Follicle-stimulating hormone (FSH) is fundamental for Sertoli cell function stimulating spermatogenesis and follicular growth by a specific receptor (FSHR). This work aimed to investigate the occurrence of Asn and Ser FSHR gene variants and its relationship with seminal anti-Müllerian hormone (AMH) among normozoospermic and infertile oligoasthenozoospermic (OAT) males. Eighty-two Caucasian males grouped into normozoospermic healthy controls (n = 30) and infertile OAT males (n = 52). FSHR gene variants were determined by DNA from anti-coagulated blood and underwent polymerase chain reaction (PCR) amplification and electrophoresis in detecting amplification products. AMH in seminal plasma was determined by ELISA. The results showed that the frequency of FSHR gene variants among fertile men was 46.7% Asn/Asn (N680S), 33.3% Asn/Ser, and 20% Ser/Ser, whereas among OAT men were 34.6%, 38.5% and 26.9% respectively with nonsignificant differences. Seminal AMH was significantly higher in fertile than infertile OAT men. There was significant increase in seminal AMH with Asn/Asn variant of FSHR gene than those with Asn/Ser or Ser/Ser. It is concluded that FSH gene variants showed no difference in distribution between fertile or infertile OAT men. However, when correlated with seminal AMH values, there was an increase in Asn/Asn in men with high seminal AMH.

The SOV is located at the superomedial quadrant of the orbit. The SPOV is a reliable reference during surgical exposure. A lid crease or subbrow incision centered over the supraorbital notch simplifies identification of the SOV.

Polyorchidism is a rare anomaly, defined as the presence of more than two testicles with about 100 cases reported in the literature. The majority of cases were triorchidism with occasional bilateral duplication. We report the case of a 32-year-old man with polyorchidism, presenting with primary infertility with oligoasthenoteratozoospermia semen profile. Scrotal examination revealed two discrete ovoid nontender, firm, mobile lumps with testicular sensation in the right side of the scrotum. Ultrasonography and magnetic resonance imaging confirmed the presence of double testes with double separate epididymides sharing a common vas deferens in the right side of the scrotum. It demonstrated similar echo texture and vascular flow in both right-sided testicles although smaller in size than the left testis. The case was managed conservatively without surgical intervention with follow-up. Tracing of similar conditions in the literature was discussed.

OBJECTIVE To assess seminal plasma insulin‐like growth factor‐I (IGF‐I) levels in cigarette smokers with idiopathic oligoasthenoteratozoospermia (iOAT). PATIENTS AND METHODS In all, 110 men were divided into fertile healthy non‐smokers, fertile smokers, infertile non‐smokers with iOAT and infertile smokers with iOAT. Semen was analysed, and seminal cotinine and seminal IGF‐I levels estimated. RESULTS There were significantly lower seminal IGF‐I levels in the smokers and in men with iOAT than in controls, and in both iOAT groups. Smokers, either fertile or with iOAT had significantly lower levels than in controls in mean semen volume, sperm production index, percentage of motile sperms, rapid linear forward progressive motility, linear velocity and sperm normal forms. Smokers with iOAT had significantly lower levels than non‐smokers with iOAT in mean sperm production index, rapid linear forward progressive motility and linear velocity. In smokers, seminal cotinine was significantly and negatively correlated with both seminal IGF‐I and sperm motility, while seminal IGF‐I was positively correlated with the percentage of motile spermatozoa. CONCLUSION Smoking effects on sperm variables could be mediated by decreased seminal IGF‐I.

Sperm lipids are important for sperm viability, maturity and function. This study aimed to identify cholesterol and desmosterol composition of human spermatozoa of two sperm populations separated on Sil-Select gradient. Forty-eight males were divided into four groups namely healthy men (n = 13), asthenozoospermia (n = 11), asthenoteratozoospermia (n = 10) and oligoasthenoteratozoospermia (n = 14). Sperm cholesterol and desmosterol were estimated in two human sperm population separated by centrifugation in a discontinuous Sil-Select gradient. The results showed that cholesterol and desmosterol were the major sterols in human spermatozoa. Spermatozoa recovered from upper/lower layer interface (fraction I) had low fertilization potential, while those from the base (fraction II) had high fertilization potential. Median values of cholesterol and desmosterol in fraction I were 2.55 micromol and 0.77 micromol/10(9) spermatozoa and in fraction II were 1.16 micromol and 0.27 micromol/10(9) spermatozoa. Cholesterol/desmosterol ratio was significantly higher in fraction II than I (4.8 vs. 3.2, p < 0.01). Cholesterol, desmosterol, total phospholipids and sterols/phospholipids were negatively correlated with sperm concentrations, sperm motility, linear velocity, normal sperm morphology and acrosome reaction percentage whereas cholesterol/desmosterol ratio was positively correlated with these parameters. It is concluded that the difference in sterol composition of sperm subpopulations separated on Sil-Select gradient suggests that composition of sterols is related to sperm functions.

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Introduction Erectile dysfunction (ED) treatment studies do not measure treatment response and treatment satisfaction (both patient and partner satisfaction) where dissatisfaction reflects an aspirations/achievement gap. Aim To test the subjective implications of satisfaction to various therapeutic modalities for pure or mixed organic ED, and to address changes in the health-oriented quality of life (QoL) and the relation of psychiatric status of these patients to treatment satisfaction. Methods A prospective study included of 354 couples classified according to their line of therapy into five treated groups: testosterone, sildenafil citrate, intracavernosal injection, external negative vacuum device, and penile prosthesis. Main Outcome Measures Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and the International Index of Erectile Function (IIEF). Satisfied patients were compared to unsatisfied cases using the PCASEE scale for QoL and Middlesex Hospital Questionnaire (MHQ) for psychiatric status. Results Sildenafil citrate-treated group represented the highest mean value of satisfaction score on EDITS, erectile function, orgasmic function, and overall satisfaction domains of IIEF. Penile implants-treated group was the second for satisfaction score on EDITS. The testosterone-treated group represented the highest mean value for sexual desire domain score of IIEF. Low scores in various domains of QoL were significantly improved among satisfied cases more than unsatisfied subjects after therapy. High association was found between dissatisfaction and scores for anxiety, obsession, and phobia, followed by scores of depression and somatic concomitant of anxiety. Conclusion ED is best conceived as intermingle of somatic, lifestyle, psychological, and partner relationship determinants. This should be taken into account to increase sexual satisfaction with improved QoL, and not only to produce rigid erection.