Ninety-six patients with varicocele were followed for 4 years in a prospective randomized study. Seventeen patients were excluded from the study in accordance with exclusion criteria. In 26 patients varicocele was treated surgically and 12 patients were treated either by sclerosation or embolization. Forty-one patients with varicocele had no therapy. In 54 patients oligoasthenozoospermia and in 25 normozoospermia was certified. In the group of patients without treatment, the pregnancy rate in the women was higher (22/41, or 53.7%) than in the group receiving treatment (13/38, or 34.2%). The difference was not statistically significant. After therapy, sperm concentration increased and sperm motility improved also. The differences were not statistically significant. The study showed that varicocele therapy bears no influence on male fertility.
Eighty-nine oligozoospermic men, treated by clomiphene or tamoxifen or with no treatment at all, were evaluated during a 4-year follow-up period. Ejaculate volume, sperm concentration, and sperm motility were determined and concentrations of prolactin (PRL), estradiol, beta hCG, prostaglandin E2, zinc, and fructose were ascertained. Isoenzyme LDH-C4 activity and serum PRL and follicle stimulating hormone were also determined. During treatment there was only a minimum increase in sperm concentration. No improvement in sperm motility and no alteration in ejaculate volume were observed. The pregnancy rate was lower in the partners of patients receiving treatment (23.8%) than in the partners of those receiving none (29.6%). Statistically the difference is insignificant. After antiestrogen therapy, prolactin concentrations in serum decreased and zinc concentrations in seminal plasma increased. For the treatment of idiopathic oligozoospermia in infertile men, clomiphene and tamoxifen were ineffective medication.
Selective reduction was performed in a patient with triplet pregnancy in the 9th week of gestation. Selective reduction of the fetuses to two was performed by puncture using vaginal ultrasound probe. No complications occurred and the patient was delivered of healthy twins.
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