[Effect of methylene dioxy metha amphetamine administration during pregnancy on reproductive system of BALB/c mice]

The pregnancy period is very sensitive and complicative stages of life. It has been shown that addictive drugs such as ecstasy [MDMA: Methylene Dioxy Metha Amphetamine] can interfere in this stage. The aim of this study was to assess the effect of Methylene Dioxy Metha Amphetamine administration during pregnancy on reproductive system of BALB/c mice. In this experimental study, 10 and 5 female BALB/c mice were randomly selected as cases and controls, respectively. The pregnancy was induced following ovarian hyperstimulation with PMSG and hCG followed by mating with male animals. MDMA [5 mg/kg] and saline was injected intraperitoneally in day 7 and 14 of pregnancy in experimental and controls, respectively. The ovarian structure, as well as uterine tube, uterine horns and body, and vagina were studied histologically using light microscopy 27 days post delivery date. Data analyzed by using SPSS-17 and Chi-Square and Fisher exact test. The rate of primary follicles was decreased from 18.42% in experimental to 33.33% in controls [P<0.05]. The rate of mature follicles was significantly increased in experimental mice as compared to controls [P<0.05]. The number of atretic bodies was lower in experimental than controls. The cellular alterations were observed in some portions of uterine tubes and uterine horns after ecstasy administration. However, no alterations observed in other parts of reproductive system. This study showed that MDMA cause some structural alterations in the uterine tubes and uterine horns, increase follicular maturation and reduction of follicular atresia in BALB/c mice

[Effects of different doses of adenosine on sperm motility in infertile men]

One of the causes of male infertility is the lack of proper mobility. One way to deal with this problem is to add adenosine to human sperms in the laboratory. Therefore, this study aimed to determine the effect of different doses of adenosine on sperm motility in the ejaculates of fertile and infertile individuals. In this experimental laboratory study, 60 samples of seminal fluid of infertile and fertile men who referred to Yazd Infertility Center were analyzed according to WHO guidelines. Sperm counts, morphology and motility [fast, slow and immotile] were studied. After using Swim-up technique, the washed samples were divided into 4 groups, containing doses of 0, 2, 5 and 10 mg adenosine. The sperm parameters were evaluated after the addition of adenosine. Data were analyzed statistically using paired Ttest and independent T-test. The initial assessment indicated significant differences in sperm parameters, except for slow motility between the two groups. In fertile group, dose of 5 mg adenosine increased sperm count, and rapid motility, but lowered the rates of sperm immotility at doses of 5 and 10 mg. In the infertile group, sperm count improved at dose of 5 mg adenosine, but it showed no effect on slow sperm motility. 5 mg adenosine also improved rapid sperm motility, but dose of 10 mg had no effect. Both 5 and 10 mg adenosine significantly lowered rates of immotile sperms. Based on the results of this study, it can be concluded that addition of 5 mg adenosine to washed sperms can improve sperm motility of infertile men in vitro

Effects of combined magnetic fields on human sperm parameters

In previous investigations, it has been clarified that electromagnetic fields [ELF] can cause some changes in cellular behavior. The aim of this prospective study was to investigate the effect of magnetic field [MF] on human sperm parameters of motility, morphology, and viability. Semen samples were collected from 12 fertile men, and were allowed to liquefy for 15-30 min. Each sample was then divided into two aliquots. The experimental samples were placed in the ELF, while the control one was left intact. The applied fields were pulsed with distance of 6 m/sec and effective intensity of 1mT and different frequencies of 10, 25 and 45 Hz at different time intervals. The constant field intensity was 1mT in all experiments. In frequency of 10Hz, an increase in quick motility of sperm [1.8 times] occurred after 4h; however, slow motility was decreased by 40% after 2h. Also, the quick motility increased by 1.6 times in frequency 25 Hz after 4 h, while the MF had no effect on other sperm parameters. MF had no effect on any of sperm parameters in frequency of 40 Hz in 4 h. The stimulation ratio on the sperm viability was only significant at frequency of 10 Hz after 2 h after incubation. The sperm morphology was not influenced in any of the fields. This study reports the existence of certain frequency windows for the resonance of the effects of the MF on human spermatozoa. Rapid motility was significantly affected by the exposure of spermatozoa to MF, but sperm structural parameter had remained intact

effect of hydroalcoholic extract of olive leaves on blood pressure in rat model of two-kidney, one-clip goldblatt hypertension

