Novel concepts in male factor infertility: clinical and laboratory perspectivesSandro Esteves
Presentation Objectives:
1. Update on the WHO reference values for semen parameters, and understand the role of sperm DNA fragmentation testing to decision-making strategies;
2. Learn how to counsel azoospermic men seeking fertility, and the role of gonadotropin therapy in this infertility condition;
3. Understand the benefits of microsurgery to both sperm retrieval and varicocele treatment;
4. Appraise the role of medical and surgical interventions to infertile men undergoing ART.
This file accompanies a Youtube clip which covers the manner in which 1: biofeedback, 2: relaxation & meditation, 3: exercise & 4: social support can help manage stress. See facebook page 'epsychvce.com' or twitter account 'psyccounting' for link.
Novel concepts in male factor infertility: clinical and laboratory perspectivesSandro Esteves
Presentation Objectives:
1. Update on the WHO reference values for semen parameters, and understand the role of sperm DNA fragmentation testing to decision-making strategies;
2. Learn how to counsel azoospermic men seeking fertility, and the role of gonadotropin therapy in this infertility condition;
3. Understand the benefits of microsurgery to both sperm retrieval and varicocele treatment;
4. Appraise the role of medical and surgical interventions to infertile men undergoing ART.
This file accompanies a Youtube clip which covers the manner in which 1: biofeedback, 2: relaxation & meditation, 3: exercise & 4: social support can help manage stress. See facebook page 'epsychvce.com' or twitter account 'psyccounting' for link.
The 2nd Gulf Andrology Conference
Riyadh Military Hospital, Ministry of Defense
Riyadh, Saudi Arabia, March 3-4, 2012
Lectures: Current and Future Treatments for Azoospermia
The very brief slide-show looks at the physical, sexual, intellectual, moral and social developments we parents need to be aware of in our adolescent kids.
A Power Point Presentation offering some tips to help one cope with stress. Done by Bro. Oh Teik Bin, Lower Perak Buddhist Association, Teluk Intan, Perak, Malaysia. Please download for some background music and animation effects.
Clinical management of men with nonobstructive azoospermia - Azoospermia Diff...Sandro Esteves
Reproductive Andrology Workshop III
17-21 January 2016 - Kuwait City - KUWAIT
Organized by: Al Jahra Reproductive Medicine Unit - Ministry of Health
Lecture 1: Azoospermia Differential Diagnosis
Sperm Retreival: Optimizing Sperm Retrieval and Pregnancy in Nonobstructive A...The Turek Clinics
Dr. Paul Turek’s Society for the Study of Male Reproduction (SSMR) presentation at the American Urology Association (AUA) annual conference in Orlando, FL on Tuesday, May 20, 2014.
Clinical management of men with nonobstructive azoospermia - Steps Before Spe...Sandro Esteves
Reproductive Andrology Workshop III
17-21 January 2016 - Kuwait City - KUWAIT
Organized by: Al Jahra Reproductive Medicine Unit - Ministry of Health
Lecture 3: Steps Before Sperm Retrieval in Nonobstructive Azoospermia
Clinical management of men with nonobstructive azoospermia - Chances of Harve...Sandro Esteves
Reproductive Andrology Workshop III
17-21 January 2016 - Kuwait City - KUWAIT
Organized by: Al Jahra Reproductive Medicine Unit - Ministry of Health
Lecture 2: Chances of Harvesting Sperm in Nonobstructive Azoospermia
Clinical management of men with nonobstructive azoospermia - Sperm Retrieval ...Sandro Esteves
Reproductive Andrology Workshop III
17-21 January 2016 - Kuwait City - KUWAIT
Organized by: Al Jahra Reproductive Medicine Unit - Ministry of Health
Lecture 4: Sperm Retrieval Methods in Nonobstructive Azoospermia
Air quality: is it that important? And if so, how to measure and control it?Sandro Esteves
Quality and Risk Management in the IVF Laboratory; Redlara Brasil, Belo Horizonte, 14-15 September 2016
Content:
1.Air quality: is it that important?
