Comparison of Sperm Parameters in Patients with Infertility Induced by Genital Infection versus Varicocele

Association of Semen Bacteriological Profile with Infertility:- A Cross-Sectional Study in a Tertiary Care Center

Context:

Infections are an important cause of male infertility. The specific effects of infections on various semen parameters remain unexplored, especially within the Indian subcontinent.

Aim:

The aim of the study was to determine the bacteriologic profile of semen, and its effect on semen parameters, with particular emphasis given to Ureaplasma urealyticum and Mycoplasma hominis tested by semen polymerase chain reaction (PCR).

Study Setting and Design:

The research was a cross-sectionl analaytical study conducted in a tertiary care center in South India from March 2018 to November 2019, on 48 male partners of couples presenting with infertility.

Methodology:

After obtaining informed consent from the study participants, semen collection was done. The sample was subjected to standard semen analysis according to the WHO 2010 Manual, followed by bacteriological testing using routine culture methods. In addition, real-time PCR was done to test for U. urealyticum and M. hominis.

Statistical Analysis:

Demographic data, semen analysis parameters, bacteriological culture findings, and real-time PCR results were compared and analyzed using the software IBM^® SPSS 19.0.

Results:

A significant difference in viscosity of semen, which was higher in the samples that were positive for real-time PCR of M. hominis, was found. Other than this, no other parameter had a statistically significant difference between culture or real-time PCR positive samples and negative samples.

Conclusion:

Our study, though limited by a small sample size, highlights the role played by seminal infections in the context of male infertility. Larger scale prospective studies in this area would be invaluable in deciding the management plans of male factor infertility.

Preoperative duplex ultrasound parameters predicting male fertility after successful varicocelectomy

OBJECTIVES

To assess duplex ultrasound (DUS) parameters, and predicti the outcome of varicocele ligation in male infertility. 

METHODS

This retrospective and follow up study was conducted at Dr. Sulaiman Al Habib Hospital, AlQassim, Saudi Arabia between January 2011 and December 2012. Eighty-two patients were selected, who presented with clinical/subclinical varicocele and male infertility. All these patients had DUS of the scrotum and underwent for low ligation varicocelectomy. These patients were followed for a period of 12-24 months after surgery for the occurrence of paternity. We reviewed pre-operative scrotal DUS of these 82 patients for the testicular size and volume, pampiniform veins caliber and duration of reflux in the dilated veins at rest, and after valsalva maneuver. These DUS parameters were correlated with the postoperative paternity rate.  

RESULTS

Postoperative paternity was achieved in 18 patients (31.6%) with normal-sized testes, and in 3 patients (12%) with small size testes. The positive paternity rate was higher (38.5%) in patients with clinically detected varicocele, compared with only 16.7% of patients with subclinical varicocele (detected by ultrasound only). In addition, postoperative paternity was significantly higher in patients with bilateral varicocele (70.6%), with shunt-type varicocele (71.4%), and patients with a permanent grade of venous reflux (62.5%).  

CONCLUSION

Selection of patients for the successful paternity after varicocele repair depends mainly on DUS parameters, which includes normal size testicles with shunt type of bilateral varicocele and continuous reflux.

A correlation between selenium and carnitine levels with hypo-osmotic swelling test for sperm membrane in low-grade varicocele patients

OBJECTIVE

The hypo-osmotic swelling (HOS) test predicts membrane integrity by determining the ability of the sperm membrane to maintain equilibrium between the sperm cell and its environment. The aim of our study was to determine the correlation between selenium and carnitine levels in the seminal fluid with HOS test for sperm membrane in low-grade varicocele patients.

PATIENTS AND METHODS

Study numbered 64 examinees who suffered from low-grade varicocele and were divided into two groups, according to fertility potential and HOS test outcome. The study also included a control group of 64 healthy subjects, with no varicocele.

RESULTS

From the Shapiro-Wilk's test, it is clear that carnitine distribution differs significantly from normal (0.938, p = 0.03). In distribution of selenium, Kolmogorov-Smirnov test clearly shows statistically significant deviation from the normal curve (z = 0.225, p < 0.000), likewise Shapiro-Wilk's statistic (0.787, p < 0.000). According to the results, the second group had significantly higher levels of carnitine and selenium than the first group of examinees (p < 0.05); therefore, when we compared epididymal markers with HOS tests outcomes, we found significant differences between the two groups. There were no significant differences between second group and healthy subjects (p > 0.05).

CONCLUSIONS

HOS test outcome in varicocele patients is directly proportional to the carnitine and selenium levels, which could play a major role in both determining fertility parameters and in the treatment of its impairment. This result is important for sub-clinical varicocele in infertile patients with normal semen analysis, since there is no evidence of benefit from any treatment so far.