To investigate the outcome of intracytoplasmic sperm injection with fresh and cryopreserved-thawed testicular spermatozoa in the first cycle in patients with obstructive azoospermia (OA) and non-obstructive azoospermia (NOA), a total of 90 cases, 48 OA and 42 NOA were studied. All patients underwent sperm retrieval by testicular sperm extraction (TESE) while their wives received conventional ovarian hyperstimulation. The hormone levels, testicular histology, the rates of sperm retrieval, fertilization, implantation and pregnancy were analysed and evaluated. This study and other four similar studies were subjected to meta-analysis. Sperm retrieval was successful in 100% OA and 61% NOA. Fresh spermatozoa were used in 87.5% and 92.4% of OA and NOA cases respectively; while cryopreserved-thawed spermatozoa were used in 12.5% and 7.6% of OA and NOA, respectively. The fertilization, implantation and clinical pregnancy rates were 65.5%, 15% and 25% respectively in OA group, and 54.2%, 5% and 23.1% respectively in NOA group. Sperm status (fresh or thawed), male partner's age, female age and male serum follicle-stimulating hormone had no significant effect upon fertilization rate, implantation rate, or pregnancy rate per embryo transfer. The results of meta-analysis indicate that there is no statistically significant difference in clinical pregnancy rates between the two groups. There was a significantly higher fertilization rate among OA patients in all analysed studies (95% CI = 14.29-15.71, d.f. 832, T = 1.96). In conclusion, although the fertilization rate was significantly higher in the OA group in our study and from the given meta-analysis, there were some differences as regards pregnancy rates. Although the overall effect was more or less similar pregnancy rates in both subtypes of azoospermia, this may not be true if non-male infertility variables were controlled for in all studies.

Our RTRs have higher prevalence rates of folliculitis and superficial fungal infections than the healthy population and they should be searched for in every patient with renal transplantation to ensure early treatment and avoid complications. Low-dose ketoconazole should be considered in renal transplant populations with high rates of superficial fungal infections, as it may reduce risk of such infections.

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They all had caesarean section in their last pregnancy. They were seen in two public hospitals and one privately owned hospital.RESULTS: The mean age of the patients was 31.3 years with age range of 23 to 37 years. Of the 53 patients, 10 (18.9%) were para 1, 19 (35.8%) para 2, 13 (24.5%) para 3 and 11 (20.8%) were para 4 and above. Among the 43 patients that were para 2 and above, 9 (20.9%) had had more than 1 caesarean sections. Mean duration of infertility was 2.2 years with range of 1.5 to 4.5 years. At last delivery, 35 (66.0%) of the 53 patients had emergency caesarean section while the remaining 18 (34.0%) cases were elective caesarean section. The 3 leading indication for the caesarean sections at last delivery were prolong obstructed labour 22 (41.5%), severe preeclampsia / eclampsia 9 (17.0%) and failed induction 8 (15.1%). Aetiology of infertility in the 53 patients were tubal occlusion 37 (69.8%), intrauterine adhesion 9 (17.0%), concomitant tubal occlusion and intra uterine adhesion 7(13.2%) and hyperprolactinaemic anovulation in the remaining 3 (5.7%) cases. Hysterosalpingographic assessment of 44 patients with tubal occlusion revealed 28 (63.3%) bilateral incomplete distal tubal occlusion, 7 (15.9%) bilateral complete distal tubal occlusion and 9 (20.5%) bilateral cornual occlusion. Seven patients with concurrent tubal occlusion and intrauterine adhesions, all had cornual blockage. One (2.3%) of the 44 patients with tubal occlusion had tuboplasty before the last conception was achieved.CONCLUSIONS: There is high rate of tubal occlusive disease more especially at the distal portion. This may not be unrelated to sepsis at caesarean section.OBJECTIVE: To determine if polymorphisms of the PTEN gene are associated with clinical markers of altered ovarian function.DESIGN: The phosphatase and tensin homolog (PTEN) gene product is involved in regulation of the cell cycle. Recently, early follicular loss was observed in a PTEN (-/-) mouse model. We searched for human PTEN genotypes associated with clinical markers of accelerated ovarian aging in women attempting conception through IVF.MATERIALS AND METHODS: We sequenced 15 SNPs across the PTEN gene to provide genotypes of 2763 women (2025 IVF patients, 189 egg donors). Clinical traits included day 3 estradiol and FSH levels (n¼2763), total FSH dose (n¼2703), number of mature follicles (R 14mm) present on the day of hCG administration, and the number of oocytes retrieved (n¼2402). Single SNP case-control and quantitative trait association analyses were performed. Haplotype phases were estimated and association analyses were calculated using dominant, additive, and recessive effect models with multiple testing adjustment. SNP analyses were performed with PLINK v1.0.4, haplotype analysis with haplo.stats v1.3.8 and Haploview v4.1 with data from HapMap (r22).RESULTS: The haplotype, allelic and linkage data for PTEN were consistent with the HapMap CEU population (n¼60). An age-adjusted recessive effect model yields a significant adjusted p value of association (p...