2. How to control?
3. How to measure?
Public lecture - Stem Cell and Male InfertilitySandro Esteves
Reproductive Andrology Workshop III
17-21 January 2016 - Kuwait City - KUWAIT
Organized by: Al Jahra Reproductive Medicine Unit - Ministry of Health
Public Lecture - Stem Cell and Male Infertility
Clinical management of men with nonobstructive azoospermia - Role of IVF Labo...Sandro Esteves
Reproductive Andrology Workshop III
17-21 January 2016 - Kuwait City - KUWAIT
Organized by: Al Jahra Reproductive Medicine Unit - Ministry of Health
Lecture 5: Role of IVF Laboratory in Nonobstructive Azoospermia
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Management of Non Obstructive Azoospermia
1. ISAR
2014,
Ahmedabad
INDIA
Management
of
Non-‐obstrucFve
Azoospermia
Sandro
C.
Esteves,
MD.,
PhD.
Director,
ANDROFERT
Campinas,
Brazil
2. Management
of
NOA
ISAR
2014,
Ahmedabad
INDIA
Available
at:
hMp://www.androfert.com.br/review
Esteves,
2
ANDROFERT,
Referral
Center
for
Male
ReproducFon
3. Sperm
Count
in
Humans
General
PopulaFon
of
Unscreened
Men
CenFles
2.5%
50%
97.5%
4
64
237
Sperm
count
per
mL
(x106)
Azoospermia
Complete
lack
of
sperm
in
ejaculate
1-‐3%
male
populaFon
10-‐15%
male
inferFlity
populaFon
Cooper et al. Hum Reprod Update 2009; Esteves et al, Clinics 2011
Esteves,
3
ANDROFERT,
Referral
Center
for
Male
ReproducFon
4. Management of Non-obstructive
Azoospermia (NOA)
Select
the
Diagnosis
candidates
for
sperm
retrieval
and
ICSI
Select
who
could
benefit
Select
the
best
SR
from
intervenFons
method
prior
to
SR
ANDROFERT
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
S ESTEVES, 4
2014 FEBRUARY
Proper
lab
handling
of
surgically-‐
extracted
gametes
ANDROFERT
androfert.com.br
5. Diagnosis
-‐
Semen
Analysis
(x2)
Centrifuga2on
at
3,000g
for
15
minutes
The
supernatant
is
discharged
and
the
pellet
is
examined
Esteves,
5
ANDROFERT,
Referral
Center
for
Male
ReproducFon
6. Azoospermia
–
DifferenFal
Diagnosis
Azoospermia
Subtypes
ObstrucFve
Clinical
Picture
Spermatogenesis
NL
tesFs
NL
FSH,
LH,
TT
Mechanical
block
Normal
Hypo-‐hypo
Non-‐
obstrucFve
Esteves,
6
TesFcular
failure
High
FSH/LH
(NL)
Low
TT
(NL)
Small
tesFs
(NL)
FSH/LH
<1.2
mUI/mL
Low
TT
Small
tesFs
Poor
virilizaFon
Disrupted
ANDROFERT,
Referral
Center
for
Male
ReproducFon
7. NOA
&
TesFcular
Failure
EFology
Congenital
TesFcular
dysgenesis/cryptorchidism
GeneFc
abnormaliFes
(Klinefelter
syndrome,
Yq
microdeleFons,
etc.)
Acquired
TesFcular
torsion;
Trauma
Post-‐inflammatory
(eg.
Mumps
orchiFs)
Exogenous
factors
(steroids,
cytotoxic
drugs,
irradiaFon)
TesFcular
Cancer;
Systemic
diseases
(liver
cirrhosis,
renal
failure)
Varicocele
Idiopathic (Unknown etiology)
Untreatable
condiFon
Sperm
Retrieval
and
ICSI
Esteves
SC
&
Agarwal
A.