In Iran's traditional medicine, the leaves of olive tree are of value for the treatment of hypertension. This study was designed to examine the effects of hydroalcoholic extract of olive leaves in rat model of two-kidney, one-clip hypertension and to further explore whether its hypotensive activity was mediated by enhancing the basal release of endothelium-derived nitric oxide. Animals were divided into two main groups including sham-operated and renal artery-clipped ones. The latter was further divided into 5 groups of untreated rats, vehicle-treated rats, which received daily oral administrations of one ml distilled water, and extract-treated rats receiving olive leaves extract at 50, 150 or 500 mg/kg in the same volume of vehicle starting the next day after the operation. Four weeks later, mean blood pressure and heart rate were measured under anesthesia before and after the administration of NG-nitro-L-arginine methyl ester [L-NAME]. Mean arterial pressures, and right kidney and heart weights of untreated and vehicle-treated renal artery-clipped rats were significantly higher but left kidney weights were significantly lower than those of shamoperated animals. However, there was no significant difference between the heart rates of these groups. Compared to vehicle-treated renal artery-clipped rats, treatment with hydroalcoholic extracts of olive leaves at 50, 150 or 500 mg/kg/day was associated with significantly lower mean arterial pressure, right kidney and heart weights but did not affect heart rate or left kidney weights. The intravenous administration of L-NAME resulted in a significant increase in mean arterial pressure in sham-operated and extract-treated rats whereas there was no change in renal artery clipped or vehicle-treated groups. The findings of the study show that hydroalcoholic extract of olive leaves prevents the clipinduced increase in mean arterial pressure, which might be partly mediated by enhancing the basal release of nitric oxide

effects of aqueous extract of vaccinium arctostaphylos leaves on blood pressure in renal hypertensive rats

The leaves of Vaccinium arctostaphylos [Qare qat] is advocated for the treatment of hypertension in Iran' folk medicine. The objective of wars to examine the possible hypotensive activity of aqueous extract of Vaccinium arctostaphylos leaves in rat model of two-clip hypertension. Rats were subjected to sham operation of the placement of Plexiglass clip on left renal arteries. Four weeks later, renal artery clipped rats were given intravenous injection of normal saline or the extract at 10, 25, or 75 mg/kg, and mean blood pressure and heart rate were measured before and 20, 40 and 60 minutes after vehicle or drug administration. Compared to sham group, renal artery clipped groups had a significantly higher mean blood pressure, heart and right kidney weights, lower left kidney weight and significantly indifferent heart rate. Compared to vehicle treatment, the extract at 75 mg/kg, but not at 10 or 25 mg/kg, did reduce the mean blood pressure at 20, 40 and 60 minutes after administration without changing the heart rate. The findings showed that at a higher dose the extract did have hypotensive activity without changing the heart rate. The exact hypotensive mechanism remains to be investigated

[Effect of vitrification on sperm parameters and apoptosis in fertile men]

Today, cryopreservation of the human sperm is a common technique for treating infertility. It has been indicated that cryopreservation by different methods decrease the sperm motility and viability in fertile men, but still effect of freezing of the sperm by vitrification method have not been evaluated on sperm parameters and apoptosis. The aim of this study was to evaluate the effect of vitrification of sperm of fertile men on different sperm parameters [motility, morphology, viability and count[and apoptosis after thawing. In this experimental study which was conducted at Yazd Infertility Research and Clinical Center in 2009, seventeen semen samples were collected by masturbation from people who came to this centre. Semen analysis was performed according to WHO standards. Smear was provided from these samples and fixed for TUNEL staining. Some samples were directly cryopreserved by cryoloope in liquid nitrogen and stored at least for Seven days. After thawing, samples were evaluated for sperm parameters. The collected data was analyzed by the SPSS software using paired T-test and Willcoxon statistical test. The progressive movement of sperm was significantly decreased by vitrification. Also significant decrease in viability and morphology of the sperm and increase in the rate of apoptosis was observed after vitrification. The amount of apoptosis had negatively correlated with normal parameters of spermatozoa [especially progressive motility and viability]. These results indicated that vitrification is harmful for sperm parameters and of apoptosis rate in fertile men. However, the apoptosis rate was lower compared to other freezing methods

[ effect of chronic spinal cord injury on ultrastructure of epididymal sperm in rat]

