Investigação e reprodução assistida no tratamento da infertilidade masculina

Pasqualotto, Fábio Firmbach

doi:10.1590/s0100-72032007000200008

Cited by 24 publications

(18 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Apesar das excelentes taxas de sucesso com o tratamento cirúrgico da varicocele, muitos profissionais ainda questionam a validade da realização da varicocelectomia e indicam tratamento com reprodução assistida (PAsQUALOTTO et al, 2007).…”

Section: Fisiopatologiaunclassified

“…A cirurgia pode ser realizada por meio de diversos métodos, mas a maioria dos especialistas em infertilidade realiza o tratamento por via inguinal ou subinguinal (PAsQUALOTTO, 2007).…”

Section: Tratamento Cirúrgicounclassified

“…A cirurgia laparoscópica tem sido utilizada para tratamento da varicocele; entretanto, esta técnica apresenta grande risco de complicações intraperitoneais como perfuração vesical, intestinal ou de grandes vasos sanguíneos (PAsQUALOTTO, 2007).…”

Section: Tratamento Cirúrgicounclassified

“…Todas as abordagens cirúrgicas estão associadas com baixo risco de infecção da ferida operatória, hidrocele, recorrência ou persistência da varicocele, sangramento e raramente atrofia testicular (PASQUALOTTO, 2007).…”

Section: Tratamento Cirúrgicounclassified

“…na literatura, a maioria dos estudos tem mostrado um aumento significativo na concentração e motilidade espermática após o tratamento cirúrgico, mas a melhora da morfologia dos espermatozóides parece não estar tão bem comprovada ( JALLOULi et al, 2008). Muitos profissionais ainda questionam a validade da realização da varicocelectomia e indicam tratamento com reprodução assistida (PAsQUALOTTO, 2007).…”

Section: Tratamento Cirúrgicounclassified

See 4 more Smart Citations

Varicocele: A Principal Causa da Infertilidade Masculina

Fonseca¹,

Macedo²

2015

SaudPesq

View full text Add to dashboard Cite

RESUMO: na população de homens saudáveis, a incidência geral de varicocele é de 10% a 15%. entre homens que procuram um serviço de reprodução assistida essa taxa sobe para 38%. A varicocele é uma condição que envolve a dilatação do plexo pampiniforme, que drena o sangue dos testículos. O fluxo sanguíneo reverso é impedido por pequenas válvulas de sentido único. Defeitos nestas válvulas ou de compressão podem provocar dilatação do vaso e diminuição do volume testicular. O exame físico é fundamental para o seu diagnóstico e deve ser realizado em ambiente de temperatura não refrigerada, o que favorece o relaxamento da musculatura escrotal. A varicocele pode ser corrigida através do tratamento cirúrgico ou por embolização percutânea. A reprodução assistida demonstrou taxas de sucesso em relação à concepção, com o emprego de gametas obtidos diretamente dos testículos. A detecção precoce dessa alteração e seu tratamento cirúrgico eliminam com sucesso mais de 90% das varicoceles. Desta forma a correção cirúrgica permanece uma ótima opção para devolver a fertilidade ao casal com uma relação custo-benefício muito superior a qualquer procedimento de reprodução assistida. Assim, o objetivo desse trabalho é verificar, através de uma revisão bibliográfica, a prevalência de homens com infertilidade causada pela varicocele, processos fisiopatológicos, diagnóstico, suas formas de tratamento e a importância do auxílio das técnicas de reprodução assistida nos pacientes afetados. PALAVRAS-CHAVE: reprodução Assistida; Varicocele; infertilidade; VARICOCELE: THE MAIN CAUSE FOR MALE INFERTILIT YABSTRACT: General occurrence of varicocele in healthy male population lies between 10 and 15% and percentage rises to 38% among males who seek assisted reproduction service. Varicocele is a condition that involves the swelling of the pampiniform plexus that drains blood from the testicles. Reverse blood flow is impaired by small contrary valves, while defects in the valves or compression may cause the swelling of the vessel and a decrease of the testicle volume. A physical examination is basic for diagnosis and should be undertaken in a non-refrigerated environment which favors relax of the scrotal muscle. Varicocele may be corrected by surgery or by percutaneous embolization. Assisted reproduction has produced success rates with regard to conception through the use of gametes obtained directly from the testicles. early detection of alterations and surgery eliminate successfully more than 90% of varicocele. surgery is still the best option for fertility with higher cost-benefit than any other assisted reproduction. Current paper is a bibliographical review to verify the prevalence of males suffering from infertility caused by varicocele, physiopathological processes, diagnostic treatments and importance of reproduction techniques in patients.

show abstract

Section: Fisiopatologiaunclassified

“…A cirurgia pode ser realizada por meio de diversos métodos, mas a maioria dos especialistas em infertilidade realiza o tratamento por via inguinal ou subinguinal (PAsQUALOTTO, 2007).…”

