Keywords : infertility

Association Between Testicular Microlithiasis and Infertility

Waleed Nassar Jaffal

Iraqi Postgraduate Medical Journal, 2012, Volume 11, Issue 2, Pages 280-283

Testicular microlithiasis (TM) is an uncommon condition, usually brought to attention when some other condition is being investigated. There have been reports suggesting a link between testicular microlithiasis and testicular dysfunction and tumors.
To study the association between testicular microlithiasis and male infertility.
From January 2010 to January 2011, 140 patients with different scrotal lesions presented to urologic consultation department at Al-Ramadi teaching hospital were included in this prospective study, all patients were examined by gray scale and doppler ultrasonograghy, their age ranges from 15 to 55 years. All cases of microlithiasis were recorded and complete information obtained from each patient. Seminal fluid analysis (SFA) was done for each patient with microlithiasis.
The age of patients ranges from 15 to 55 years (mean 34.6). Of 140 patients, 6 patients had microlithiasis (4.28%). Of 6 patients with microlithiasis, 5 patients were married and infertile and one of them had varicocele and one patient had testicular atrophy. One patient was unmarried but has varicocele and abnormal seminal fluid analysis.
There is strong association between testicular microlithiasis and infertility. Hypospermatogenesis in patients with TM may relate to both the degree of testicular dysgenesis and the presence or absence of concomitant scrotal pathology (eg, scrotal varicocele and testicular atrophy

Semen Quality of Infertile Couples--Comparison Between Smokers and Non-Smokers

Ammar Fadil Abid

Iraqi Postgraduate Medical Journal, 2010, Volume 9, Issue 3, Pages 293-296

The effect of cigarette smoking on spermatogenesis is unclear. Previous studies suggest a deleterious effect of cigarette smoking on semen on semen quality ,but their results have not been consistent.
To compare the various semen parameters of infertile cigarette smokers with infertile non-smokers, to study the effect of cigarette smoking on semen quality.
Semen samples of 66 cigarette smokers and 70 non-smokers infertile patients were included in the study. As far as possible; other factors which might influence semen quality were eliminated. Seminal parameters, when taken together, indicated the presence or absence of the three main semen variables: asthenospermia (A), oligospermia (O), and normospermia (N). Smokers were categorized as light, moderate and heavy smokers. Semen samples were examined for Asthenospermia and oligospermia, according to World Health Organization guidelines.
In our study, 25 non-smokers had normospermia (N) with their semen parameters falling within the normal ranges. In contrast, samples from 16 smokers qualified as N. This finding underscores the fact that smoking certainly has an adverse influence on the semen quality, as concluded in several other studies.
Asthenospermia (A) was the most dominant semen variable contributing to the semen quality of smokers (n = 34) as well as non-smokers (n = 31). Statistical analysis using Pearson chi-squared and t-test found no statistically significant effect of cigarette smoking on sperm density; motility or morphologic features of sperm were detected.
Our study shows a limited effect of smoking on conventional sperm parameters.

Status of Zinc and Copper Concentrations in Seminal Plasma of Male Infertility and Their Correlation with Various Sperm Parameters

Basil Oied Mohammed Saleh

Iraqi Postgraduate Medical Journal, 2008, Volume 7, Issue 1, Pages 76-80

Human semen contains high concentrations of zinc (Zn) and copper (Cu) in bound and ionic forms .The
presence of abnormal levels of these trace elements may affect spermatogenesis with regard to production
, maturation , motility , and fertilizing capacity of the spermatozoa. The aim of this study is to evaluate
the levels of Zn and Cu in seminal plasma in different groups of male infertility and to correlate their
concentrations with various semen parameters.
Forty primary infertile male individuals ,who had regular unprotected intercourse for at least one year
without conception with their partners ,aged 25-40 years were involved in the present study .After seminal
plasma fluid analyses they were grouped as, azoospermic (n=12), oligoasthenozoospermic (n=16) ,and
teratozoospermic (n=12) .Twelve fertile males selected from general population and after seminal fluid
investigation were taken as normospermic control group .Zinc and Copper concentrations in separated
seminal plasma of each infertile male and fertile control subject were determined by atomic absorption
This study showed significant decrease of seminal plasma Zn mean (+SEM) value in
oligoasthenozoospermic infertile males than in fertile male controls (p<0.037) .In azoospermic males, the
mean (+SEM) value of seminal plasma Zn levels was decreased (but still beyond the significant
level,p=0.08) when compared with that of fertile males. With regard to seminal plasma copper level there
was insignificant decrease in its level in azoospermic males and insignificant increase in its concentration
in oligoasthenozoospermic and in teratozoospermic males when compared with that of healthy fertile
males.In addition, there was a significant decrease in seminal plasma copper concentration in azoospermic
males than in oligoasthenozoospermic males (p<0.035).The results also revealed a significant positive
correlation between the sperm motility values and the seminal plasma zinc levels in
oligoasthenozoospermic group(r=0.68, p<0.022) along with a significant negative correlation between
sperm morphology values and zinc seminal plasma levels in teratozoospermic group (r=-0.63,p<0.049).
On the basis of the findings of this study, it seems that the estimation of seminal plasma levels of zinc and
copper may aid in investigation and treatment of infertile males.

The Value of Transvaginal Sonography Performed before Diagnostic Hysteroscopy for the Evaluation of Uterine Cavity in Infertile Women

Lilyan W. Sersam

Iraqi Postgraduate Medical Journal, 2007, Volume 6, Issue 4, Pages 276-285

Hysteroscopy have gained general acceptance as a method for the investigation of infertility. The main advantage of hysteroscopy is the capability of inspecting the uterine cavity. Transvaginal sonography (TVS) is a noninvasive modality that provide excellent imaging of the uterus and of endometrial abnormalities. The present study was designed to evaluate the use of TVS as the initial diagnostic procedure before hysteroscopy for detecting intrauterine disorders.
Seventy-eight infertile women were examined by TVS and diagnostic hysteroscopy in the late follicular phase of the menstrual cycle and the results were compared.
The uterine cavity abnormalities were present in 19.2% of the infertile females involved in the study. The Transvaginal sonography had 87.5% sensitivity, 100% specificity for detecting endometrial polyps while it had 100% sensitivity and 100% specificity for detecting other intrauterine cavity abnormalities including intrauterine adhesions, uterine septae and submucosal myomas.
Examination of the uterine cavity is an integral part of any thorough evaluation of an infertile woman. Transvaginal sonography, when performed during the follicular phase, can detect most uterine cavity abnormalities. It was an accurate tool in the identification of intrauterine adhesions, uterine septae and submucosal fibroids.