Assisted reproductive techniques in men: review of clinical guidelines and workup algorithm

Korneev, I. A.; Zasseev, Ruslan D.; Isakova, E. V.; Kinunen, A. A.; Bichevaya, N. K.

doi:10.17116/repro20182404159

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Широкое внедрение в клиническую практику ультразвуковых исследований (УЗИ), а также поддержанная профессиональными сообществами рекомендация выполнять УЗИ органов мошонки при мужском бесплодии [1,2] способствовали увеличению обращаемости пациентов по поводу тестикулярного микролитиаза (ТМ). Несмотря на то что первые описания микролитов в ткани яичек были сделаны еще в 20-х годах прошлого века [3,4], до настоящего времени не устранены противоречия в представлениях о распространенности ТМ, связанных с ним рисках и стратегии ведения пациентов с разными его формами.…”

Section: Introductionunclassified

“…Таким образом, несмотря на то что в микролитах не содержатся опухолевые элементы, выводы отечественных и зарубежных специалистов позволяют считать ТМ предраковым состоянием и проявлять при ТМ онкологическую настороженность. Так, согласно рекомендациям Европейской ассоциации урологов, врачам надлежит советовать пациентам с ТМ регулярно выполнять самообследование, а при наличии сопутствующих факторов риска развития рака яичка, к которым относят бесплодие и билатеральный ТМ, гипоплазию яичек (объем яичек менее 12 мл), крипторхизм, ранее выявленный рак яичка и ТМ с противоположной стороны -с высоким уровнем убедительности рекомендаций предлагать пациентам выполнение биопсии яичка для раннего выявления его злокачественного поражения [2].…”

Section: Introductionunclassified

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Testicular microlithiasis in male infertility: prevalence, diagnosis and treatment algorithm

Korneyev

Zasseev

Aloyan

et al. 2020

Urology reports (St. - Petersburg)

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Aim of study. To estimate testicular microlithiasis (TM) prevalence in men seeking help for infertility in reproductive medicine center, and generate an algorithm for TM management according to patients choice to perform testicular biopsy or not. Materials and methods. We retrospectively reviewed charts of 143 consecutive adult male patients between 19 and 73 years (mean age 34.6 7.9) seeking help for infertility in International Center for Reproductive Medicine. Gray-scale and color Doppler were used to calculate testicular volume and to study a spectrum of scrotal disorders including testicular microlithiasis. Results. Testicular size varied from 0.5 to 33.3 ml (mean 12.3 5.8 ml), testicular hypoplasia, varicocele, hydrocele and epididymal cysts were detected in 88 (61.5%), 35 (24.5%), 9 (6.3%) and 50 (35%) patients respectively. TM signs were identified in 12 (8.4%) men, including 5 (42%) cases of classic TM and 7 (58%) cases of limited TM; 5 (42%) men had bilateral TM. One 1 (8%) patient with bilateral ТМ had ultrasonic appearance of non-palpable testicular tumor, radical surgical treatment was performed. Patients with TM had smaller testicles, higher prevalence of azoospermia and testicular tumor (p = 0.002, 0.013 and 0.085 respectively). All patients with TM were informed about their risks to harbor testicular cancer and taught self-examination technique. Testicular biopsy was offered to all men with concomitant risk factors for testicular cancer development, however none of the patients agreed. We have consequently developed algorithm for TM management according to patients choice to perform or to avoid testicular biopsy. Conclusion. ТМ is common in infertile men, scrotum ultrasound is indicated to detect it. The suggested algorithm for TM management is aimed towards early testicular cancer detection and successful treatment with fertility potential preservation.

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Section: Introductionunclassified

Testicular microlithiasis in male infertility: prevalence, diagnosis and treatment algorithm

Korneyev

Zasseev

Aloyan

et al. 2020

Urology reports (St. - Petersburg)

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Comparison of the effectiveness of medications containing a combination of zinc and arginine for treatment of male infertility

Жуков¹,

Брагина

Левина

et al. 2020

Androl. genit. hir.

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The study objective is to perform clinical laboratory evaluation of the effectiveness of Prostatilen® AC and Arginine-zinc in treatment of patients with sperm pathology and concomitant varicocele and chronic nonbacterial prostatitis.Materials and methods. The study included 60 patients between 23 and 46 years of age. The first group included 30 patients (15 patients with varicocele and 15 patients with chronic nonbacterial prostatitis) who received Prostatilen® AC. The second group included 30 patients (15 patients with varicocele and 15 patients with chronic nonbacterial prostatitis) who received Arginine-zinc. Therapy duration was 20 days. Standard clinical and laboratory examination, spermiologic examination as well as measurement of antisperm antibodies, DNA fragmentation, oxidative stress level, cryotest, electron microscopy examination of the ejaculate were performed.Results. Five (5) days after the end of therapy, percentage of progressive motile sperm increased by 62 % in the Prostatilen® AC patient group with chronic nonbacterial prostatitis (р <0.001) compared to the baseline, and by only 10 % in the Arginine-zinc patient group. Administration of Prostatilen® AC lead to a more significant decrease of reactive oxygen intermediates in the ejaculate (р <0.001) and percentage of sperm with fragmented DNA (р <0.001) compared to administration of Arginine-zinc. The applied treatment schemes had no significant effect on the number of sperm with acrosomal hypoplasia. An anti-inflammatory effect of Prostatilen® AC was also identified (decreased number of leukocytes in sperm). During the study, 3 cases of adverse effects were registered: 1 after administration of Prostatilen® AC and 2 after administration of Arginine-zinc.Conclusion. Prostatilen® AC can be considered more effective and safer compared to Arginine-zinc for 20-day administration. In patients with sperm pathology, it more effectively improves sperm characteristics: increases sperm motility, sperm morphology, decreases DNA fragmentation and oxidative stress levels.

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Assisted reproductive techniques in men: review of clinical guidelines and workup algorithm

Cited by 2 publications

References 29 publications

Testicular microlithiasis in male infertility: prevalence, diagnosis and treatment algorithm

Testicular microlithiasis in male infertility: prevalence, diagnosis and treatment algorithm

Comparison of the effectiveness of medications containing a combination of zinc and arginine for treatment of male infertility

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