An
update
on
the
clinical
assessment
of
the
infer2le
male.
Clinics
66;
2011
Esteves,
7
ANDROFERT,
Referral
Center
for
Male
ReproducFon
8.
SelecFng
candidates
for
SR
Does
e2ology
play
a
role?
Etiology category
Cryptorchidism
Varicocele
Post-infection
Torsion
Post-chemotherapy/RT
Genetic (Klinefelter, AZFc Yq microdeletions)
Idiopathic
No
SR success rate
52-74%
63-68%
67%
>50%
25-75%
25-70%
50-60%
Presence
of
a
site
of
sperm
producFon
is
not
related
to
the
eFology
of
NOA
Esteves
et
al.,
Fer%l
Steril
94;
2010;
Raman
and
Schlegel.
J
Urol.170;
2003;
Hopps
et
al.
Hum
Reprod.
180,
2003;
Damani
et
al.
JCO.
15;
2002
Esteves, 8
ANDROFERT, Referral Center for Male Reproduction
9. SelecFng
candidates
for
SR
Can
biomarkers
predict
SR
success?
FSH
levels
No
Testosterone
levels
TesFcular
Volume
TesFcular
Histopathology
Markers
reflect
global
spermatogenic
funcFon
but
not
the
presence
of
a
site
of
sperm
producFon
in
a
dysfuncFonal
tesFs
Esteves, Miyaoka & Agarwal. Clinics 2011; Verza Jr. & Esteves. Fertil Steril 2011;
Carpi et al. Fertil Steril 2009.
Esteves, 9
ANDROFERT, Referral Center for Male Reproduction
10.
SelecFng
candidates
for
SR
YCMD
screening
by
PCR
AZFa
deleted
Sertoli
Cell
Only
SRR
=
0%
AZFc
deleted
AZFb
deleted
Matura2on
Arrest
(RBMY;
PRY)
SRR
=
0%
Hypospermatogenesis,
Matura2on
arrest,
SCO
SRR
~70%
Hamada
et
al.
2012;
Esteves
&
Agarwal
Int
Braz
J
Urol
2011;
Foresta
et
al
Endocr
Rev
2001.
Esteves, 10
ANDROFERT, Referral Center for Male Reproduction
11. Management
of
NOA
Key
Messages
(1)
Azoospermia
is
a
descripFve
term
of
ejaculates
that
lack
spermatozoa
without
implying
a
specific
underlying
cause.
NOA
due
to
tesFcular
failure
is
the
most
severe
male
inferFlity
condiFon.
It
represents
a
spectrum
of
congenital
or
acquired
tesFcular
disorders
that
cannot
be
treated.
All
men
with
tesFcular
failure
are
candidate
for
SR
but
those
with
YCMD
in
subregions
AZFa
and/or
AZFb.
Esteves,
11
ANDROFERT,
Referral
Center
for
Male
ReproducFon
12. Who
can
benefit
from
intervenFons
prior
to
sperm
retrieval?
NOA
and
hypogonadism
(TT<300ng/dL)
Esteves,
12
NOA
and
clinical
varicocele
ANDROFERT,
Referral
Center
for
Male
ReproducFon
13. Who
can
benefit
from
intervenFons
prior
to
sperm
retrieval?
Principle
Boost
testosterone
produc2on
NOA
and
hypogonadism
(TT<300ng/dl)
OpFons
AnF-‐estrogens
Aromatase
inhibitors
u-‐hCG/rec-‐hCG
Esteves,
13
ANDROFERT,
Referral
Center
for
Male
ReproducFon
14. Medical
therapy
before
SR
Hypogonadism
Klinefelter
Syndrome
with
NOA
and
hypogonadism;
N=91
Positive Tx response (increase in TT)
No response
72
55
P
=
0.03
Sperm Retrieval Rate (%)
Ramasamy
et
al.,
J
Urol.