The effects of chronic SCI on ultrastructure of spermatozoa aspirated from epididymis of rats. 45 adults Wistar rats were divided into 3 groups of SCI, control and sham. Following laminectomy, SCI was induced with a 15g weight dropped from a distance of 10 cm, onto exposed dura matter at T10 level. Sham group underwent laminectomy of T10 only, while control was not exposed to any types of injury or medication. The epididymal sperms were aspirated after 8 weeks in each groups for transmission electron microscopy [TEM] preparation. After primary and secondary fixations, dehydration and embedding, and ultrathin sections were collected on grids and stained by uranyl acetate and lead citrate, the samples were examined with TEM. In electron microscopic study, no ultrastructural changes were observed in sham or control groups. In SCI animals, the majority of spermatozoa showed several alternations such as swollen area, rupture and lysis of plasmalemma, disintegration of acrosomal membranes, persistence of numerous cytoplasmic droplets, mitochondrial swelling, absence of axonemal microtubules, complete degeneration of axoneme, deletion of one or more outer dense fibers, absence of tail plasmalemma, reduction of nuclear electron density, irregularities in tail architecture, formation of apoptotic vacuels and necrotic changes in heads and tails in their ultrastructures. Our electron microscopic study showed that following chronic SCI, several ultrastructure abnormalities developed in epididymal sperms. These changes may impair sperm quality and directly reduce the fertility potentiality after SCI

aqueous extract of vaccinium Arctostaphylus berries decreases blood pressure in rat model of two-kidney, one-clip renal hypertension

The berries of a number of Vaccinium species do reduce blood pressure. The berries Vaccinium arctostaphylus, the species native to Iran have been advocated for the treatment of hypertension in the country's folk medicine. The objective was to examine the possible hypotensive activity of aqueous extract of Vaccinium arctostaphylus berries in rat model of two-kidney, one-clip hypertension. Rats were subjected to sham operation or the placement of plexiglass clips on left renal arteries. Four weeks later, renal artery clipped rats were given intravenous injection of normal saline or the extract at 10, 25, 75 or 100 mg/kg, and mean blood pressure and heart rate were measured before and 20, 40 and 60 minutes after drug administration. Compared to sham group, renal artery clipped groups had a significantly higher mean blood pressure, heart and right kidney weights, lower left kidney weights and significantly indifferent heart rate. Compared to vehicle treatment, the extract at 75 and 100 mg/kg, but not at 10 or 25 mg/kg, did significantly reduce mean blood pressure at 20, 40 and 60 minutes after administration without changing the heart rate. The findings showed, that in agreement with Iran's folk medicine, the aqueous extract of Vacinium arctostaphylus berries did lower blood pressure. The exact hypotensive mechanism remains to be investigated

Prevalence and risk factors of ecstasy use among college students in Astara, Islamic Republic of Iran

We determined the prevalence and risk factors for 3,4-methylenedioxy-methamphetamine [MDMA, "ecstasy"] use among college students in Astara, a northern border city of Iran. In a cross-sectional questionnaire survey of 1226 students, the lifetime prevalence of ecstasy use was 5.6%. The lifetime prevalence of use of other drugs, mostly cannabis and opium, was 4.6%. A fifth of students [21.8%] were current cigarette smokers and 24.8% had ever used alcohol. After logistic regression, the factors influencing ever use of ecstasy were ever use of other drugs, ever use of alcohol, current cigarette smoking and living alone or with friends. Targeted prevention programmes should be conducted in all colleges

[ correlation between reactive oxygen species and leukocytes in normozoospermia and oligoasthenoteratozoospermia ejaculates]

