Objective: To investigate the usage and the efficacy of vitamins as primary or adjuvant treatment in infertile men with varicocele. Methods: A systematic search in PubMed, the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cochrane Library with the terms (varicocele) AND (vitamins) was performed. We searched for studies: a) reporting the administration of vitamins (individually or as part of a complex) in men with varicocele and infertility, b) primarily or adjuvant to invasive treatment, and c) reporting the impact on semen parameters and/or pregnancy rates. Exclusion criteria were animal, adolescent and non-English studies, grey literature and trials reporting abstracts only. Results: Seven studies were identified eligible for qualitative analysis. All studies were randomised except one (case series). Vitamins were administered dominantly as part of antioxidant complex and only two studies used vitamins (C and E, respectively) as sole agent. In two studies, vitamin monotherapy resulted in improvement in semen quality, but the effect on pregnancy rates is unknown. One study reported no efficacy of adjuvant multivitamin treatment after embolisation in terms of both semen quality and pregnancy rates. Finally, four studies reported a positive effect of vitamins on semen parameters after varicocelectomy, but the effect on pregnancy rates is conflicting; one study reported improved pregnancy rates with adjuvant treatment, two studies did not evaluate the pregnancy rates, and in one study the outcome was unclear due to missing data. Conclusions: Vitamins have been used mostly as part of an antioxidant panel for the management of infertile men with varicocele. Most studies have found a positive impact on semen parameters in selected men with varicocele and infertility, as primary or adjuvant treatment. However, the clinical benefit of vitamins administration on pregnancy rate is under-evaluated and should be the target of future research.
Objective: The increasing use of scrotal ultrasonography (US) for non-cancerous indications has led to greater detection of incidental, small testicular masses. Operative intervention is currently the mainstay of treatment for all testicular tumours; however, despite the low malignant potential of small, incidental masses, little is known about conservative management using radiological surveillance. Methods: A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted and studies meeting the inclusion criteria were reviewed for patient outcomes. Results: A total of 293 patients across six studies underwent radiological surveillance for an incidental small testicular mass. Infertility was the main indication for investigation and all studies used US as the surveillance modality. A total of 37 patients (12.6%) underwent surgical exploration during follow-up, with only 10 (3.4%) found to have malignant disease at histology. Conclusions: Radiological surveillance of incidental small testicular masses is safe when used for select patient groups due to the high probability of benign disease, although optimal patient selection criteria and a well-defined protocol are lacking. This approach could be considered in patients with incidental, impalpable testicular masses of ≤5 mm in diameter displaying no significant size increase or internal vascularity on US and with negative tumour markers, as the probability of malignancy in these patients is low.
An analysis of sperm abnormalities can be used as a rapid method to determine the mutagenic potential of chemical agents as well as the toxic potential of chemicals on the whole animal. 0-Xylene was investigated for its potential mutagenicity by the sperm abnormality assay. Sprague Dawley rats 10-16 weeks old were injected intraperitoneally (ip) with 0.5 and 1.5 ml/kg body weight of o-xylene in corn oil. Five weeks after treatment, animals were sacrificed and sperm examined for morphological abnormalities. Several morphologically abnormal sperm types were observed; among these were those with amorphous heads, and banana-like heads. Animals housed at room temperatures of 20-24°C showed no significant increase in abnormal sperm over the control. Rats housed at temperatures between 24 and 30°C after ip injection with 0.5 rnl/kg o-xylene showed a significant increase in abnormal sperm.
Using a modified Giemsa-banding technique we have observed what appear to be chromosomes during interphase in nuclei from Allium cepa root tips and Chinese hamster cells (CHO line). During telophase through G1 chromosomes progressively uncoil and decondense. During S chromosomes are comparatively decondensed, but some segments have structure similar to chromosomes in G1 and G2. During G2 the chromosomes progressively recondense and coil in apparent preparation for prophase. Although specific structural modifications of chromosomes occur in G1, Sand G2 nuclei, chromosomes appear never to decondense to the point that they lose their 3-dimensional integrity, but remain in distinct domains throughout interphase.
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