Letrozole is particularly beneficial in cases of clomiphene citrate resistance
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This document discusses various topics related to dealing with ART (assisted reproductive technology) failure, including potential stimulation options and factors to consider. It addresses empty follicle syndrome diagnosis and causes. Poor versus hypo-responder differences and options for each are outlined. The role of LH supplementation for hypo-responders is discussed. Ongoing debates around optimal versus excessive egg yields and coasting for hyper-responders are also summarized. Genetic factors like LHCGR and FSH receptor polymorphisms that could influence treatment are mentioned.
Progesterone measurement .
1. The document discusses measuring progesterone levels during IVF treatment and the role of progesterone in implantation.
2. There is debate around what progesterone levels indicate successful implantation, with some studies finding levels above 1.0 or 1.5 ng/ml can negatively impact outcomes, while others find higher thresholds.
3. Accurately measuring progesterone is challenging due to issues with assays, sample handling, and lack of standards between clinics. Establishing a standardized reference level could help improve IVF success rates.
Lh hormone 2017
This document discusses the rationale for using luteinizing hormone (LH) for ovulation induction and superovulation. It notes that LH plays an important role in the mid-follicular phase by regulating theca cell function and androgen production, which is necessary for follicular development. The concept of an optimal "therapeutic window" of LH levels is introduced, with both insufficient and excessive LH being detrimental to follicular growth and oocyte maturation. Certain patient groups, such as poor responders, older women, and those with LH polymorphisms, may benefit from LH supplementation during assisted reproductive technology cycles to improve outcomes.
Evaluation of male infertility
This document discusses the evaluation of male infertility, which is often neglected. It outlines the components of a complete evaluation, including history, physical exam, semen analysis, imaging, and hormonal and genetic testing. Lifestyle factors like smoking, alcohol, obesity, medications, and environmental exposures can negatively impact fertility. A physical exam evaluates secondary sex characteristics, genitals, and tests for issues like varicocele. Semen analysis assesses volume, concentration, motility, and morphology. Additional tests may include ultrasounds, hormone levels, sperm DNA fragmentation, and genetic testing. Finding the cause of infertility helps determine the best treatment approach.
Managing poor responder
This document discusses the definition and management of poor responders in IVF treatment. It begins by outlining the ESHRE consensus definition of a poor responder as having two of three features: advanced maternal age, a previous poor response, or an abnormal ovarian reserve test. It then lists factors that can predict a poor response such as AFC, AMH, ovarian volume, and prior poor response. The document discusses precyle adjuvants like DHEA supplementation, cyst drainage, and oral contraceptives. It also reviews stimulation protocols including agonist versus antagonist, natural cycle IVF, and dosing intervals. Laboratory options for poor responders like ICSI, PGS, and embryo transfer timing are discussed. The role of donor
LH hormone in assited reproduction
This document discusses the use of recombinant luteinizing hormone (rLH) in assisted reproduction. It begins by asking if an appropriate patient population has been defined that could benefit from rLH supplementation. It then discusses LH and FSH action on follicles, the LH therapeutic window concept, and how central nervous system influence can cause hypothalamic-pituitary-hypogonadism. The document presents studies showing improved follicular development and outcomes like pregnancy rates with the addition of rLH for poor responders and women over 35 undergoing fertility treatments. It also discusses dose-finding studies that identified a safe and effective dose of 75IU/day rLH. In conclusion, the risks of rLH supplementation are addressed as
Embryo transfer
This document discusses techniques for improving embryo transfer in IVF procedures. It recommends:
1) Proper evaluation of the uterine cavity and removal of cervical mucus to minimize trauma and avoid uterine contractions.
2) The use of soft catheters and avoiding negative pressure from the catheter to prevent complications.
3) Completing the procedure in a timely manner to increase chances of success.
Vitrification in IVF
This document summarizes key concepts in vitrification and cryobiology. It discusses the components involved in vitrification including cryoprotectants like sucrose, ethylene glycol, DMSO, and propylene glycol. It outlines the steps in vitrification - adding cryoprotectants, cooling cells to -196C, warming/thawing, and removing cryoprotectants. Variables that can influence vitrification effectiveness are discussed. Composition of vitrification and warming solutions from different studies are presented. Similar survival rates between vitrification and slow freezing are noted. Open questions around water removal from oocytes during vitrification are raised. The need for long term follow up studies on neonatal outcomes is emphasized.