Section: Tratamento Cirúrgicounclassified

See 3 more Smart Citations

Varicocele: A Principal Causa da Infertilidade Masculina

Fonseca¹,

Macedo²

2015

SaudPesq

View full text Add to dashboard Cite

show abstract

Molecular and cytogenetic studies of 101 infertile men with microdeletions of Y chromosome in 1,306 infertile Korean men

Kim

Choi

Park

et al. 2012

J Assist Reprod Genet

View full text Add to dashboard Cite

Objectives To determine the prevalence of Y chromosome microdeletions in infertile Korean men with abnormal sperm counts and to assess the clinical features and frequency of chromosomal abnormalities in Korean patients with microdeletions. Methods A total of 1,306 infertile men were screened for Y chromosome microdeletions, and 101 of them had microdeletions. These 101 men were then retrospectively studied for cytogenetic evaluation, testicular biopsy and outcomes of IVF and ICSI. ResultsThe overall prevalence of Y chromosome microdeletions in infertile men was 7.7 % (101/1,306). Most microdeletions were in the AZFc region (87.1%), including deletions of AZFbc (24.7 %) and AZFabc (8.9 %). All patients with AZFa, AZFbc and AZFabc deletions had azoospermia, whereas patients with an AZFc deletion usually had low levels of sperm in the ejaculate or in the testis tissues. Chromosomal studies were performed in 99 men with microdeletions, 36 (36.4%) of whom had chromosomal abnormalities. Among the infertile men with Y chromosome microdeletions in this study, the incidence of chromosomal abnormality was 48.6% in the azoospermic group and 3.7% in the oligozoospermic group. Among the 69 patients with microdeletions and available histological results, 100.0% of the azoospermic group and 85.7% of the oligozoospermic group had histological abnormalities. The frequency of both chromosomal abnormalities and histological abnormalities was higher in the azoospermic group compared to the oligozoospermic group. Thirtyfour ICSI cycles with either testicular (n014) or ejaculated spermatozoa (n020) were performed in 23 couples with men with AZFc microdeletion. Thirteen clinical pregnancies (39.4%) were obtained, leading to the birth of 13 babies. Conclusions The study results revealed a close relationship between microdeletions and spermatogenesis, although IVF outcome was not significantly affected by the presence of the AZFc microdeletion. Nevertheless, Y chromosome microdeletions have the potential risk of being transmitted from infertile fathers to their offspring by ICSI. Therefore, before using ICSI in infertile patients with severe spermatogenic defects, careful evaluations of chromosomal abnormalities and Y chromosome microdeletions screening should be performed and genetic counseling should be provided before IVF-ET.Capsule A close relationship exists between microdeletions and spermatogenesis, although IVF outcome was not significantly affected by the presence of an AZFc microdeletion.

show abstract

Comparison of microfluid sperm sorting chip and density gradient methods for use in intrauterine insemination cycles

Göde

Bodur

Güntürkün

et al. 2019

Fertility and Sterility

View full text Add to dashboard Cite

Objective: To compare the effect of microfluiding sperm sorting chip and density gradient methods on ongoing pregnancy rates (PRs) of patients undergoing IUI. Design: Retrospective cohort study. Setting: Hospital IVF unit. Patient(s): Couples with infertility undergoing IUI cycles between 2017 and 2018. Intervention(s): Not applicable. Main Outcome Measure(s): Ongoing PRs. Result(s): A total of 265 patients were included in the study. Microfluid sperm sorting and density gradient were used to prepare sperm in 133 and 132 patients, respectively. Baseline spermiogram parameters, including volume, concentration, motility, and morphology, were similar between the two groups. Total motile sperm count was lower in the microfluiding sperm sorting group at baseline (35.96 AE 37.69 vs. 70.66 AE 61.65). After sperm preparation sperm motility was higher in the microfluid group (96.34 AE 7.29 vs. 84.42 AE 10.87). Pregnancy rates were 18.04% in the microfluid group and 15.15% in the density gradient group, and ongoing PRs were 15.03% and 9.09%, respectively. After using multivariable logistic regression and controling for confounding factors, there was a significant increase in ongoing PRs in the microfluid sperm sorting group. The adjusted odds ratio for ongoing pregnancy in the microfluid group compared with the density gradient group was 3.49 (95% confidence interval 1.12-10.89). Conclusion(s):The microfluid sperm sorting method significantly increased the ongoing PRs compared with the density gradient group in IUI cycles. (Fertil Steril Ò 2019;112:842-8. Ó2019 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

show abstract

Investigação e reprodução assistida no tratamento da infertilidade masculina

Cited by 24 publications

References 24 publications

Varicocele: A Principal Causa da Infertilidade Masculina

Varicocele: A Principal Causa da Infertilidade Masculina

Molecular and cytogenetic studies of 101 infertile men with microdeletions of Y chromosome in 1,306 infertile Korean men

Comparison of microfluid sperm sorting chip and density gradient methods for use in intrauterine insemination cycles

Contact Info

Product

Resources

About