• Title/Summary/Keyword: azoospermia

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Effectiveness of Permanent Silicone Stent-Assisted Vasovasostomy (정관내 부목을 이용한 정관복원술 : Permanent Silicone Stent의 효용가치)

  • Kim, Tae-Hyoung;Kim, Sae-Chul
    • Clinical and Experimental Reproductive Medicine
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    • v.23 no.1
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    • pp.67-71
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    • 1996
  • During a 2-year period microsurgical vasovasostomies using permanent silicone stent(c-shaped stent with 0.6mm slit, 5mm in length, 0.8mm in outer diameter, 0.5mm in inner diameter) were performed in 30 patients for vasectomy revesal. The stent-assisted vasovasostomy(SVV) was intended to decrease the technical demand, the time requirement and the occurrence of reobstruction due to postoperative stricture. The effectiveness of the permanent silicone stent for vasovasostomy was compared with that of microsurgical two-layered vasovasostomy(VV). Sperms were present in all the ejaculates of the 25 men on semen analysis 1-2 months after SVV. Pregnancy occurred in 10 of 22 couples(45.5%) during 2-24 months of follow-up and it took 4-10 months(average 7.2 months) to get pregnant. Average operation time for the VV was 150 minutes and that for the SVV 125 minutes. Among 12 men who had sperms in the ejaculates 1-2 months after SVV, 4 revealed azoospermia 3-17 months postoperatively. Among the 4 patients with postoperative azoospermia, 2 underwent reoperation. On histopathologic examination, previously anastomsed sites showed obliterated lumen of the stent and strictures of vas proximal and/or distal to the stents due to granulation tissues. In conclusion, the SVV was not more efficacious in terms of patency and pregnancy rate than the VV.

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Pregnancy and Delivery by Round Spermatid Injection into Oocytes in Human (원형정자세포의 주입에 의한 임신과 분만 1례)

  • Lee, S.M.;Jung, J.Y.;Han, Y.T.;Park, H.T.;Park, H.D.;Chung, K.S.;Lee, K.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.2
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    • pp.233-237
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    • 1998
  • We demonstrated that the normal pregnancy and delivery by round spermatid injection (ROSI) into oocytes was achieved from nonobstructive azoospermia patient. In this case, the normal fertilization rate was 50%. All of the two pronuclear stage embryos cleaved and were transferred to the patient's uterus. A singleton pregnancy was achieved and resulted in the birth of normal female infant. This resuJt show that intracytoplasraic injection of round spermatid seems to be new treatment of nonobstmctive azoospermia male infertility. Further research is needed to evaluate the required culture conditions to induce progression of the round spermatid into a more elongated stage.

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Update on genetic screening and treatment for infertile men with genetic disorders in the era of assisted reproductive technology

  • Lee, Seung Ryeol;Lee, Tae Ho;Song, Seung-Hun;Kim, Dong Suk;Choi, Kyung Hwa;Lee, Jae Ho;Kim, Dae Keun
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.4
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    • pp.283-294
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    • 2021
  • A genetic etiology of male infertility is identified in fewer than 25% of infertile men, while 30% of infertile men lack a clear etiology, resulting in a diagnosis of idiopathic male infertility. Advances in reproductive genetics have provided insights into the mechanisms of male infertility, and a characterization of the genetic basis of male infertility may have broad implications for understanding the causes of infertility and determining the prognosis, optimal treatment, and management of couples. In a substantial proportion of patients with azoospermia, known genetic factors contribute to male infertility. Additionally, the number of identified genetic anomalies in other etiologies of male infertility is growing through advances in whole-genome amplification and next-generation sequencing. In this review, we present an up-to-date overview of the indications for appropriate genetic tests, summarize the characteristics of chromosomal and genetic diseases, and discuss the treatment of couples with genetic infertility by microdissection-testicular sperm extraction, personalized hormone therapy, and in vitro fertilization with pre-implantation genetic testing.

Misuse of testosterone replacement therapy in men in infertile couples and its influence on infertility treatment

  • Song, Seung-Hun;Sung, Suye;Her, Young Sun;Oh, Mihee;Shin, Dong Hyuk;Lee, Jinil;Baek, Jeongwon;Lee, Woo Sik;Kim, Dong Suk
    • Clinical and Experimental Reproductive Medicine
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    • v.46 no.4
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    • pp.173-177
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    • 2019
  • Objective: We investigated the clinical characteristics of men with testosterone replacement therapy (TRT)-induced hypogonadism and its effect on assisted reproductive technology (ART) in infertile couples. Methods: This study examined the records of 20 consecutive male patients diagnosed with azoospermia or severe oligozoospermia (< 5 × 106/mL) who visited a single infertility center from January 2008 to July 2018. All patients were treated at a primary clinic for erectile dysfunction or androgen deficiency symptoms combined with low serum testosterone. All men received a phosphodiesterase 5 inhibitor and TRT with testosterone undecanoate (Nebido®) or testosterone enanthate (Jenasteron®). Patients older than 50 years or with a chronic medical disease such as diabetes were excluded. Results: The mean age of patients was 37 years and the mean duration of infertility was 16.3 ± 11.6 months. At the initial presentation, eight patients had azoospermia, nine had cryptozoospermia, and three had severe oligozoospermia. Serum follicle-stimulating hormone levels were below 1.0 mIU/mL in most patients. Three ongoing ART programs with female factor infertility were cancelled due to male spermatogenic dysfunction; two of these men had normal semen parameters in the previous cycle. After withholding TRT, serum hormone levels and sperm concentrations returned to normal range after a median duration of 8 months. Conclusion: TRT with high-dose testosterone can cause spermatogenic dysfunction due to suppression of the hypothalamic-pituitary-testicular axis, with adverse effects on infertility treatment programs. TRT is therefore contraindicated for infertile couples attempting to conceive, and the patient's desire for fertility must be considered before initiation of TRT in a hypogonadal man.