An important factor involved in infertility is reactive oxygen species [ROS]. ROS can damage sperm DNA, and involve lipid per-oxidation. ROS elevation is under the influence of leukocyte activation. The objective of this study was to evaluate the level of ROS as well as leukocyte, in normozoospermic [NO] and ologoasthenoteratozoospermic [OAT] ejaculates. The study population consisted of 75 individuals who were referred to the Research and Clinical Center, regarding infertility in Yazd, for semen analysis. Fifty [50] out of Seventy-Five [75] men were NO, and the remaining was OAT. ROS was measured with laminator, while leukocyte concentration was analyzed with the ENDTZ test The results showed that ROS levels in OAT was significantly higher compared with NO [1253.49 +/- 200.95 vs. 75.64 +/- 149.52; P=0.00]. Furthermore, men with OAT were divided into 2 groups, with sperm morphology and motility >5% and <5%. In group >5%, ROS level was significantly higher than the group with <5% [3627.55 +/- 407.79 vs. 81.29 +/- 100.48; P=0.007]. In addition, leukocyte concentration in NO was 0.07 +/- 0.22x10[6]; while it was 0.12 +/- 0.20x10[6] in OAT samples; P=0.35]. The results indicate although ROS is present in normal seminal samples, it is significantly higher in OAT. This shows the vital role of antioxidants, which may improve the sperm quality. Further clinical studies will pinpoint the antioxidant capacity in improving the seminal contents

[Sex selection by using albumin gradient technique for sperm separation in IUI cycles]

One of the primary desirers of couples, especially in Asian countries, is to have a male offspring. This wish is generally higher in fertile than infertile couples. One of the tech-niques used in infertility centers for separating the spermatozoa containing Y or X chromosomes, is the Ericsson method that is simple, cheap and practical with application of no toxic material. The goal of this study was to evaluate the results of sex selection with sperm separation using albumin gradient technique in fertile and infertile couples under IUI treatment cycles. This was a descriptive-analytical study. A total of 32 couples [30 fertile and 2 infertile couples] were enrolled for sex selection techniques [31 asking for male and one for female offsprings] using Ericsson method. Following sperm evaluation, the sperm samples were prepared with Ericsson technique in less than 2 hours. Through a transfer catheter400-500?l of the fluid, containing more than 1x106 spermatozoa, was transferred into uterine cavity. All candidates had been super-ovulated for IUI cycles. The data were analyzed using ?2, t-test and Wilcoxon nonparametric tests. Out of 32 couples under study, 30 individuals already had one child. The rate of pregnancy after IUI plus albumin gradient was 34.4%. The pregnancies of 4 couples were aborted. The live birth rate was 21.8% and achieving the desirable offspring was 71.4% among the born babies. The findings also showed that two sperm parameters of fast and slow motilities and normal morphology, following sperm separation with albumin gradient, were significantly increased [p<0.001, p<0.05 and p<0.05, respectively]. In addition, the rate of sperm progressive motility and normal morphology was higher in subjects who gave birth to male off springs than other candidates. Only one couple had asked for a female offspring, but the process resulted in a normal male infant. The separation of spermatozoa by albumin gradient technique, which was introduced by Ericsson, is a suitable technique for sex selection of off springs. However, the applicability of this technique for infertile couples needs further studies. The aforementioned technique is considered safe, since it neither requires toxic materials during sperm separation, nor involves embryo manipulation

[ comparative study on safety and environmental health of public and private school of Qazvin]

Preparing a suitable physical environment for schools will allow us to improve the efficiency of educational programs. To compare the security and environment health of public and private schools of Qazvin. This comparative study was carried out on randomly selected schools including 20 private and 68 public schools of Qazvin in 2001. A pre-designed questionnaire was filled out through interview, observation and measuring the variables related to safety and environmental health. The collected data were compared with the existing criteria and analyzed and examined using T-test and Fisher exact test. The safety and environmental health was generally poor in both sectors. Only in 3 out of 34 items [one omitted from the study due to invalid criteria of measurement] the health requirements were satisfactorily met in both sectors. In contrast, it was shown that in three out of 34, the safety and environmental health in private schools was nonexistent. Regarding all safety and health requirements, it was revealed that in adopting 4 criteria, the private sector showed a more acceptable condition than public sector, whereas for other 8 criteria the public sector preceded the private one and proved to be meaningful, statistically. In can be concluded that the public schools in terms of safety and environmental health are practicing a higher standard comparing with those in private sector.