Polycystic ovary
This document discusses polycystic ovary syndrome (PCOS) and its implications. It begins with the diagnostic criteria for PCOS including hyperandrogenism, oligo/amenorrhea, and polycystic ovaries. It then covers the diagnostic workup involving physical exams, laboratory tests, ultrasound, and optional tests. The document discusses the implications of PCOS for health including metabolic syndrome and future cardiovascular risks. It covers the implications for infertility such as treatments including lifestyle changes, clomiphene citrate, gonadotropins, laparoscopic ovarian drilling, metformin, and assisted reproduction. The implications for pregnancy with PCOS including gestational diabetes, pregnancy induced hypertension, preterm birth, birth weight,
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Azoospermia fnac
- 1. Negative FNAC in Azoospermia is it the end of the road.
- 2. 1995 human reproduction :landmark. BIOLOGICAL FATHERHOOD HAS BEEN POSSIBLE FOR MEN WITH NOA SINCE EARLY 1995 THROUGH SPERM EXTRACTION OR BIOPSIES
- 4. ART USING TESTICULAR SPERM obstruction vas recanalization epidydimal obstruction CBAVD POST INFLAMATORY transport PSYCHOGENIC ANEJACULATION SPINAL CORD INJURY LYMPHADENECTOMY production IDIOPATHIC AZOOSPERMIA CRYPTORCHIDISM IATROGENIC KLINEFELTER SYNDROME HYPOGONADOTROPHIC HYPOGONADISM
- 6. AT KRISHNAIVF WE LOOK INTO 3D ULTRSOUND
- 7. TYPES OF AZOOSPERMIA DECREASED FSH HYPOGONADOTROPIC PRETESTICULAR HORMONAL DYSFUNCTION HORMONAL TREATMENT SPERM RETRIEVAL NORMAL FSH NORMOGONADOTROPHIC POST TESTICULAR OBSTRUCTION SURGICAL CORRECTION SRT ICSI INCREASED FSH HYPERGONADOTROPHIC PRIMARY TESTICLAR DYSFYNCTION SPERM RETRIEVAL ICSI AID ADOPTION
- 8. Issues to consider before treatment SPERM genetic evaluation HORMONAL OPTIMIZATION MEDICAL THERAPY hypogonadotrophin hypogonadism VARICOCELE TREATMENT NOA
- 9. METHOD OF SPERM RETRIEVAL TESTICULAR SPERM ASPIRATION TESTICULAR SPERM EXTRACTION cTESE MICRO TESTICULAR SPERM EXTRACTION mtese Tetsicular mapping
- 11. Fnac
- 15. mtese.
- 16. AGE SEMEN VOLUME WEIGHT TOTAL TESTOSTERONE ULTRASOUND TESTICULAR VOLUME FSH LH BMI ARTIFICIAL INTELLIGENCE
- 18. IN THE NEXT COUPLE OF YEARS Invitro Spermatogenesis
- 20. Conclusions
- 21. CONCLUSION AND THOUGHTS TO PONDER SPERM LIVE BIRTH PROPER EVALUATION COUNSELLING OF OPTIONS LIMITATIONS AND COSTING SPERM RETRIEVAL + DIFFERENT FROM CARRY HOME BABY RATE SPERM STORAGE NUMBER OF CYCLES FEMALE AGE
Editor's Notes
- 1) 5 to 10% of infertile men for infertility are azoospermic 2) cause is by severe deficit mostly from primary sperm defect 3 ) a small percentage due to hypothalamic-pituitary dysfunction The goal of the management of any azoospermia should include a comprehensive clinical history , physical examination , serum testosterone, and fsh estimation. Cytogenetic evaluation is needed to detect Klinefelter's syndrome , Robertson translocation , reciprocal translocation, chromosomal inversion which can be harmful to embryo leading to aneuploidy.In addition, they should undergo y chromosome deletion .4% of NOA have AZF deletion which has an inheritance isssue