2009
Esteves,
14
NOA
and
favorable
tesFcular
hystopathology;
N=43
Anti-estrogen (CC 50mg)
every other day; no
controls
64% men had sperm in the
ejaculates post-Tx (mean:
3.8 M/mL);
Spermatozoa obtained by
SR in all who remained
azoospermic.
Hussein
et
al,
J
Androl
2005
ANDROFERT,
Referral
Center
for
Male
ReproducFon
15. hCG
for
men
with
NOA
and
hypogonadism
Classic treatment
Urinary hCG 1,000-2,000 UI IM
injections; twice or t.i.w;
minimum 12 weeks
SC
self-‐injec2on
w/
pre-‐filled
syringe,
qw
FraieMa
&
Esteves
Clinics
2013;
Esteves
&
Papanikolaou
FerFl
Steril
2011
Esteves,
15
ANDROFERT,
Referral
Center
for
Male
ReproducFon
16. NOA
and
clinical
varicocele
Microsurgical
Varicocele
Repair
Meta-analysis of 11 case series (N=233)
39% men had motile sperm in postop.
ejaculates (mean: 1.6 M/mL)
Weedin
JW
et
al,
J
Urol.
2010
Retrospective study with SR in 96 pts.
with treated and untreated varicocele
Success: 53% vs 30% (increased by 2.6fold in treated pts.)
Inci
et
al,
J
Urol.
2009
Miyaoka
&
Esteves.
Adv
Urol
2012
Esteves,
16
ANDROFERT,
Referral
Center
for
Male
ReproducFon
17. Which
is
the
best
sperm
retrieval
technique
in
NOA
?
30-‐50%
cases:
minimal
producFon
within
the
tesFs,
but
not
enough
for
sperm
to
appear
in
ejaculate
Goal
is
to
iden2fy
site
of
produc2on
and
retrieve
sperm
for
ICSI
Geographic
loca2on
unpredictable
Esteves,
17
Esteves SC & Agarwal A. Sperm Retrieval Techniques; In: Gardner D et al (Eds.), Human Assisted
Reproductive Technology. Cambridge University Press, pp. 41-53, 2011
ANDROFERT,
Referral
Center
for
Male
ReproducFon
18. Sperm
retrieval
in
NOA
which
is
the
best
technique?
Schlegel
1999
Controlled
Series
Amer
et
al.
2000
Okada
et
al.
2002
Okubu
et
al.
2002
Tsujimura
et
al.
2002
Ramon
et
al.
2003
43%-‐53%
TESE
25%-‐41%
Esteves
et
al.
2011
Esteves
et
al.
Sperm
retrieval
Techniques.
Int
Braz
J
Urol
2011
Esteves, 18
ANDROFERT, Referral Center for Male Reproduction
19. Esteves
SC,
Int
Braz
J
Urol
2013
hMp://androfert.com.br/videos
20. Management
of
NOA
Key
Messages
(2)
Men
with
hypogonadism
(TT<300)
and
clinical
varicocele
may
benefit
from
intervenFons
prior
to
SR,
but
evidence
is
modest
Men
with
NOA
are
not
sterile.
Foci
of
sperm
producFon
is
found
in
30-‐50%
of
cases.
Micro-‐TESE
best
method
to
idenFfy
areas
of
sperm
producFon;
minimal
Fssue
removal
facilitaFng
sperm
search
and
processing
Esteves,
20
ANDROFERT,
Referral
Center
for
Male
ReproducFon
21. Laboratory handling of surgicallyretrieved spermatozoa
Avoid iatrogenic damage
Optimize sperm retrieval
Optimize ICSI outcomes
Esteves, 21
ANDROFERT, Referral Center for Male Reproduction
22. ICSI
Outcome
in
Azoospermia
Non-‐obstrucFve
(N=151)
ObstrucFve
(N=146)
100
41.4
47
64
Sperm
retrieval
(%)
2PN
FerFlizaFon
(%)
OR=0.033
95%
CI:
0.007-‐0.164;
p<0.001
P<0.01
43.3
61
20
Top
Quality
Embryos
(%)
34.2
Live
Birth
(%)
OR=0.38
95%
CI:
0.23-‐0.61;
p<0.001
Esteves
et
al.