Rate of cumulus cell apoptosis from fertilized and unfertilized oocytes and acid phosphatase levels in follicular fluids after intracytopasmic sperm injection

The main role of cumulus cells [CC] is to provide nutritious materials for developing oocytes. Follicular fluid [FF] contains the enzyme acid phosphatase, which plays a role in ovulation and fertilization of oocyte. The objective of this prospective study was to evaluate the levels of acid phosphatase in FF and the rate of apoptosis in CC of fertilized and unfertilized oocytes in intracytoplasmic sperm injection [ICSI] program with male factor infertility. Following ovarian hyperstimulation, 101 mature oocytes were prepared for ICSI. Fertilized [n = 51] and unfertilized [n = 50] oocytes were evaluated for apoptosis in CC. CC of each oocyte were stained with Hoechst 33258 for immunofluorescent microscopy. For evaluation of acid phosphatase, FF was centrifuged and the enzymes levels were measured with spectrophotometer. Nuclei of apoptotic cells were fragmented, the chromatins condensed, and the apoptotic bodies were observed in some cells. Rates of apoptotic CC in fertilized and unfertilized oocytes were 15.83% and 13.34%, respectively [P>0.05], r = 0.520]. The acid phosphatase level was reduced as the rate of apoptosis increased P<0.05, r = -0.520]. Also, the concentration of the enzyme increased when the percentage of normal CC increased P<0.05. Our results confirm that neither the evaluation of CC apoptosis, nor the level of acid phosphatase have a prognostic value in the outcome of ICSI. However, the FF level of acid phosphatase is directly related to the quality of retrieved MII oocyte

Cryocalcium glue: a new formulation for dural repair augmentation

Cerebrospinal fluid leakage is a major problem in neurosurgical operations. For preventing it, the dural closure should be augmented. Current glues which use for augmentation are prepared with mixing cryoprecipitate, bovine thrombin and calcium gluconate in suitable concentrations which are expensive and unavailable anywhere. A new formulation is introduced here. This is a prospective randomized clinical trial in patients who need dural patch graft by using Cryocalcium glue, mixing the cryoprecipitate, calcium gluconate and patient's own blood as the origin of thrombin, in our operating room. Comparing two groups of cases[1o6] and controls[100], we found overall C.S.F leak 3.8% and 15% respectively, with 3.6%, Zero%, Zero% and 16.7% in supratentorial, infratentorial, skull base and spinal cord operations in cases versus 12%, 20%, 33% and 28.6% in controls respectively. Using Cryocalcium glue for dural closure augmentation was with better results in comparison with control group. In addition in reviewing literature, comparing this new formulation and old fashion of fibrin glue, revealed that the new one, if not better, is similar to the old one in quality point of view

CSF ascites: Review of articles and a case presentation

Cerebrospinal fluid [CSF] ascites is a rare complication after ventriculopritoneal [VP] shunts. Most patients have gradual abdominal protrusion without any neurological sign or symptom of shunt malfunction. We presented a girl with posterior third ventricle glioblastoma and acute hydrocephalus who developed increasingly abdominal protrusion one month after VP shunt operation. Ascites fluid examination showed characteristic findings similar to CSF with no evidence of infection or malignant cells. Ventriculo-atrial shunt revision cured patient's ascites. Review articles of patients with CSF ascites after VP shunt were presented in details

level of anxiety and depression among Iranian infertile couples undergoing in vitro fertilization or intra cytoplasmic sperm injection cycles

Approximately 10% of Iranian couples wishing to have a child experience some types of infertility which may impose a considerable psychological burden on them. The main objective of this cross-sectional study was to examine the level of anxiety and depression among infertile couples undergoing IVF or ICSI treatment cycles in Iran. Fifty infertile couples that who undergoing IVF [n=25] or ICSI [n=25] cycles were considered for this descriptive cross-sectional study. Also, 25 married couples [18-40 years old] with history of fertility served as control subjects. All husbands and wives were examined by means of Beck Depression and Spielberger Anxiety Inventories. Comparing with controls, the highest rates of moderate and severe anxiety, were observed in women undergoing IVF [76% and 12%, respectively; P<0.05]. However, the rate of depression among women in IVF group was comparable to women undergoing ICSI. Also, the highest rates of severe depression and anxiety were demonstrated among housewives [23.9% and 11%, respectively]. The lowest rates of severe anxiety and depression were observed in husbands participated in either IVF or ICSI cycles. In addition, illiterates, compared with educated couples, undergoing IVF or ICSI program were shown to have the highest rates of both depression and anxiety. The results showed that the levels of anxiety and depression were higher in women, especially housewives, undergoing IVF or ICSI cycles than control subjects. Also, men showed lower rates of anxiety and depression than women undergoing IVF or ICSI. Therefore, this can provide useful information and guidance for health professionals working with infertile patients

Correlation between asymptomatic urethritis with bacteriospermia in seminal plasma of fertile and infertile men