Analysis of the Azoospermia Factor (AZF) Gene on Y Chromosome and Expression Pattern of DAZ Gene in Korean Infertile Men (한국 남성 불임환자에서 Y 염색체상의 AZF Gene에 대한 분석 및 DAZ Gene의 발현 양상)

  • Lee, Ho-Joon;Lee, Hyoung-Song;Song, Gyun-Jee;Byun, Hye-Kyung;Seo, Ju-Tae;Kim, Jong-Hyun;Lee, You-Sik
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.1
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    • pp.57-65
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    • 1997
  • Cytogenetic observations of loss of the distal portion of the Y chromosome long arm were found to be associated with disrupted spermatogenesis. The existence of a gene involved in the regulation of spermatogenesis, the azoospermia factor (AZF), was postulated. In this study, we screened the AZF region including DAZ and DAZH genes and observed the expression pattern of DAZ and DAZH transcript in infertile men with azoospermia and oligospermia by using a sequence-tagged site (STS)-based PCR method. PCR primers were synthesized for 11 STSs that span Yq interval 6, SRY, DAZ, and DAZH, functional DAZ homologue on chromosome 3. Microdeletions were detected in 4/32 (12.5%) azoospermic men and 1/11 (9%) severe oligospermic men. Only 2 of 5 patients had microdeletions of Yq that contained the DAZ gene, whereas the other 3 patients had deletions extending from intervals 5L-6F proximal to the DAZ gene on Yq. Testis biopsies of the azoospermic patients revealed a variety from Sertoli cell-only syndrome to testicular maturation arrest. Of 4 men with clinical data available, average testis size was R: 13.8 cc, L: 13.8 cc, serum T was $4.0{\pm}1.25$ ng/ml, LH was $3.63{\pm}1.90$ mIU/ml, and FSH was $8.85{\pm}5.13$ mIU/ml. These values did not differ significantly from the remainder of the patients tested. We could not observed the DAZ transcript in 2 patients, who have no mature spermatozoa. In 11.6% of patients microdeletions of the AZF could be detected. These deletions in the AZF region seem to be involved causing spermatogenic failure. But the frequency of microdeletions proximal to DAZ suggests that DAZ is not the only gene associated with spermatogenic failure.

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Expression of HBP2 in Human Spermatogonial Stem Cell-like Cells from Nonobstructive Azoospermia Patients and Its Role in G1/S Transition & Downregulation in Colon Cancer

  • Yoo, Jung-Ki;Lee, Dong-Ryul;Lim, Jung-Jin;Kim, Jin-Kyeoung
    • Reproductive and Developmental Biology
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    • v.32 no.4
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    • pp.211-215
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    • 2008
  • The HMG box containing protein (HBP) has a high mobility group domain and involved in the regulation of proliferation and differentiation of tissues. We screened HBP2 in glioblastoma using Suppression Subtractive Hybridization (SSH) and isolated human spermatogonial stem cell-like cells (hSSC-like cells) derived from patients of nonobstructive azoospermia (NOA). Expression of HBP2 was analyzed by RT-PCR in undifferentiated stem cells (human Embryonic Stem Cells, hSSC-like cells 2P) and spontaneous differentiated stem cells (hSSC-like cells 4P). It was overexpressed in hESC and hSSC-like cells 2P but not in hSSC-like cells 4P. Also, the expression level of HBP2 was downregulated in colon tumor tissues compared to normal tissues. Specifically in synchronized WI-38 cells, HBP2 was highly upregulated until the G1 phase of the cell cycle and gradually decreased during the S phase. Our results suggest that HBP2 was downregulated during the spontaneous differentiation of hSSC-like cells. HBP2 was differently expressed in colon tissues and was related to G1-progression in WI-38 cells. It may playa role in the maintenance of an undifferentiated hSSC-like cell state and transits from G1 to S in WI-38 cells. This research was important that it identified a biomarker for an undifferentiated state of hSSC-like cells and characterized its involvement to arrest during cell cycle in colon cancer.

An infertile patient with Y chromosome b1/b3 deletion presenting with congenital bilateral absence of the vas deferens with normal spermatogenesis

  • Kuroda, Shinnosuke;Usui, Kimitsugu;Mori, Kohei;Yasuda, Kengo;Asai, Takuo;Sanjo, Hiroyuki;Yakanaka, Hiroyuki;Takeshima, Teppei;Kawahara, Takashi;Hamanoue, Haruka;Kato, Yoshitake;Miyoshi, Yasuhide;Uemura, Hiroji;Iwasaki, Akira;Yumura, Yasushi
    • Clinical and Experimental Reproductive Medicine
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    • v.45 no.1
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    • pp.48-51
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    • 2018
  • We report the case of a 46-year-old Chinese male patient who visited our clinic complaining of infertility. Semen analysis revealed azoospermia, and azoospermia factor c region partial deletion (b1/b3) was detected using Y chromosome microdeletion analysis. Testicular sperm extraction was performed after genetic counseling. The bilateral ductus deferens and a portion of the epididymis were absent, whereas the remaining epididymis was expanded. Motile intratesticular spermatozoa were successfully extracted from the seminiferous tubule. On histopathology, nearly complete spermatogenesis was confirmed in almost every seminiferous tubule. To our knowledge, this is the first case report of b1/b3 deletion with a congenital bilateral absence of the vas deferens and almost normal spermatogenesis.