Asian
J
Androl.
In
press
Esteves,
22
ANDROFERT,
Referral
Center
for
Male
ReproducFon
23. Conven2onal
TESE
Micro-‐TESE
Fragment
weight
Microsurgical
vs
single-‐biopsy
TESE
Fragment
weight
Tissue removed (mg)
Open Large Micro-TESE
PSingle-Biopsy
value
TESE
65
±
25
Esteves, 23
8.9
±
2.5
<0.01
Verza
Jr
&
Esteves.
Fer5l
Steril
2011;
Esteves
&
Varghese,
2013
ANDROFERT, Referral Center for Male Reproduction
24.
25.
Health
of
Babies
Born
in
NOA
NOA
(n=63)
Ejaculated
Sperm
(n=247)
ObstrucFve
Azoospermia
(n=117)
244.6
273.3
257.7
P = NS
35.7
36.9
37.0
GestaFonal
age
(wks)
6.3
Birth
weight
(gramsx10)
2.0
2.5
%
Perinatal
death
3.2
1.2
1.7
%
Birth
defects
Esteves & Agarwal. Reproductive outcomes including neonatal data of sperm
injection in men with obstructive and nonobstructive azoospermia: case series and
systematic review. CLINICS, 2013
Esteves, 25
ANDROFERT, Referral Center for Male Reproduction
26.
Neonatal
Outcome
of
Babies
Born
Region
Palermo
et
al.
1999
Vernaeve
et
al.
2005
N
children
TesFcular
failure
vs
OA
Outcomes
Main
findings
USA
22
vs
158
Congenital
abnormali2es
4.5%
TF
vs
1.3%
OA
(ns)
Belgium
61
vs
196
Perinatal
data
Congenital
abnormali2es
Congenital
abnormali2es
Perinatal
data;
Lower
gesta2onal
age
(singletons);
Increased
frequency
of
premature
twins
ajor
n
childre
352
Fedder
et
al
2007
Denmark
76
vs
282
Belva
et
al.;
2011
Belgium
193
vs
474
Congenital
abnormali2es
No m
4%
TF
vs
ference
dif 3%
OA
(ns)
0%
TF
vs
4.0%
OA
(ns)
Similar
perinatal
outcomes;
4.2%
TF
vs
5.2%
OA
(ns)
Esteves & Agarwal. Reproductive outcomes including neonatal data of sperm
injection in men with obstructive and nonobstructive azoospermia: case series
and systematic review. CLINICS, 2013
27. Management
of
NOA
Key
Messages
(3)
SR
rates
and
reproducFve
outcomes
arer
ICSI
are
differenFally
affected
by
NOA
Controlled
lab
condiFons
and
techniques
important
to
improve
SR
and
ICSI
outcomes
Health
of
neonates
not
differenFally
affected
by
NOA;
limited
data
Esteves,
27
ANDROFERT,
Referral
Center
for
Male
ReproducFon
28. Management of NOA
Summary
Improve
SR
Semen
analyses
and
differenFaFon
between
azoospermia
subtype
1.
Diagnosis
Medical
Tx
in
hypogonadism
2.
Select
candidates
for
SR
YCMD
Microsurgical
repair
of
clinical
varicoceles
3.
Check
who
benefit
of
intervenFons
prior
to
SR
ANDROFERT
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
S ESTEVES, 28
2014 FEBRUARY
4. Select
the best
SR
method
Micro-‐
TESE
Avoid
iatrogenic
damage
Not
jeopardize
ICSI
outcomes
5.
OpFmal
lab
condiFons
and
techniques
ANDROFERT
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