Urogenital infection can influence the fertilization potential of the spermatozoa, which may lead to male infertility. The symptomatic urethiritis can change the semen parameters, however the role of asymptomatic urethirtis in fertility is still obscure. In this descriptive investigation, a total of 148 samples from urethra and semen of fertile as well as 146 samples from urethra and semen of infertiles men were examined for the presence of 5 bacterial species including streptococcus group A., Entercoccus, E.coli, coagulase positive and negative Staphylococcus. The rate of infection of urethra and semen of fertile men were 49.22% and 29.05%, respectively. The aforementioned rates were 34.9% and 60.27% for infertile men. The seminal infection was significantly different between two groups of fertile and infertile [p < 0.01]. The results showed that the most common pathogen in semen of fertile and infertile men was Entrococcus with prevalence of 32.60% [14 cases], and 42% [37 cases], respectively. A total of 90 out of 131 samples contaminated with bacteria showed high rate of Leuckocytes [pyospermia]. The remaining 41 infected samples lacked or had low number of leuckocytes. In conclusion, bacteriospermia is significantly higher in seminal samples of infertile than fertile men [p < 0.01]. Therefore, the pathogens involved in urethritis may be involved in male infertility. In addition, seminal culture is necessary for detection of bacteria presence in the semen, and thus it is important to note that presence or absence of Leukocyte in semen may not represent the urogenital infection

Correlation between endothelial injury and cerebral vasospasm following a double subarachnoid hemorrhage in the rat hemorrhage

While a wide array of pathological changes occur in cerebral arteries following subarachnoid hemorrhage [SAH], the most consistent is endothelial damage. Since the endothelium normally modulates reflexes that influence vascular tone, any damage to it may represent a significant contributor to cerebral vasospasm following SAH. This experimental study investigates the correlation between endothelial injury of rat basilar [BA] and middle cerebral arteries [MCA] and vasospasm following a double SAH. Animals were divided into three groups of control [nonsurgical-noninjected], saline-injected, and blood-injected rats. Rats in the blood-injected group were injected with two 0.3 mL doses of autologous blood into the subarachnoid space at intervals of 72 hours. Rats were killed at different time intervals to study the time course of endothelial injury along with vasospasm following the second SAH with scanning electron microscopy and image analysis system, respectively. Cerebral arteries exposed to blood demonstrated severe pathological alterations during acute [30 min. to 2 hrs.] and chronic [48 hrs.] periods of time post second SAH. Concurrent with endothelial injury, there was widening of inter-endothelial tight junctions. Morphometric evaluation revealed severe arterial constriction starting at 30 min. [p<0.01] and again at 48 hrs. [p<0.05] post second SAH. The correlation between the time course of ultrastructural alteration of endothelial cells with arterial constriction provides further morphological contribution to the major complication of SAH-cerebral vasospasm

Relation between histology of testicular biopsy and level of sex hormones in infertile men with non-obstructive azoospermia

Testicular retrieval of spermatozoa which is known as testicular extraction [TESE] with subsequent microinjection of spermatozoon into oocyte intracytoplasmic sperm injection [ICSI], is an effective treatment program for cases with azoospermia. The main objective of this prospective study was to evaluate the histology of testicular biopsy and it,s correlation with sex hormones of men with non-obstructive azoospermia. A total of 50 infertile men with above condition with mean age of 32.6 years were involved in this study. The level of FSH, LH and testosterone with the TESE results and the size of testicles were recorded in full. In the absence of sperm in TESE samples, the specimens were sent to pathology Laboratory for further evaluation. The results show that spermatozoa were present in TESE samples of 12 cases, while 15 and 7 cases show sertoli cell only syndrome and maturation arrest, respectively. A total of 46%[23 cases] were presented with small testicular size, and 16 of them had high level of FSH. Only 4 individuals with normal size of testis had high elevation of FSH, which was directly related, with the level of LH. However, the abnormal concentration of FSH LH was indirectly correlated with abnormal levels of testosterone. In addition, an indirect correlation between abnormal FSH with type of testicular pathology was noticed. The results indicate that a successful TESE could be done regardless of the hormonal condition of FSH LH, Therefore, it is important to note that TESE is unnecessary in cases with atrophied testis with extremely high concentration of FSH. This certainly reduces not only the surgical cost, but also may reduce the psycho-stress upon the infertile couples